Human anatomy 7th ed f martini, m timmons, r tallitsch (cummings, 2012) 1

HUMAN ANATOMY
Seventh Edition
Frederic H. Martini, Ph.D.
University of Hawaii at Manoa

Michael J. Timmons, M.S.
Moraine Valley Community College

Robert B. Tallitsch, Ph.D.
Augustana College

with

William C. Ober, M.D.
Art Coordinator and Illustrator

Claire W. Garrison, R.N.
Illustrator

Kathleen Welch, M.D.
Clinical Consultant

Ralph T. Hutchings
Biomedical Photographer


Executive Editor: Leslie Berriman
Associate Editor: Katie Seibel
Editorial Development Manager: Barbara Yien
Editorial Assistant: Nicole McFadden

Senior Managing Editor: Deborah Cogan
Production Project Manager: Caroline Ayres
Director of Media Development: Lauren Fogel
Media Producer: Aimee Pavy
Production Management and Composition: S4Carlisle Publishing Services, Inc.
Copyeditor: Michael Rossa
Art Coordinator: Holly Smith
Design Manager: Marilyn Perry
Interior Designer: Gibson Design Associates
Cover Designer: Yvo Riezebos
Photo Researcher: Maureen Spuhler
Senior Manufacturing Buyer: Stacey Weinberger
Marketing Manager: Derek Perrigo
Cover Illustration Credit: Bryan Christie
Credits and acknowledgments borrowed from other sources and reproduced, with
permission, in this textbook appear on the appropriate page within the text or on page 845.

Copyright © 2012, 2009, 2006 by Frederic H. Martini, Inc., Michael J. Timmons, and Robert B.
Tallitsch. Published by Pearson Education, Inc., publishing as Pearson Benjamin Cummings. All
rights reserved. Manufactured in the United States of America. This publication is protected by
Copyright and permission should be obtained from the publisher prior to any prohibited
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trademark claim, the designations have been printed in initial caps or all caps.
Mastering A&P™, Practice Anatomy Lab™ (PAL™), and A&P Flix™ are trademarks, in the U.S. and/or
other countries, of Pearson Education, Inc. or its afffiliates.

Library of Congress Cataloging-in-Publication Data
Martini, Frederic.
Human anatomy/Frederic H. Martini, Michael J. Timmons, Robert B. Tallitsch; with William C.
Ober, art coordinator and illustrator; Claire W. Garrison, illustrator; Kathleen Welch, clinical
consultant; Ralph T. Hutchings, biomedical photographer.—7th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-321-68815-6 (student ed.)
ISBN-10: 0-321-68815-5 (student ed.)
ISBN-13: 978-0-321-73064-0 (exam copy)
ISBN-10: 0-321-73064-X (exam copy)
1. Human anatomy. 2. Human anatomy—Atlases. I. Timmons, Michael J. II. Tallitsch, Robert B. III.
Title.
[DNLM: 1. Anatomy—Atlases. QS 17 M386h 2012]
QM23.2.M356 2012
612—dc22
2010022870

ISBN 10: 0-321-68815-5 (Student edition)
ISBN 13: 978-0-321-68815-6 (Student edition)
ISBN 10: 0-321-76626-1 (Exam copy)
ISBN 13: 978-0-321-76626-7 (Exam copy)
1 2 3 4 5 6 7 8 9 10—DOW—14 13 12 11 10


Text and Illustration Team

Frederic (Ric) Martini
Author

Michael J. Timmons
Author

Robert B. Tallitsch
Author

Dr. Martini received his Ph.D. from Cornell
University in comparative and functional
anatomy for work on the pathophysiology of
stress. In addition to professional publications that include journal articles and contributed chapters, technical reports, and
magazine articles, he is the lead author of
nine undergraduate texts on anatomy or
anatomy and physiology. Dr. Martini is currently affiliated with the University of Hawaii
at Manoa and has a long-standing bond with
the Shoals Marine Laboratory, a joint venture
between Cornell University and the University of New Hampshire. Dr. Martini is a President Emeritus of the Human Anatomy and
Physiology Society, and he is a member of the
American Association of Anatomists, the
American Physiological Society, the Society
for Integrative and Comparative Biology, and
the International Society of Vertebrate Morphologists.

Michael J. Timmons received his degrees from
Loyola University, Chicago. For more than
three decades he has taught anatomy to nursing, EMT, and pre-professional students at
Moraine Valley Community College. He was
honored with the Professor of the Year Award
by MVCC and the Excellence Award from the
National Institute for Staff and Organizational
Development for his outstanding contributions to teaching, leadership, and student

learning. He is the recipient of the Excellence in
Teaching Award by the Illinois Community
College Board of Trustees. Professor Timmons,
a member of the American Association of
Anatomists, has authored several anatomy and
physiology lab manuals and dissection guides.
His areas of interest include biomedical photography, crafting illustration programs, and
developing instructional technology learning
systems. He chaired the Midwest Regional Human Anatomy and Physiology Conference and
is also a national and regional presenter at the
League for Innovation Conferences on Information Technology for Colleges and Universities and at Human Anatomy and Physiology
Society meetings.

Dr. Tallitsch received his Ph.D. in physiology
with an anatomy minor from the University
of Wisconsin-Madison. Dr. Tallitsch has
been on the biology faculty at Augustana
College (Illinois) since 1975. His teaching responsibilities include Human Anatomy, Neuroanatomy, Histology, and Kinesiology. He is
also a member of the Asian Studies faculty at
Augustana College, teaching a course in Traditional Chinese Medicine. In ten out of the
last twelve years the graduating seniors at Augustana have designated Dr. Tallitsch as one
of the “unofficial teachers of the year.” Dr.
Tallitsch is a member of the American Physiological Society, American Association of
Anatomists, American Association of Clinical Anatomists, AsiaNetwork, and the Human Anatomy and Physiology Society. In
addition to his teaching responsibilities at
Augustana College, Dr. Tallitsch has served
as a visiting faculty member at the Beijing
University of Chinese Medicine and Pharmacology (Beijing, PRC), the Foreign Languages
Faculty at Central China Normal University
(Wuhan, PRC), and in the Biology Department at Central China Normal University

(Wuhan, PRC).

iii


iv

Text and Illustration Team

William C. Ober
Art Coordinator and Illustrator
Dr. William C. Ober received his undergraduate degree from Washington and Lee University and his M.D. from the University of
Virginia. While in medical school, he also
studied in the Department of Art as Applied
to Medicine at Johns Hopkins University. After graduation, Dr. Ober completed a residency in Family Practice and later was on the
faculty at the University of Virginia in the
Department of Family Medicine. He is currently a Visiting Professor of Biology at
Washington and Lee University and is part of
the Core Faculty at Shoals Marine Laboratory, where he teaches Biological Illustration
every summer. The textbooks illustrated by
Medical & Scientific Illustration have won
numerous design and illustration awards.
Claire W. Garrison
Illustrator
Claire W. Garrison, R.N., B.A., practiced pediatric and obstetric nursing before turning
to medical illustration as a full-time career.
She returned to school at Mary Baldwin College where she received her degree with distinction in studio art. Following a five-year
apprenticeship, she has worked as Dr. Ober’s
partner in Medical & Scientific Illustration
since 1986. She is on the Core Faculty at

Shoals Marine Laboratory and co-teaches the
Biological Illustration course.

Kathleen Welch
Clinical Consultant

Ralph T. Hutchings
Biomedical Photographer

Dr. Welch received her M.D. from the University of Washington in Seattle and did her residency at the University of North Carolina in
Chapel Hill. For two years she served as Director of Maternal and Child Health at the LBJ
Tropical Medical Center in American Samoa
and subsequently was a member of the Department of Family Practice at the Kaiser Permanente Clinic in Lahaina, Hawaii. She has
been in private practice since 1987. Dr. Welch
is a Fellow of the American Academy of Family Practice and a member of the Hawaii Medical Association and the Human Anatomy and
Physiology Society.

Mr. Hutchings was associated with The Royal
College of Surgeons of England for 20 years.
An engineer by training, he has focused for
years on photographing the structure of the
human body. The result has been a series of
color atlases, including the Color Atlas of Human Anatomy, the Color Atlas of Surface
Anatomy, and The Human Skeleton (all published by Mosby-Yearbook Publishing). For
his anatomical portrayal of the human body,
the International Photographers Association
has chosen Mr. Hutchings as the best photographer of humans in the twentieth century. He
lives in North London, where he tries to balance the demands of his photographic assignments with his hobbies of early motor cars
and airplanes.

Preface

Welcome to the Seventh Edition of Human Anatomy!
THROUGH SEVEN EDITIONS, the authors and illustrators have continued to build on this text’s
hallmark qualities: its distinctive atlas-style format and its unsurpassed visual presentation of anatomy
and anatomical concepts. Our approach for this text has been to provide a seamless learning system
with closely integrated art and text. The illustrations do more than provide occasional support for the
narrative; they are partners with the text in conveying information and helping students understand
structures and relationships in a way that distinguishes this human anatomy textbook from all others.

New to the Seventh Edition
In approaching this Seventh Edition, we paid particular attention to the most difficult topics in human
anatomy and to areas identified by students and reviewers. Our primary goal was to build upon the
strengths of the previous edition while addressing the changing needs of today’s students. The changes
described below are intended to enhance student learning and increase student engagement.
• A more visual and dynamic presentation of clinical information. Select Clinical Notes
covering key clinical topics now feature new, dramatic layouts that integrate
illustrations, photos, and text in a way that makes reading
easy and science relevant
(see pp. 108–109, 127,
132–133). Clinical Cases,
which appear at the end of
each body system section, now
include patient photos and
diagnostic images (see
pp. 110–111, 501–502, 602–604).
Every Clinical Case begins with a
photo of the patient and his/her
background information, making

the case personal and real to the
students. Diagnostic images (photos,
x-rays, and MRI scans) also appear
within the narrative.
• Over 65 new and visually stunning
histology photomicrographs. These
photomicrographs appear in chapters 3, 4,
5, 13, 19–21, and 23–27. The slides
prepared for these photos match the types

v


vi

Preface

of slides that beginning students will encounter in the anatomy
lab.
• New spiral scans. Using the most up-to-date imaging technique
available, these spiral scans (see Figures 8.16 and 22.16) provide
students with unparallelled views of anatomical structures and
introduce them to a new imaging technique that is increasingly
used in clinical settings. These spiral scan images have been provided by Fovia, Inc., and by TeraRecon, Inc.
• Improved presentation of figures. Figure legends now appear
consistently above figures, and the detailed figure captions that
describe parts within figures now appear within the figures.
This new figure presentation style guides students through
multi-part figures and compels them to read the part captions
as they view each part of a figure. The result is easier reading

and improved understanding of figures.
• A reorganized and streamlined presentation of the nervous
system chapters (Chapters 13–18). These chapters have been
reorganized to take a “bottom up” rather than a “top down” approach to make the nervous system easier for instructors to
present and students to understand. Specifically, the discussion
of the spinal cord started in Chapter 14 (The Nervous System:
The Spinal Cord and Spinal Nerves) now continues in Chapter
15 (The Nervous System: Sensory and Motor Tracts of the
Spinal Cord) so that sensory and motor tracts of the spinal cord
are covered before the brain and cranial nerves in Chapter 16
(The Nervous System: The Brain and Cranial Nerves). Additionally, Chapter 16 also presents the brain and cranial nerve information in a “bottom up” sequence, starting with the brain
stem and ending with the cerebrum.

• New “Hot Topics: What’s New in Anatomy” highlight current research. These brief boxes introduce students to new
peer-reviewed anatomical research findings that have been
published within the past two years. This feature appears in
chapters 2–5, 10, 13, 19, 21, and 23–28.
• Increased focus on learning methodology. Each chapter now
opens with concrete Student Learning Outcomes instead of
learning objectives.
In addition, approximately 85 percent of the figures in this
edition are either new or have been revised. Some figures were
updated for increased visual appeal to students (see Figures 1.1,
4.1, and 4.12). In many figures, areas of detail have been revised
to improve clarity. All bone photos in chapters 6 and 7 received a
new silhouette treatment that results in a cleaner, more
contemporary look and makes bone markings easier to see. The
presentation of boxes and banners has been improved to better
organize many figures (see Figures 9.11, 26.6, and 23.7). The
overlay of illustrations on surface anatomy photos has been

continued in this edition to provide students with a better
understanding of where structures are located within the human
body. The information derived from superficial and deep
dissections is more easily understood as a result of a new heading
style that has been continued in many of the figures (see Figure
23.14b).
The following section provides a detailed description of this
edition’s chapter-by-chapter revisions.


Preface

Chapter-by-Chapter Revisions
Specific chapter-by-chapter revisions, with select examples, include:

1

Foundations: An Introduction to Anatomy

• Twelve illustrations are either new or have been significantly revised.
• Changes were made in terminology according to the Terminologia

Anatomica (TA).

2

Foundations: The Cell

• Fifteen illustrations are either new or have been significantly revised.
• Changes were made in terminology according to the TA and Terminologia

• New material was added, and existing material has been clarified, in the dis-

cussions of the clavicle, scapula, humerus, pelvic girdle, patella, tibia, and the
arches of the foot.

8

• Seven illustrations are either new or have been significantly revised.
• New material was added and existing material clarified for better student

comprehension.

9

Histologica (TH).
• The presentation order of some material was rearranged in order to facilitate

student learning.

The Skeletal System: Articulations

The Muscular System: Skeletal Muscle Tissue and
Muscle Organization

• Eight illustrations are either new or have been significantly revised.
• Considerable material within the chapter was revised to better facilitate stu-

dent comprehension and learning.

3

Foundations: Tissues and Early Embryology

Nineteen illustrations are either new or have been significantly revised.
Seventeen new photomicrographs were added.
Changes were made in terminology according to the TA and TH.
The presentation order of some material was rearranged in order to facilitate
student learning.
• New material was added to update the chapter according to current histological research.
•
•
•
•

4
•
•
•
•

The Integumentary System

Fourteen illustrations are either new or have been significantly revised.
Four new photomicrographs were added.
Changes were made in terminology according to the TA and TH.
New material was added to the discussion of the epidermis, and the existing
material was revised for easier comprehension.

5

The Skeletal System: Osseous Tissue and Skeletal
Structure

• Eleven illustrations are either new or have been significantly revised.
• Two new photomicrographs were added.
• New material was added to the discussion of bone remodeling and repair, and

the existing material was revised for easier reading and comprehension.
• New material was added to the discussion of the cells of bone to match current histological terminology and research.

6

The Skeletal System: Axial Division

• Twenty-three illustrations are either new or have been significantly revised.
• New material was added to the discussion of the bones of the cranium to

match current anatomical terminology and research.
• New material was added, and existing material has been clarified, in the dis-

cussions of the vertebral regions.

7

The Skeletal System: Appendicular Division

• Twenty-one illustrations are either new or have been significantly

revised.

10

The Muscular System: Axial Musculature

• Five illustrations are either new or have been significantly revised.
• Two new photomicrographs were added.
• The sections entitled “Muscles of the Vertebral Column” and “Muscles of the

Perineum and the Pelvic Diaphragm” have been updated and clarified.

11

The Muscular System: Appendicular Musculature

• Nine illustrations are either new or have been significantly revised.
• A new section entitled “Factors Affecting Appendicular Muscle Function”

was added to this chapter in the Sixth Edition and has been revised for this
Seventh Edition. This section helps students work through the process of
understanding the actions of skeletal muscles at a joint. This section also explains the concept of the action line of a muscle, and how students, once they
have determined the action line, may apply three simple rules in order to determine the action of a muscle at that joint.

12

Surface Anatomy and Cross-Sectional Anatomy

• Nine illustrations are either new or have been significantly revised.

13

The Nervous System: Neural Tissue

• Five illustrations are either new or have been significantly revised.
• Two new photomicrographs were added.
• The sections entitled “Neuroglia of the CNS” and “Synaptic Communication”

were updated in order to match current research findings in the field.

14

The Nervous System: The Spinal Cord and Spinal Nerves

• Seven illustrations are either new or have been significantly revised.
• The discussion of the meninges of the spinal cord was expanded.
• The discussion of the sectional anatomy of the spinal cord was expanded,

with particular emphasis on the revision of the section on “Organization of
the Gray Matter.”
• The section on “Spinal Nerves” has been rewritten in order to facilitate student learning and comprehension.

vii


viii

Preface

• The sections on “The Brachial Plexus” and “The Lumbar and Sacral Plexuses”

were rewritten to make them easier to understand.

15

The Nervous System: Sensory and Motor Tracts of the
Spinal Cord

• Two new illustrations have been included and eight others have been signifi-

cantly revised.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.
• At the request of reviewers and instructors, the section dealing with Higher-

• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

23

The Lymphoid System

• Eight illustrations are either new or have been significantly revised.
• Four new photomicrographs were added.
• All sections of this chapter were updated in order to match current research

findings in the field.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

Order Functions has been deleted.

24
16

The Nervous System: The Brain and Cranial Nerves

• Ten illustrations have been significantly revised.

17

The Nervous System: Autonomic Division

• Seven illustrations are either new or have been significantly revised.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

18

The Nervous System: General and Special Senses

• Seven illustrations are either new or have been significantly revised.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

The Respiratory System

• Seven illustrations are either new or have been significantly revised.
• Two new photomicrographs were added.
• Revisions were made to reflect the current histological information on the

respiratory system.
• All sections of this chapter were revised, either partially or totally, to make
them easier to understand.

25

The Digestive System

• Thirteen illustrations are either new or have been significantly revised.
• Thirteen new photomicrographs were added.
• Revisions were made to reflect the current histological information on the

various organs of the digestive system.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

19

The Endocrine System

• Five illustrations are either new or have been significantly revised.
• Five new photomicrographs were added.
• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

26

The Urinary System

• Seven illustrations are either new or have been significantly revised.
• Six new photomicrographs were added.
• Revisions were made to reflect the current histological information on the

various organs of the urinary system.

20

The Cardiovascular System: Blood

• Six illustrations are either new or have been significantly revised.
• Five new photomicrographs were added.
• All sections of this chapter were updated in order to match current research

findings in the field.

21

The Cardiovascular System: The Heart

• Eight illustrations are either new or have been significantly revised.
• One new photomicrograph was added.
• The sections on “The Intercalated Discs” and “Coronary Blood Vessels” were

rewritten in order to reflect new research findings in the field and to make
them easier to understand.

22

The Cardiovascular System: Vessels and Circulation

• Eleven illustrations are either new or have been significantly revised.
• All sections of this chapter were updated in order to match current research

findings in the field.

• All sections of this chapter were revised, either partially or totally, to make

them easier to understand.

27

The Reproductive System

• Seven illustrations are either new or have been significantly revised.
• Six new photomicrographs were added.
• Revisions were made to reflect the current histological information on the

various organs of the male and female reproductive systems.
• All sections of this chapter were revised, either partially or totally, to make
them easier to understand.

28

The Reproductive System: Embryology and Human
Development

• All of the Embryology Summaries have been revised.


Acknowledgments
The creative talents brought to this project by our artist team, William Ober,
M.D., Claire Garrison, R.N., and Anita Impagliazzo, M.F.A., are inspiring and
valuable beyond expression. Bill, Claire, and Anita worked intimately and tirelessly with us, imparting a unity of vision to the book while making each illustration clear and beautiful. Their superb art program is greatly enhanced by the
incomparable bone and cadaver photographs of Ralph T. Hutchings, formerly
of The Royal College of Surgeons of England. In addition, Dr. Pietro Motta, Professor of Anatomy, University of Roma, La Sapienza, provided several superb
SEM images for use in the text. We also gratefully acknowledge Shay Kilby, Ken
Fineman, and Steve Sandy of Fovia, Inc., and Donna Wefers and Cormac Donovan of TeraRecon, Inc., for creating and providing the 3-D spiral scans that appear in this edition.
We are deeply indebted to Jim Gibson of Graphic Design Associates for his
wonderful work and suggestions in the design aspect of the Seventh Edition of
Human Anatomy. Jim provided new insight into the design concept, and most
of the design changes and innovations in this edition of Human Anatomy reflect
Jim’s expertise.
We would like to acknowledge the many users and reviewers whose advice,
comments, and collective wisdom helped shape this text into its final form.
Their passion for the subject, their concern for accuracy and method of presentation, and their experience with students of widely varying abilities and backgrounds have made the revision process interesting and educating.

Reviewers
Lori Anderson, Ridgewater College
Tamatha R. Barbeau, Francis Marion University
Steven Bassett, Southeast Community College
Martha L. Dixon, Diablo Valley College
Cynthia A. Herbrandson, Kellogg Community College
Judy Jiang, Triton College

Kelly Johnson, University of Kansas
Michael G. Koot, Michigan State University
George H. Lauster, Pulaski Technical College
Robert G. MacBride, Delaware State University
Les MacKenzie, Queen’s University
Christopher McNair, Hardin-Simmons University
Qian F. Moss, Des Moines Area Community College
Tim R. Mullican, Dakota Wesleyan University
John Steiner, College of Alameda
Lucia J. Tranel, Saint Louis College of Pharmacy
Maureen Tubbiola, Saint Cloud State University
Jacqueline Van Hoomissen, University of Portland
Michael Yard, Indiana University-Purdue University at Indianapolis
Scott Zimmerman, Missouri State University
John M. Zook, Ohio University

We are also indebted to the Pearson Benjamin Cummings staff, whose efforts
were vital to the creation of this edition. A special note of thanks and appreciation goes to the editorial staff at Benjamin Cummings, especially Leslie Berriman, Executive Editor, for her dedication to the success of this project, and
Katie Seibel, Associate Editor, for her management of the text and its supplements. Thanks also to Barbara Yien, Editorial Development Manager, and
Nicole McFadden, Editorial Assistant. We express thanks to Aimee Pavy, Media
Producer, and Sarah Young-Dualan, Senior Media Producer, for their work on
the media programs that support Human Anatomy, especially Mastering A & P™
and Practice Anatomy Lab™ (PAL™). Thanks also to Caroline Ayres, Production
Supervisor, for her steady hand managing this complex text; and Debbie Cogan,
Norine Strang, Holly Smith, Maureen Spuhler, and Donna Kalal for their roles
in the production of the text.
We are very grateful to Paul Corey, President, and Frank Ruggirello, Editorial Director, for their continued enthusiasm and support of this project. We appreciate the contributions of Derek Perrigo, Marketing Manager, who keeps his
finger on the pulse of the market and helps us meet the needs of our customers,
and the remarkable and tireless Pearson Science sales reps.
We are also grateful that the contributions of all of the aforementioned people have led to this text receiving the following awards: The Association of Medical Illustrators Award, The Text and Academic Authors Award, the New York

International Book Fair Award, the 35th Annual Bookbuilders West Award, and
the 2010 Text and Academic Authors Association “Texty” Textbook Excellence
Award.
We would also like to thank Steven Bassett of Southeast Community College; Kelly Johnson of University of Kansas; Jason LaPres of North Harris College; Agnes Yard of University of Indianopolis; and Michael Yard of Indiana
University-Purdue University at Indianapolis for their work on the media and
print supplements for this edition.
Finally, we would like to thank our families for their love and support during the revision process. We could not have accomplished this without the help
of our wives—Kitty, Judy, and Mary—and the patience of our children—P.K.,
Molly, Kelly, Patrick, Katie, Ryan, Molly, and Steven.
No three people could expect to produce a flawless textbook of this scope
and complexity. Any errors or oversights are strictly our own rather than those
of the reviewers, artists, or editors. In an effort to improve future editions, we
ask that readers with pertinent information, suggestions, or comments concerning the organization or content of this textbook send their remarks to
Robert Tallitsch directly, by the e-mail address below, or care of Publisher, Applied Sciences, Pearson Benjamin Cummings, 1301 Sansome Street, San Francisco, CA 94111.
Frederic H. Martini, Haiku, HI
Michael J. Timmons, Orland Park, IL
Robert B. Tallitsch, Rock Island, IL
()

ix


ART THAT TEACHES
Step-by-Step Figures break down complex
processes into numbered step-by-step illustrations that
coordinate with narrative descriptions.

Side-by-Side Figures

show

multiple views of the same structure or
tissue, allowing students to compare an
illustrator’s rendering with a photo of the
actual structure or tissue as it would be
seen in a laboratory or operating room.

NEW! Silhouetted
treatment of bones
results in a cleaner, more
contemporary look.

Atlas-Quality Photographs
NEW! Spiral CT Scans with
3D Volume Rendering, the
most up-to-date imaging available,
provide students with unparalleled
visualization of anatomical structures.

x


Macro-to-Micro Figures
help students to bridge the gap between
familiar and unfamiliar structures of the
body by sequencing larger anatomical
views from whole organs or other
structures down to their smaller parts.

Illustration-over-Photo Figures
bring depth, dimensionality, and visual

interest to the page and show that the
illustrated structures are proportional in
size to the human body.

NEW! Over 65 visually stunning histology
photomicrographs, often with paired art, match the
types of slides that student will encounter in their anatomy lab.

xi


CLINICAL CONTENT THAT ENGAGES
Clinical Notes present pathologies and
their relation to normal function.
CLINIC AL NOTE

Congenital Disorders of the Skeleton
dwarf. The condition results from an abnormal
gene on chromosome 4
that affects a fibroblast
growth factor. Most
cases are the result of
spontaneous mutations. If both parents
have achondroplasia, the
chances are that 25 percent of
their children will be unaffected,
50 percent will be affected to
some degree, and 25 percent will
inherit two abnormal genes,
leading to severe abnormalities

and early death.

Gigantism
Excessive growth resulting
in gigantism occurs if there
is hypersecretion of growth
hormone before puberty.

Pituitary Dwarfism
Inadequate production of
growth hormone before puberty, by contrast, produces
pituitary dwarfism. People
with this condition are very
short, but unlike achondroplastic dwarfs (discussed
below), their proportions
are normal.

NEW! Clinical Notes with Dramatic
One- or Two-Page Layouts

Marfan’s Syndrome

Achondroplasia
᭿

Achondroplasia (a-kon-dro-PLA-se-uh) also results from abnormal
epiphyseal activity. The child’s epiphyseal cartilages grow unusually
slowly, and the adult has short, stocky limbs. Although other skeletal
abnormalities occur, the trunk is normal in size, and sexual and mental
development remain unaffected. An adult with

achondroplasia is known as an achondroplastic
᭿

᭿

Marfan’s syndrome is also
linked to defective connective tissue structure. Extremely long and slender
limbs, the most obvious
physical indication of this
disorder, result from excessive cartilage formation at
the epiphyseal cartilages. An
abnormality of a gene on chromosome 15 that affects the protein
fibrillin is responsible. The skeletal effects are striking, but associated
arterial wall weaknesses are more dangerous.

integrate text with illustrations and photos to
make reading easy and science relevant.

Osteomalacia
᭿

In osteomalacia (os-te-o-ma-LA-she-uh; malakia, softness) the size of
the
C Lskeletal
I N I C Aelements
L N O T E does not change, but their mineral content decreases, softening the bones. The osteoblasts work hard, but the matrix
doesn’t accumulate enough
calcium salts. This condition,
called rickets, occurs in
adults or children whose diet

contains inadequate levels of
calcium or vitamin D3.
᭿

᭿

᭿

Fractures and Their Repair

Types of Fractures
Fractures are named according to
their external appearance, their
location, and the nature of the
crack or break in the bone.
Important types of fractures are
illustrated here by representative
x-rays. The broadest general
categories are closed fractures
and open fractures. Closed, or
simple, fractures are completely
internal. They can be seen only on
x-rays, because they do not
involve a break in the skin. Open,
or compound, fractures project
through the skin. These fractures,
which are obvious on inspection,
are more dangerous than closed
fractures, due to the possibility of
infection or uncontrolled bleeding.

Many fractures fall into more than
one category, because the terms
overlap.

Transverse fracture

Colles
fracture

Transverse fractures, such as
this fracture of the ulna, break a
bone shaft across its long axis.

Displaced fractures produce
new and abnormal bone
arrangements; nondisplaced
fractures retain the normal
alignment of the bones or
fragments.

Spiral fractures, such as
this fracture of the tibia,
are produced by twisting
stresses that spread
along the length of the
bone.

Epiphyseal fractures, such as this fracture
of the femur, tend to occur where the bone
matrix is undergoing calcification and

chondrocytes are dying. A clean transverse
fracture along this line generally heals well.
Unless carefully treated, fractures between
the epiphysis and the epiphyseal cartilage
can permanently stop growth at this site.

Comminuted fractures, such as
this fracture of the femur, shatter
the affected area into a multitude
of bony fragments.

In a greenstick fracture, such
as this fracture of the radius,
only one side of the shaft is
broken, and the other is bent.
This type of fracture generally
occurs in children, whose long
bones have yet to ossify fully.

Repair
of a
fracture

CLINIC AL NOTE

Fracture
hematoma

External
callus

Dead
bone

Bone
fragments

Immediately after the fracture,
1 extensive bleeding occurs.
Over a period of several hours, a
large blood clot, or fracture hematoma, develops.

Spongy bone of
external callus

Periosteum

Internal
callus

An internal callus forms as
2 a network of spongy bone
unites the inner edges, and an
external callus of cartilage and
bone stabilizes the outer edges.

External
callus

The cartilage of the external callus

3 has been replaced by bone, and
struts of spongy bone now unite the
broken ends. Fragments of dead bone
and the areas of bone closest to the break
have been removed and replaced.

A swelling initially marks
4 the location of the fracture.
Over time, this region will be
remodeled, and little evidence of
the fracture will remain.

CLINIC AL NOTE

Shoulder Injuries

Bell’s Palsy

WHEN A HEAD-ON CHARGE leads to a collision,

BELL’S PALSY results from an inflammation of the

such as a block (in football) or check (in hockey), the
shoulder usually lies in the impact zone. The clavicle provides the
only fixed support for the pectoral girdle, and it cannot resist large
forces. Because the inferior surface of the shoulder capsule is
poorly reinforced, a dislocation caused by an impact or violent
muscle contraction most often occurs at this site. Such a dislocation can tear the inferior capsular wall and the glenoid labrum.
The healing process often leaves a weakness and inherent instability of the joint that increases the chances for future dislocations.

facial nerve that is probably related to viral infection.
Involvement of the facial nerve (N VII) can be deduced from
symptoms of paralysis of facial muscles on the affected side and
loss of taste sensations from the anterior two-thirds of the
tongue. The individual does not show prominent sensory
deficits, and the condition is usually painless. In most cases,
Bell’s palsy “cures itself ” after a few weeks or months, but this
process can be accelerated by early treatment with corticosteroids and antiviral drugs.

Find the Clinical Notes in every chapter.

xii

Greenstick

Epiphyseal fracture

Pott fracture

Spiral fracture
Compression fractures
occur in vertebrae subjected
to extreme stresses, such
as those produced by the
forces that arise when you
land on your sacrum in
a fall.

fracture

Comminu
ted
fracture

Displaced fracture

Tibia with inadequate
calcium deposition and
resultant bone deformity

Compression
fracture

A Colles fracture, a break
in the distal portion of the
radius, is typically the
result of reaching out to
cushion a fall.

A Pott fracture occurs at
the ankle and affects both
bones of the leg.


Clinical Cases bring a single patient’s story to life
and challenge students to analyze a real-life case.

CLINICAL CASE

The Muscular System

Grandma’s Hip
You stop to see your 75-year-old grandmother during your weekly
visit to her apartment to set out her medications for the coming week.
As you enter her apartment, you find her lying on her back in severe
pain. She is confused and does not recognize you when you enter the
room. In addition, she is unable to tell you how she came to be lying
on the floor.
You try to help her up off the floor, but she immediately complains of significant pain in the groin area. You dial 911 and an ambulance arrives. As the paramedics make their initial assessment and
transfer her to the gurney, they note that the right lower limb is laterally rotated and noticeably shorter than her left lower limb. An attending resident does the initial assessment upon admission to the ER.

FPO
Evelyn - 75 years old

Upon examination the orthopedic surgeon notes the following:
• The patient appears to be in a rather poor nutritional state.

• The right thigh is externally rotated, and the patient is unable to
change the limb’s position without considerable pain.

• Initially she seemed to be mentally confused, but I.V. fluid and
electrolyte replacement caused a significant improvement in her
condition.

• Passive movement of the hip causes extreme pain, especially
upon external and internal rotation.
• White Blood Cell count (WBC) is 20,000/mm3.
• Hemoglobin (Hgb) is 9.8 g/dl.
• Although confused, your grandmother repeatedly states that she
was lying on the floor of her apartment for a long time prior to

being found.
The resident is concerned that the time lag between the injury
and being discovered and transported to the hospital may have
caused complications. As a result, he is not sure about how treatment
should proceed. He administers a painkiller to make your grandmother more comfortable and then pages the orthopedic surgeon on
call for a consult.
The attending orthopedic surgeon arrives and immediately suggests intravenous fluid replacement to alleviate the dehydration

• Reveals the results of physical
examinations and lab work
• Isolates key points to consider

Follow-up Examination

• The right lower limb is noticeably shorter than the left.

• On palpation, the groin region is tender, but there is no obvious
swelling.

• Includes helpful patient photos and
diagnostic images
• Describes the patient’s symptoms

Initial Examination and Laboratory Results
The resident does the initial assessment of your grandmother and the
following is noted:

Each Clinical Case:

• The right lower limb is externally rotated and the patient is unable to lift her right heel from the stretcher.

• Offers an analysis and interpretation
of the key points with references to
relevant pages and figures in the
preceding chapters
• Provides a diagnosis

• The right lower limb is shorter, which is confirmed by measuring the
3. What
areiliac
the spine
anatomical
of the hip joint?
distance between the anterior,
superior
and thecharacteristics
distal tip
of the medial malleolus of the
tibia,patient’s
and comparing
the results
with rotated and she is unable
4. The
lower limb
is externally
those of the left lower limb (after
passive
rotation
byfrom
the surgeon).

to lift
her right
heel
the stretcher. Would this condition be

result
axialappears
or appendicular
muscles? What specific mus• The greater trochanter on thethe
right
sideofalso
to be higher
clesofwould
involved in the external rotation of the hip? What
and more prominent than that
the leftbeside.
muscles
would
be
involved
in
flexion
• Palpation yields tenderness in the femoral triangle on the ante- of the hip?

4. The muscles involved in the positioning of your grandmother’s
lower limb would all be appendicular muscles. The muscles involved in externally (laterally) rotating the hip and flexing the
hip may be found in Table 11.6 on p. 310.

Diagnosis

Your grandmother is 75 years old, and her skeleton is undergoing
several anatomical changes as a result of the aging process.
∞ pp. 129–130 Your grandmother has a displaced, subcapital fracture
Points to Consider
1. The anatomical characteristics of the bones of the lower limb
of the femur. The angle between the head and neck of the femur is
As you examine the information may
presented
above,
review the
∞ pp. 199–206
be found
in Chapter
7. material
decreased, and the neck and shaft are externally rotated. The pelvic
covered in Chapters 5 through 11, and determine what anatomical
2. The following anatomical landmarks are mentioned in this
bones and femur have a high probability of marked osteoporosis.
information will enable you to sort through the information given to
problem:
∞
p. 130 This condition increases the likelihood of fractures in elderly
you about your grandmother and her
• groin
• distal tip of the medial
individuals,
and also lengthens the time required for the repair of a
particular problems
• anterior, superior iliac
malleolus of the tibia

fracture. ∞ pp. 129–133
spine
• greater trochanter of the femur
The position of your grandmother’s lower limb is due to tightening of the external rotators (piriformis, superior and inferior
These landmarks may be found in Chapter 7. ∞ pp. 192–206
gemelli, and obturator externus muscles). ∞ pp. 308–311 Her right
3. The anatomical characteristics of the hip joint may be found in
lower limb is shorter than the left due to (a) the fracture of the hip
Chapter 8. ∞ pp. 228–231
and (b) contraction of the hip flexors and extensors (Table 11.6,
Figure 11.24 X-Ray of the Hip After Surgery
p. 310). Her hip will probably require surgery. Although there are
several procedures that might be used, removal of the head of the femur
Polyethylene
Acetabular
(∞ pp. 199–202) and replacement with a
liner
shell
prosthesis is a common procedure. The
chosen prosthesis would replace the head
of the femur and would also possess a
Femoral
head
long stem that would be inserted into the
medullary cavity of the bone and exNeck
tended almost halfway down the femoral
Stem
shaft to anchor the head into place
(Figure 11.24). The stem of the prosthesis
would be designed with holes through it,

and bits of spongy bone (∞ pp. 118–120)
Assembled
Unassembled
would be inserted into the holes to serve
total hip
total hip
as bone grafts. Another procedure commonly followed is cementing the prosthesis into place, which might be more likely
a X-ray of an individual with
b Hip prostheses
for your grandmother considering her ada surgically implanted hip
vanced age and reduced level of activity.
rior surface of the hip joint.

Analysis and Interpretation

prosthesis

Find the Clinical Cases at the end of every body system.

xiii


PRACTICE ANATOMY LAB (PAL ) 3.0
™

™

PAL 3.0 is an indispensable virtual anatomy study and practice tool that gives
students 24/7 access to the most widely used lab specimens, including human cadaver,
anatomical models, histology, cat, and fetal pig. PAL 3.0 retains all of the key advantages of

version 2.0, including ease-of-use, built-in audio pronunciations, rotatable bones, and
simulated fill-in-the-blank lab practical exams.

NEW! Carefully prepared dissections show
nerves, blood vessels, and arteries across body systems.

NEW! Photo gallery

allows
students to quickly see thumbnails
of images for a particular region or
sub-region.

NEW! Layering slider

allows students to
peel back layers of the human cadaver and view
and explore hundreds of brand-new dissections
especially commissioned for 3.0.

PAL 3.0 is available in the Study Area of MasteringA&P™ (www.masteringaandp.com).

xiv


NEW! Interactive Histology module

allows
students to view the same tissue slide at varying magnifications,
thereby helping them identify structures and their characteristics.

3-D Anatomy Animations of origins,
insertions, actions, and innervations of over
65 muscles are now viewable in both Cadaver and
Anatomical Models modules. A new closedcaptioning option provides textual presentation of
narration to help students retain information and
supports ADA compliance.

PAL 3.0 also includes:
• NEW! Question randomization feature gives students more
opportunities for practice and self-assessment. Each time the student
retakes a quiz or lab practical, a new set of questions is generated.
• NEW! Hundreds of new images and views are included, especially
in the Human Cadaver, Anatomical Models, and Histology modules.
• NEW! Turn-off highlight feature in quizzes and lab practicals gives
students the option to see a structure without the highlight overlay.

xv


AN ASSIGNMENT AND ASSESSMENT SYSTEM

Get your students ready for your course.
Get Ready for A&P allows you to assign tutorials and
assessments on topics students should have learned prior
to their anatomy course:
• Study Skills
• Basic Math Review
• Terminology
• Body Basics

• Chemistry
• Cell Biology

Motivate your students to
come to class prepared.
Assignable Reading Quizzes motivate
your students to read the textbook
before coming to class.

Assign art from the textbook.
Assign and assess figures from the textbook.

xvi


Give your students extra coaching.
Assign tutorials from your favorite media—such
as A&P Flix™—to help students visualize and understand
tough topics. MasteringA&P provides coaching through
helpful wrong-answer feedback and hints.

Give students 24/7 lab practice.
Practice Anatomy Lab™ (PAL™) 3.0 is a tool that
helps students study for their lab practicals
outside of the lab. To learn more about version
3.0, see pages xiv-xv.

Identify struggling students
before it’s too late.
MasteringA&P has a color-coded gradebook that

helps you identify vulnerable students at a glance.
Assignments in MasteringA&P are automatically
graded, and grades can be easily exported to
course management systems or spreadsheets.

Go to www.masteringaandp.com to watch the demo movie.

xvii


TOOLS TO MAKE THE GRADE
STUDY AREA
Mastering A&P™ includes a Study Area that will help students get
ready for tests with its simple three-step approach. Students can:
1. Take a pre-test and obtain a personalized study plan.
2. Learn and practice with animations, labeling activities,
and interactive tutorials.
3. Self-test with quizzes and a chapter post-test.
Highlight text
and make notes.

Get Ready for A&P
Students can access the Get Ready for
A&P eText, activities, and diagnostic
tests for these important topics:
• Study Skills
• Basic Math Review
• Terminology
• Body Basics
• Chemistry

• Cell Biology

eText
Students can access their textbook wherever and whenever
they are online. eText pages look exactly like the printed text
yet offer additional functionality. Students can:
• Create notes.
• Highlight text in different colors.
• Create bookmarks.
• Zoom in and out.
• View in single-page or two-page view.
• Click hyperlinked words and phrases to view definitions.
• Link directly to relevant animations.
• Search quickly and easily for specific content.

xviii

Easily access definitions
of key words.

View animations
from within the eText.


A&P Flix™
A&P Flix are 3-D movie-quality animations
with self-paced tutorials and gradable quizzes
that help students master the toughest topics
in human anatomy:
• Origins, Insertions, Actions, Innervations

• Group Muscle Actions & Joints

Practice Anatomy Lab™ (PAL™) 3.0
Practice Anatomy Lab (PAL) 3.0 is a virtual
anatomy study and practice tool that gives students
24/7 access to the most widely used lab specimens,
including the human cadaver, anatomical models,
histology, cat, and fetal pig.
PAL 3.0 retains all of the key advantages of 2.0,
including ease-of-use, built-in audio pronunciations,
rotatable bones, and simulated fill-in-the-blank lab
practical exams. New features includes layering of
human cadaver dissections, quiz question
randomization, multiple views of same histology
tissue slide at varying magnifications, hundreds of
new images, plus much more. To learn more about
version 3.0, see pages xiv–xv.

xix


SUPPORT FOR INSTRUCTORS
Instructor Resource DVD (IRDVD)
978-0-321-73592-8 • 0-321-73592-7
This IRDVD offers a wealth of instructor media resources, including presentation art, lecture outlines, test
items, and answer keys—all in one convenient location. The IRDVD includes:
•Textbook images in JPEG format (in two
versions—one with labels and one without)

• PRS-enabled Active Lecture Clicker Questions

• Customizable textbook images embedded in
PowerPoint slides (in three versions—one with
editable labels, one without labels, and one with
step-edit art)

• Martini’s Atlas of the Human Body images

• Customizable PowerPoint lecture outlines,
including figures and tables from the book and
links to the A&P Flix

• Muscle Origins and Insertions images

• PRS-enabled Quiz Show Clicker Questions
• MRI/CT scans
• Histology slides
• PDF files of Transparency Acetate masters

• A&P Flix™ 3-D movie-quality animations on tough
topics

• The Test Bank in TestGen® format and Microsoft
Word® format
• The Instructor’s Manual in Microsoft Word® format

eText with Whiteboard Mode
The Human Anatomy, Seventh Edition, eText comes with Whiteboard Mode, allowing
instructors to use the eText for dynamic classroom presentations. Instructors can show
one-page or two-page views from the book, zoom in or out to focus on select topics, and

use the Whiteboard Mode to point to structures, circle parts of a process, trace pathways,
and customize their presentations.
Instructors can also add notes to guide students, upload documents, and share their customenhanced eText with the whole class.

Instructor’s Manual

Instructor’s Visual Guide

by Kelly Johnson
978-0-321-73591-1 • 0-321-73591-9
This useful resource includes a wealth of
materials to help instructors organize their
lectures, such as lecture ideas, analogies,
common student misconceptions/problems,
and vocabulary aids.

978-0-321-73201-9 • 0-321-73201-4
This handy resource is a printed and
bound collection of thumbnails of the art
and media on the IRDVD. (See above.)
With this take-anywhere supplement,
instructors can plan their lectures when
away from their computers.

Printed Test Bank

Instructor Resource DVD with Test Bank for

by Jason LaPres
978-0-321-73584-3 • 0-321-73584-6

A test bank of more than 3,000 questions tied to
the Learning Outcomes in each chapter helps
instructors design a variety of tests and quizzes.
The test bank includes text-based and art-based
questions. This supplement is the print version
of the TestGen that is on the IRDVD.

xx

VERSON 3.0

practice
anatomy
lab

Practice Anatomy Lab™ 3.0
(PAL™ 3.0) IRDVD
978-0-321-74963-5 • 0-321-74963-4
This IRDVD includes everything instructors
need to present and assess PAL in lecture and
lab. It includes images in PowerPoint® and
JPEG formats, links to animations, and a test
bank of 4,000 lab practical and quiz questions.

Transparency Acetates

CourseCompass™/ Blackboard

978-0-321-73590-4 • 0-321-73590-0
All figures and tables from the text are included in this printed supplement.

Complex figures are broken out for readable projected display.

Pre-loaded book-specific content and test item files accompanying the
text are available in several course management formats.

See pages xvi-xvii for MasteringA&P.


SUPPORT FOR STUDENTS
Martini’s Atlas of
the Human Body

A&P Applications
Manual

by Frederic H. Martini
The Atlas offers an abundant
collection of anatomy
photographs, radiology scans,
and embryology summaries,
helping students visualize
structures and become familiar
with the types of images seen
in a clinical setting.

By Frederic H. Martini and
Kathleen Welch
This manual contains
extensive discussions on
clinical topics and disorders to

help students apply the
concepts of anatomy and
physiology to daily life and
their future health professions.

Get Ready for A&P

Practice Anatomy Lab™
(PAL)™ 3.0 DVD

by Lori K. Garrett
This book and online
component were created to
help students be better
prepared for their course.
Features include pre-tests,
guided explanations followed
by interactive quizzes and
exercises, and end-of-chapter
cumulative tests. Also available
in the Study Area of
www.masteringaandp.com.

VERSON 3.0

practice
anatomy
lab

Ace Your Lab Practical

PAL 3.0 is an indispensable virtual
anatomy study and practice tool
that gives students 24/7 access to
the most widely used lab
specimens including human
cadavers, anatomical models,
histology, cat, and fetal pig.

eText

Option for Your Lab

Students can access their textbook wherever and
whenever they are online. eText pages look exactly like the
printed text yet offer additional functionality. Students can:

Laboratory Manual
for Human Anatomy
with Cat Dissections

• Create notes.
• Highlight text in different colors.
• Create bookmarks.
• Zoom in and out.
• View in single-page or two-page view.
• Click hyperlinked words and phrases to view definitions.
• Link directly to relevant animations.
• Search quickly and easily for specific content.

See pages xviii–xix for the MasteringA&P Study Area.

By Michael G. Wood
© 2009, 512 pages
This full-color laboratory manual
combines illustrations (modified, as
needed) and photos from Human
Anatomy with Michael G. Wood’s easyto-follow writing style and student
focused features, making it the most
learner-centered Human Anatomy
laboratory manual available.

xxi


C ONTENT S

1

Foundations:
An Introduction to Anatomy

The Golgi Apparatus
Lysosomes 44
Peroxisomes 45

1

Microscopic Anatomy 2

Membrane Flow

Intercellular Attachment 45

Other Perspectives on Anatomy 2

The Cell Life Cycle

Mitosis 48

Clinical Note

The Language of Anatomy 14

Cell Division and Cancer 47

Superficial Anatomy 14
Anatomical Landmarks 14
Anatomical Regions 15
Anatomical Directions 16

Clinical Terms 49

Sectional Anatomy 18
Planes and Sections 18
Body Cavities 19

3

Foundations:

Tissues and Early Embryology
Epithelial Tissue

Clinical Notes

Maintaining the Integrity of the Epithelium
Intercellular Connections 56
Attachment to the Basal Lamina 56
Epithelial Maintenance and Renewal 56

27
28

Light Microscopy 28
Electron Microscopy

29

Cellular Anatomy 30
The Plasmalemma 32
Membrane Permeability: Passive Processes 33
Membrane Permeability: Active Processes 34
Extensions of the Plasmalemma: Microvilli 36
The Cytoplasm 37
The Cytosol 37
Organelles 37
Nonmembranous Organelles 37
The Cytoskeleton 37
Centrioles, Cilia, and Flagella 38
Ribosomes 39

Membranous Organelles 40
Mitochondria 40
The Nucleus 40
The Endoplasmic Reticulum 41

54

Specializations of Epithelial Cells 55

Clinical Terms 24

Foundations:
The Cell

53

Functions of Epithelial Tissue 55

Disease, Pathology, and Diagnosis 4
The Diagnosis of Disease 7
The Visible Human Project 19
Clinical Anatomy and Technology 22

The Study of Cells

46

Interphase 46
DNA Replication 47

5

An Introduction to Organ Systems 7

2

45

Gross Anatomy 2

Levels of Organization

43

56

Classification of Epithelia 57
Squamous Epithelia 57
Cuboidal Epithelia 58
Columnar Epithelia 59
Pseudostratified and Transitional Epithelia 59
Glandular Epithelia 61
Types of Secretion 61
Gland Structure 61
Modes of Secretion 62

Connective Tissues

64

Classification of Connective Tissues

64

Connective Tissue Proper 64
Cells of Connective Tissue Proper 65
Connective Tissue Fibers 66
Ground Substance 66
Embryonic Tissues 66
Loose Connective Tissues 66
Dense Connective Tissues 69
Fluid Connective Tissues 69
Supporting Connective Tissues
Cartilage 71
Bone 72

71


xxiii

Contents

Membranes 75

Accessory Structures 98

Mucous Membranes 75

Hair Follicles and Hair 98

Hair Production 99
Follicle Structure 99
Functions of Hair 99
Types of Hairs 101
Hair Color 101
Growth and Replacement of Hair 101

Serous Membranes 75
The Cutaneous Membrane
Synovial Membranes

75

77

The Connective Tissue Framework of the Body 77
Muscle Tissue

Glands in the Skin 102
Sebaceous Glands 102
Sweat Glands 103
Control of Glandular Secretions 105
Other Integumentary Glands 106

78

Skeletal Muscle Tissue 78
Cardiac Muscle Tissue

78

Smooth Muscle Tissue 78

Neural Tissue

Nails

78

Local Control of Integumentary Function 106

Tissues, Nutrition, and Aging 80

Aging and the Integumentary System 107

Embryology Summaries
The Formation of Tissues 82
The Development of Epithelia 83
Origins of Connective Tissues 84
The Development of Organ Systems 85

Clinical Notes
Repairing Injuries to the Skin 104
Skin Disorders 108

Clinical Case

Clinical Notes

Anxiety in the Anatomy Laboratory 110

Liposuction 69
Cartilages and Knee Injuries 75
Problems with Serous Membranes 76
Tumor Formation and Growth 81

Clinical Terms 112

5

Clinical Terms 86

4

The Integumentary System
Integumentary Structure and Function 92
The Epidermis 92
Layers of the Epidermis 93
Stratum Basale 93
Stratum Spinosum 93
Stratum Granulosum 93
Stratum Lucidum 94
Stratum Corneum 94
Thick and Thin Skin 94
Epidermal Ridges 94
Skin Color 95

The Dermis 96

106

The Skeletal System:
Osseous Tissue and Skeletal Structure

115

Structure of Bone 116

90

The Histological Organization of Mature Bone
The Matrix of Bone 116
The Cells of Mature Bone 116

Compact and Spongy Bone 118
Structural Differences between Compact and Spongy
Bone 118
Functional Differences between Compact and Spongy
Bone 118
The Periosteum and Endosteum 120

Bone Development and Growth 122
Intramembranous Ossification 122
Endochondral Ossification 123
Increasing the Length of a Developing Bone 124
Increasing the Diameter of a Developing Bone 126

Dermal Organization 96
Wrinkles, Stretch Marks, and Lines of Cleavage 97

Formation of the Blood and Lymphatic Supply

Other Dermal Components 97
The Blood Supply to the Skin 98
The Nerve Supply to the Skin 98

Factors Regulating Bone Growth

The Subcutaneous Layer 98

116

Bone Innervation 128
128

Bone Maintenance, Remodeling, and Repair
Remodeling of Bone 129
Injury and Repair 129
Aging and the Skeletal System 129

129

128


xxiv

Contents

Anatomy of Skeletal Elements 131

Classification of Bones

The Thoracic Cage 174

131

Bone Markings (Surface Features)

The Ribs 174
134

The Sternum

Clinical Notes

Integration with Other Systems 136

Sinus Problems 160
Kyphosis, Lordosis, and Scoliosis 167
Spina Bifida 170
Cracked Ribs 176
The Thoracic Cage and Surgical Procedures 176

Clinical Notes
Congenital Disorders of the Skeleton 127
Osteoporosis and Age-Related Skeletal Abnormalities 130
Fractures and Their Repair 132
Examination of the Skeletal System 135

Clinical Terms 177

Clinical Terms 136

6

The Skeletal System:
Axial Division

139

7

The Upper Limb 185
The Humerus 185
The Ulna 185
The Radius 187
The Carpal Bones 190
The Metacarpal Bones and Phalanges 190

Bones of the Face 154
The Maxillae 154
The Palatine Bones 156
The Nasal Bones 157
The Inferior Nasal Conchae 157
The Zygomatic Bones 157
The Lacrimal Bones 157
The Vomer 157
The Mandible 157

The Pelvic Girdle and Lower Limb

192

The Pelvic Girdle 192
The Hip Bones 192
The Pelvis 192
The Lower Limb 199
The Femur 199
The Patella 202
The Tibia 202
The Fibula 202
The Tarsal Bones 205
The Metatarsal Bones and Phalanges

The Orbital and Nasal Complexes 158
The Orbital Complex 158
The Nasal Complex 158
The Hyoid Bone 159

205

Individual Variation in the Skeletal System 206

The Skulls of Infants, Children, and Adults 164

Clinical Notes

164

Scaphoid Fractures 190

Problems with the Ankle and Foot 207

Spinal Curves 164

Vertebral Regions 169
Cervical Vertebrae 169
Thoracic Vertebrae 172
Lumbar Vertebrae 173
The Sacrum 173
The Coccyx 174

180

The Pectoral Girdle 182
The Clavicle 182
The Scapula 182

Bones of the Cranium 148
Occipital Bone 148
Parietal Bones 148
Frontal Bone 148
Temporal Bones 151
Sphenoid 152
Ethmoid 153
The Cranial Fossae 154

Vertebral Anatomy 167
The Vertebral Body 167
The Vertebral Arch 167
The Articular Processes 168

Vertebral Articulation 168

The Skeletal System:
Appendicular Division
The Pectoral Girdle and Upper Limb 182

The Skull and Associated Bones 141

The Vertebral Column

176

Clinical Terms 208

8

The Skeletal System:
Articulations
Classification of Joints 212
Synarthroses (Immovable Joints) 212
Amphiarthroses (Slightly Movable Joints) 212

211