Ross and Wilson ANATOMY and PHYSIOLOGY in Health and Illness Eleventh Edition Anne Waugh, BSc(Hons) MSc CertEd SRN RNT FHEA Senior Lecturer and Senior Teaching Fellow, School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK Allison Grant, BSc PhD RGN Lecturer, Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK Churchill Livingstone Front matter Senior Commissioning Editor: Ninette Premdas Development Editor: Clive Hewat Project Manager: Elouise Ball Designer: Kirsteen Wright Illustration Manager: Merlyn Harvey Illustrator: Graeme Chambers Ross and Wilson ANATOMY and PHYSIOLOGY in Health and Illness 11th Edition Anne Waugh BSc(Hons) MSc CertEd SRN RNT FHEA, Senior Lecturer and Senior Teaching Fellow, School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK Allison Grant BSc PhD RGN, Lecturer, Department of Biological and Biomedical Sciences, Glasgow Caledonian University, Glasgow, UK Illustrations by Graeme Chambers Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2010 Copyright © E. & S. Livingstone Ltd 1963, 1966, 1968 © Longman Group Limited 1973, 1981, 1987, 1990 © Pearson Professional Limited 1997 © Harcourt Brace and Company Limited 1998 © Harcourt Publishers Limited 2001 © Elsevier Science Limited 2002. All rights reserved. © Elsevier Limited 2006. All rights reserved. © Elsevier Limited 2010. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). ISBN 9780702032271 International edition ISBN 9780702032288 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. The Publisher Printed in China Preface Anne Waugh, Allison Grant, Edinburgh, 2009 Ross and Wilson has been a core text for students of anatomy and physiology for over 40 years. This latest edition is aimed at healthcare professionals including nurses, students of nursing, the allied health professions and complementary therapies, paramedics and ambulance technicians, many of whom have found previous editions invaluable. It retains the straightforward approach to the description of body systems and how they work, and the normal anatomy and physiology is followed by a section that covers common disorders and diseases: pathology. The human body is described system by system. The reader must, however, remember that physiology is an integrated subject and that, although the systems are considered in separate chapters, they must all function cooperatively to maintain health. The first three chapters provide an overview of the body and describe its main structures. The later chapters are organised into three further sections, reflecting those areas essential for normal body function: communication; intake of raw materials and elimination of waste; and protection and survival. Much of the material for this edition has been revised and rewritten. Many of the diagrams have been revised and over 50 new coloured electron micrographs and photographs included to provide detailed and enlightening views of many anatomical features. This edition is accompanied by a companion website (www.rossandwilson.com) with over 100 animations and an extensive range of new online self-test activities that reflect the content of each chapter. The material in this textbook is also supported by a new edition of the accompanying study guide, which provides students who prefer paper-based activities the opportunity to test their learning and improve their revision skills. Most features from the previous edition have been retained and revised, including learning outcomes, a list of common prefixes, suffixes and roots, and extensive in-text cross-references. A new and comprehensive glossary has been prepared for this edition. Some biological values, extracted from the text, are presented as an appendix for easy reference. In some cases, slight variations in ‘normals’ may be found in other texts and used by different medical practitioners. Acknowledgements Author’s acknowledgements The eleventh edition of this textbook would not have been possible without the efforts of many people. In preparing this edition, we have continued to build on the foundations established by Kathleen Wilson and we would like to acknowledge her immense contribution to the success of this title. Thanks are due once again to Graeme Chambers for his patience in the preparation of the new and revised artwork. We are indebted to readers of the tenth edition for their feedback and constructive comments, many of which have influenced the current revision. We are also grateful to the staff of Elsevier, particularly Ninette Premdas, Clive Hewat, Elouise Ball, Colin McEwan, Kirsty Guest and Fraser Johnston for their continuing support. Thanks are also due to our families, Andy, Michael, Seona and Struan, for their continued patience, support and acceptance of lost evenings and weekends. Publisher’s acknowledgements The following figures are reproduced with kind permission from: Elsevier Health Sciences Ltd: Figures 3.14, 5.3 and 12.21B from Telser AG, Young JK, Baldwin KM (2007) Elsevier’s integrated histology. Mosby, Edinburgh Figures 3.25, 7.11 and 13.19 from Young B, Lowe JS, Stevens A et al (2006) Wheater’s functional histology: a text and colour atlas. Churchill Livingstone, Edinburgh Figures 3.7, 3.8, 7.12, 7.13 and 17.1 from Standring S et al (2005) Gray’s anatomy: the anatomical basis of clinical practice, 39th edn. Churchill Livingstone, Edinburgh. The Science Photo Library: Figures 1.1, 1.6, 1.15, 1.17; 3.2B, 3.3 3.6 3.3 3.4 3.53.6 3.9, 3.12, 3.15C, 3.16B, 3.17B, 3.21B, 3.22B; 4.3C, 4.13; 6.6; 7.4, 7.18A; 8.2, 8.11C, 8.12, 8.25C; 9.13 9.16 9.13 9.149.159.16 10.8A, 10.12B, 10.19, 10.28; 12.5B, 12.20, 12.26, 12.47; 13.6, 13.7, 13.9; 14.1, 14.3, 14.4; 15.1; 16.4, 16.5B, 16.7, 16.55, 16.57; 17.2; 18.8. Common prefixes, suffixes and roots Prefix/suffix/root To do with Examples in the text a-/an- lack of anuria, agranulocyte, asystole, anaemia ab- away from abduct ad- towards adduct -aemia of the blood anaemia, hypoxaemia, uraemia, hypovolaemia angio- vessel angiotensin, haemangioma ante- before, in front of anterior anti- against antidiuretic, anticoagulant, antigen, antimicrobial -blast germ, bud reticuloblast, osteoblast brady- slow bradycardia broncho- bronchus bronchiole, bronchitis, bronchus card- heart cardiac, myocardium, tachycardia chole- bile cholecystokinin, cholecystitis, cholangitis circum- around circumduction cyto-/-cyte cell erythrocyte, cytosol, cytoplasm, cytotoxic derm- skin dermatitis, dermatome, dermis di- two disaccharide, diencephalon dys- difficult dysuria, dyspnoea, dysmenorrhoea, dysplasia -ema swelling oedema, emphysema, lymphoedema endo- inner endocrine, endocytosis, endothelium enter- intestine enterokinase, gastroenteritis epi- upon epimysium, epicardium erythro- red erythrocyte, erythropoietin, erythropoiesis exo- outside exocytosis, exophthalmos extra- outside extracellular, extrapyramidal -fferent carry afferent, efferent gast- stomach gastric, gastrin, gastritis, gastrointestinal -gen- origin/production gene, genome, genetic, antigen, pathogen, allergen -globin protein myoglobin, haemoglobin haem- blood haemostasis, haemorrhage, haemolytic hetero- different heterozygous homo- the same, steady homozygous, homologous -hydr- water dehydration, hydrostatic, hydrocephalus hepat- liver hepatic, hepatitis, hepatomegaly, hepatocyte hyper- excess/above hypertension, hypertrophy, hypercapnia hypo- below/under hypoglycaemia, hypotension, hypovolaemia intra- within intracellular, intracranial, intraocular -ism condition hyperthyroidism, dwarfism, rheumatism -itis inflammation appendicitis, hepatitis, cystitis, gastritis lact- milk lactation, lactic, lacteal lymph- lymph tissue lymphocyte, lymphatic, lymphoedema lyso-/-lysis breaking down lysosome, glycolysis, lysozyme -mega- large megaloblast, acromegaly, splenomegaly, hepatomegaly micro- small microbe, microtubules, microvilli myo- muscle myocardium, myoglobin, myopathy, myosin neo- new neoplasm, gluconeogenesis, neonate nephro- kidney nephron, nephrotic, nephroblastoma, nephrosis neuro- nerve neurone, neuralgia, neuropathy -oid resembling myeloid, sesamoid, sigmoid olig- small oliguria -ology study of cardiology, neurology, physiology -oma tumour carcinoma, melanoma, fibroma -ophth- eye xerophthalmia, ophthalmic, exophthalmos -ory referring to secretory, sensory, auditory, gustatory os-, osteo- bone osteocyte, osteoarthritis, osteoporosis -path- disease pathogenesis, neuropathy, nephropathy -penia deficiency of leukopenia, thrombocytopenia phag(o)- eating phagocyte, phagocytic -plasm substance cytoplasm, neoplasm pneumo- lung/air pneumothorax, pneumonia, pneumotoxic poly- many polypeptide, polyuria, polycythaemia -rrhagia excessive flow menorrhagia -rrhoea discharge dysmenorrhoea, diarrhoea, rhinorrhoea -scler hard arteriosclerosis sub- under subphrenic, subarachnoid, sublingual tachy- excessively fast tachycardia thrombo- clot thrombocyte, thrombosis, thrombin, thrombus -tox- poison toxin, cytotoxic, hepatotoxic tri- three tripeptide, trisaccharide -uria urine anuria, polyuria, haematuria, nocturia vas, vaso- vessel vasoconstriction, vas deferens, vascular