II Contents Contents III The Human Body An Introduction to Structure and Function Adolf Faller, M.D. Former Professor University of Fribourg Fribourg, Switzerland Michael Schünke, M.D., Ph.D. Professor Institute of Anatomy CAU Kiel Kiel, Germany Gabriele Schünke, M.Sc. Dipl.-Biol. Kronshagen, Germany Translated by Oliver French, M.D.; edited by Ethan Taub, M.D. 316 colored illustrations Thieme Stuttgart · New York IV Contents LibraryofCongressCataloging-in-Publication Thisbookisanauthorizedandrevisedtransla- Dataisavailablefromthepublisher tionofthe13thGermaneditionpublishedand copyrighted1999byGeorgThiemeVerlag, Stuttgart,Germany.TitleoftheGermanedition: DerKörperdesMenschen:EinführunginBau undFunktion Translator:OliverFrenchM.D.,Brooktondal,NY, Importantnote:Medicineisanever-changing USA scienceundergoingcontinualdevelopment.Re- searchandclinicalexperiencearecontinually Editor:EthanTaub,M.D.,Diplomateofthe expandingourknowledge,inparticularour AmericanBoardofNeurologicalSurgery,Klinik knowledgeofpropertreatmentanddrugther- imPark,Zürich,Switzerland apy.Insofarasthisbookmentionsanydosage orapplication,readersmayrestassuredthat 1stDutchedition1970 theauthors,editors,andpublishershavemade 2ndDutchedition1974 everyefforttoensurethatsuchreferencesare 3rdDutchedition1978 inaccordancewiththestateofknowledgeat 4thDutchedition1981 thetimeofproductionofthebook. 1stFrenchedition1970 Nevertheless,thisdoesnotinvolve,imply, 2ndFrenchedition1983 orexpressanyguaranteeorresponsibilityon 3rdFrenchedition1988 thepartofthepublishersinrespecttoany 4thFrenchedition2000 dosageinstructionsandformsofapplications statedinthebook.Everyuserisrequestedto 1stGermanedition1966 examinecarefullythemanufacturers’leaflets 2ndGermanedition1967 accompanyingeachdrugandtocheck,ifneces- 3rdGermanedition1969 saryinconsultationwithaphysicianorspecial- 4thGermanedition1970 ist,whetherthedosageschedulesmentioned 5thGermanedition1972 thereinorthecontraindicationsstatedbythe 6thGermanedition1974 manufacturersdifferfromthestatementsmade 7thGermanedition1976 inthepresentbook.Suchexaminationispar- 8thGermanedition1978 ticularlyimportantwithdrugsthatareeither 9thGermanedition1980 rarelyusedorhavebeennewlyreleasedonthe 10thGermanedition1984 market.Everydosagescheduleoreveryformof 11thGermanedition1988 applicationusedisentirelyattheuser’sown 12thGermanedition1995 riskandresponsibility.Theauthorsandpub- 1stItalianedition1973 lishersrequesteveryusertoreporttothepub- 1stJapaneseedition1982 lishersanydiscrepanciesorinaccuraciesno- 2ndJapaneseedition1993 ticed. 3rdJapaneseedition1998 Someoftheproductnames,patents,andregis- 1stSpanishedition1968 tereddesignsreferredtointhisbookareinfact 2ndSpanishedition1984 registeredtrademarksorproprietarynames eventhoughspecificreferencetothisfactisnot alwaysmadeinthetext.Therefore,theappear- ©2004GeorgThiemeVerlag, anceofanamewithoutdesignationaspro- Rüdigerstrasse14,70469Stuttgart,Germany prietaryisnottobeconstruedasarepresenta- http://www.thieme.de tionbythepublisherthatitisinthepublic ThiemeNewYork,333SeventhAvenue, domain. NewYork,NY10001USA http://www.thieme.com Thisbook,includingallpartsthereof,islegally protectedbycopyright.Anyuse,exploitation,or Coverdesign:Cyclus,Stuttgart commercializationoutsidethenarrowlimitsset TypesettingbyprimustypeHurlerGmbH, bycopyrightlegislation,withoutthepublisher’s Notzingen consent,isillegalandliabletoprosecution.This PrintedinGermanybyGrammlich,Pliezhausen appliesinparticulartophotostatreproduction, copying,mimeographing,preparationofmicro- ISBN3-13-129271-7(GTV) films,andelectronicdataprocessingand ISBN1-58890-122-X(TNY) 12345 storage. Contents V Preface to the First English Edition ThefirstGermaneditionofthisbook,whichwaslaterlovinglyknownas “The Faller,” published in 1966. At this time nobody could ever have imaginedthat“TheHumanBody,”writtenbySwissanatomistAdolfFal- ler,wouldremainuniquelysuccessfulforalmost40years.ThirteenGer- man editions and several editions in other languages speak for them- selves.FifteenyearsafterFaller’sdeath,thethoroughlyandextensively revised 13th German edition published. The current English edition is baseduponthisGermanedition. Thenewversioncontainsalmost200morepagesthantheoriginal.In addition,morethan50newillustrationshavebeenaddedtofacilitatean easier approach to sometimes difficult information. Where necessary, entirechaptershavebeenrewrittentocoverthelatestdevelopmentsin human biology and medicine. All these changes have been made with thereaderinmind.Infact,manyofthechangesweresuggestionsfrom thereaderswhichwehavehappilyincorporated.Theseincludeabrief summaryattheendofeachchapter,afold-outdepictingthecomplete humanskeleton,andatableofcontentsatthebeginningofeachchapter. Wethereforethankourreadersfortheirmanyhelpfulsuggestionsand hopethatreadersoftheEnglisheditionwillfollowsuit. Many thanks go to our translator Oliver French MD, who not only skilfully translated the text but also adapted it to American medical practice.Duetohisexpertisethisbookisfarmorethanasimpletransla- tion of a German textbook; it has really become an international text- bookinitsownright.ManyhelpfulsuggestionsfromEthanTaubMD,a NewYork-trainedneurosurgeon,werealsoincorporatedintothetext. Preparing this English edition was a rewarding experience and we hopethatthereaderwillshareourenthusiamwhenstudyingthefasci- natingfabricofthehumanbody.Thisworkhasbeenmadeparticularly enjoyablebythehelpoftheexperiencedThiemestaff.Wewouldliketo expressourappreciationtoMsGKuhn,MrRZepf,andDrCBergman.Mr VI Contents Markus Voll professionally and skillfully prepared all the new illustra- tions.Manythankstothemall! Finally a note on the chapter Evolution. We are aware that many Americaneducationalinstitutionsdonotteachthetheoryofevolution andmanyAmericansbelieveincreationism.However,thetheoryofevo- lutioniswidelyacceptedinEuropeanditsapplicationformsthebasisof manyobservationsonwhichmedicalpracticeisfounded.Itsinclusionin thistextshouldthereforenotberegardedas“Weltanschauung”butasa ratherneutralstatementaboutcurrentbiologicaltheory. Kiel,Spring2004 GabrieleandMichaelSchünke Contents VII Contents Amoredetailedtableofcontentscanbefoundatthebeginningofeachchapter 1 BiologyoftheCell 1 Introduction ......................................... 2 Number,Size,Shape,andPropertiesofCells............... 2 StructureoftheCellandCellOrganelles .................. 4 CellDivision(Mitosis) .................................. 18 ReductionorMaturationDivision(Meiosis) ................ 21 ExchangeofMaterialsbetweentheCellandItsEnvironment .. 24 MembraneorRestingPotentialofaCell .................. 27 SolidandFluidTransport ............................... 28 2 GeneticsandEvolution 39 Genetics(TheScienceofHeredity) ....................... 40 Evolution(TheScienceofDevelopment;Phylogeny)......... 55 3 Tissues 67 EpithelialTissue....................................... 68 ConnectiveandSupportingTissues....................... 72 MuscleTissue ........................................ 85 NerveTissue ......................................... 97 4 TheLocomotorSystem(MusculoskeletalSystem) 113 Axes,Planes,andOrientation ........................... 114 GeneralAnatomyoftheLocomotorSystem ............... 116 SpecialAnatomyoftheLocomotorSystem ................ 129 VIII Contents 5 TheHeartandBloodVessels 205 TheHeart(Cor)....................................... 206 TheVascularSystem—StructureandFunction .............. 228 TheVascularSystem—PhysiologicalPrinciples .............. 244 6 Blood,theImmuneSystem,andLymphoidOrgans 259 TheBlood ........................................... 260 TheImmuneSystem................................... 282 TheLymphoidOrgans(ImmuneOrgans) .................. 287 7 TheEndocrineSystem 307 Hormones ........................................... 309 Hypothalamic−HypophysealAxis......................... 313 PituitaryGland(Hypophysis) ............................ 314 PinealGland(PinealBody,EpiphysisCerebri)............... 317 ThyroidGland ........................................ 318 AdrenalGlands(SuprarenalGlands) ...................... 321 IsletApparatusofthePancreas .......................... 325 TheGonads .......................................... 327 OtherTissuesandSingleCellsSecretingHormones ......... 328 8 TheRespiratorySystem 333 ThePathofOxygentotheCell:ExternalandInternal Respiration .......................................... 334 OrgansoftheAirPassages ............................. 335 SerousCavitiesandMembranesoftheChestandAbdomen .. 348 Lungs(Pulmones) ..................................... 348 VentilationoftheLungs................................ 353 Contents IX GasExchangeandtheBlood−AirBarrier................... 357 TheRegulationofBreathing ............................ 363 TheMechanicsofBreathing............................. 365 9 TheDigestiveSystem 377 Metabolism,EnergyRequirements,andNutrients........... 378 TheDigestiveOrgans .................................. 389 OverviewoftheDigestiveProcesses...................... 428 10 TheKidneysandUrinaryTract 441 RoleoftheKidneys.................................... 442 OverviewoftheStructureandFunctionoftheKidneys ...... 442 TheKidney(Ren,Nephros) ............................. 443 UrinaryTract ......................................... 457 11 TheReproductiveOrgans 471 FunctionandStructureoftheReproductiveOrgans ......... 472 MaleReproductiveOrgans.............................. 472 FemaleReproductiveOrgans............................ 485 12 Reproduction,Development,andBirth 505 GermCells........................................... 506 Fertilization .......................................... 506 TransportthroughtheUterineTubeandSegmentation ...... 511 ImplantationandDevelopmentofthePlacenta(Afterbirth)... 513 DevelopmentoftheEmbryo ............................ 516 DevelopmentoftheFetus .............................. 520 Birth ................................................ 523 PostnatalDevelopment ................................ 525 X Contents 13 TheCentralandPeripheralNervousSystems 533 ClassificationoftheNervousSystem ..................... 534 RoleoftheNervousSystem............................. 534 DevelopmentoftheNervousSystem ..................... 535 CentralNervousSystem ................................ 536 PeripheralNervousSystem ............................. 584 14 TheAutonomicNervousSystem 605 FunctionandComponents.............................. 606 OutlineoftheSystem ................................. 608 SympatheticNervousSystem ........................... 609 ParasympatheticNervousSystem ........................ 613 NervousSystemoftheIntestinalWall .................... 616 15 SenseOrgans 623 ReceptorsandSensoryCells ............................ 624 TheEye ............................................. 625 TheEar.............................................. 644 TheSenseofTaste .................................... 654 TheSenseofSmell .................................... 655 16 TheSkinandItsAppendages 663 Skin(Cutis)andSubcutaneousTissue(TelaSubcutanea) ..... 664 SkinAppendages ..................................... 668 17 QuantitiesandUnitsofMeasurement 673 Abbreviations ........................................ 674