MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd ii 1122//77//22001111 66::5588::2222 PPMM MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd iiii 1122//77//22001111 66::5588::3300 PPMM MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd iiiiii 1122//77//22001111 66::5588::3300 PPMM Executive Editor: David Troy Development Editor: Laura Bonazzoli Senior Product Manager: Eve Malakoff-Klein Designer: Terry Mallon Artist: Christine Vernon/Hearthside and Dragonfl y Media Group Cover Art: Imagineering Compositor: SPi Global Printer: C&C Offset Printing 12th Edition Copyright © 2013, 2009, 2005 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Two Commerce Square Baltimore, MD 21201 2001 Market Street Philadelphia, PA 19103 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their offi cial duties as U.S. government employees are not covered by the above- mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via e-mail at [email protected], or via Web site at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Cohen, Barbara J. Memmler’s the human body in health and disease.—12th ed. / Barbara Janson Cohen ; consulting editors/authors, Jason James Taylor, Kerry E. Hull. p. ; cm. Human body in health and disease Includes bibliographical references and index. ISBN 978-1-60913-905-6 I. Taylor, Jason J. II. Hull, Kerry E. III. Memmler, Ruth Lundeen. IV. Title. V. Title: Human body in health and disease. [DNLM: 1. Physiology. 2. Anatomy. 3. Pathology. QT 104] 612—dc23 2011048302 Care has been taken to confi rm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care providers to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: http://www.lww.com. Lippincott Williams & Wilkins customer service represen- tatives are available from 8:30 am to 6:00 pm, EST. 9 8 7 6 5 4 3 2 1 MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd iivv 1122//77//22001111 66::5588::3388 PPMM PPrreeffaaccee M emmler’s The Human Body in Health and Disease is Organization and a textbook for introductory-level health professions Structure and nursing students who need a basic understanding of anatomy and physiology, the interrelationships between structure and function, and the effects of disease on body Like previous editions, the 12th edition uses a body systems systems. approach to the study of the normal human body and how Like preceding editions, the 12th edition remains true disease affects it. The book is divided into seven units, group- to Ruth Memmler’s original vision. The features and con- ing related information and body systems together as follows: tent specifi cally meet the needs of those who may be start- ■ Unit I, The Body as a Whole (Chapters 1–4), focuses ing their health career preparation with little or no science on the body’s organization, basic chemistry needed to background. This book’s primary goals are: understand body functions, cells and their functions, ■ To provide the essential knowledge of human anatomy, and tissues, glands, and membranes. physiology, and the effects of disease at an ideal level of ■ Unit II, Disease and the First Line of Defense (Chapters detail and in language that is clear and understandable. 5 and 6), presents information on disease, organisms ■ To illustrate the concepts discussed with anatomic art that produce disease, and the integumentary system, that depicts the appropriate level of detail with accu- which is the body’s fi rst line of defense against injury racy, simplicity, and elegance, and that is integrated and disease. seamlessly with the narrative. ■ Unit III, Movement and Support (Chapters 7 and 8), ■ To incorporate the most recent scientifi c fi ndings into includes the skeletal and muscular systems. the fundamental material on which Ruth Memmler’s ■ Unit IV, Coordination and Control (Chapters 9–12), classic text is based. focuses on the nervous system, the sensory system, and ■ To include pedagogy designed to enhance interest in the endocrine system. and understanding of the concepts presented. ■ Unit V, Circulation and Body Defense (Chapters ■ To teach the basic anatomic and medical terminology 13–17), includes the blood, the heart and heart disease, used in healthcare settings, preparing students to func- blood vessels and circulation, the lymphatic system, tion effi ciently in their chosen health career. and the immune system. ■ To present an integrated teaching–learning package ■ Unit VI, Energy: Supply and Use (Chapters 18–22), that includes all of the elements necessary for a success- includes the respiratory system; the digestive system; ful learning experience. metabolism, nutrition, and temperature control; body fl uids; and the urinary system. This revision is the direct result of in-depth market feed- ■ Unit VII, Perpetuation of Life (Chapters 23–25), covers back solicited to tell us what instructors and students at this the male and female reproductive systems, development level most need. We listened carefully to the feedback, and and birth, and heredity and hereditary diseases. the results we obtained are integrated into many features of this book and into the ancillary package accompanying it. The main Glossary defi nes the chapters’ boldfaced The text itself has been revised and updated where needed terms. An additional Glossary of Word Parts is a reference to improve organization of the material and to refl ect cur- tool that not only teaches basic medical and anatomic ter- rent scientifi c thought. minology but also helps students learn to recognize unfa- Because visual learning devices are so important to miliar terms. Appendices include a variety of supplementary students at this level, this edition includes a new section, information that students will fi nd useful as they work “The Body Visible,” a series of illustrations and trans- with the text, including a photographic dissection atlas parent overlays of the major body major systems that are (Appendix 5) and answers to the Chapter Checkpoint ques- presented in the text. In addition to being a learning tool, tions and Zooming In illustration questions (Appendix 4) these illustrations provide enrichment and are a valuable that are found in every chapter. general reference. The 12th edition retains its extensive art program with Pedagogic Features updated versions of fi gures from previous editions. These features appear in a modifi ed design that makes the content Every chapter contains pedagogy that has been designed more user-friendly and accessible than ever. Our innova- with the health professions and nursing student in mind. tive PASSport to Success® ancillary package helps students match their learning styles to a wealth of resources, while ■ Learning Outcomes: Chapter objectives at the start of the comprehensive package of instructor resources provides every chapter help the student organize and prioritize instructors with maximum fl exibility and effi ciency. learning. v MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd vv 1122//77//22001111 66::5588::3388 PPMM vi Preface ■ Ancillaries At-A-Glance: Learning Tools, Learning ■ Color fi gure and table callouts: Figure and table num- Resources, and Learning Activites are highlighted in a bers appear in color in the narrative, helping students one-stop overview of the supplemental materials avail- quickly fi nd their place after stopping to look at an able for the chapter. illustration or table. ■ Disease in Context: Familiar scenarios transport chap- ■ Word Anatomy: This chart defi nes and illustrates the var- ter content into a real-life setting, bringing the informa- ious word parts that appear in terms within the chapter. tion to life for students and showing how disease may The prefi xes, roots, and suffi xes presented are grouped affect the body’s state of internal balance. according to chapter headings so that students can fi nd the relevant text. This learning tool helps students build ■ A Look Back: With the exception of Chapter 1, each vocabulary and promotes understanding of even unfamil- chapter starts with a brief review of how its content iar terms based on a knowledge of common word parts. relates to prior chapters. ■ Chapter Wrap-Up (NEW to this edition): A graphic ■ Chapter Checkpoints: Brief questions at the end of main outline at the end of each chapter provides a concise sections test and reinforce the student’s recall of key overview of chapter content, aiding in study and test information in that section. Answers are in Appendix 4. preparation. ■ Key Points (NEW to this edition): Critical information ■ Key Terms: Selected boldface terms throughout the highlighted in fi gure legends spotlights essential aspects text are listed at each chapter’s end and defi ned in the of the illustrations. book’s glossary. ■ “Zooming In” questions: Questions in the fi gure legends ■ Questions for Study and Review: Study questions are test and reinforce student understanding of concepts organized hierarchically into three levels. (Note that depicted in the illustration. Answers are in Appendix 4. answers appear in the Instructor’s Manual as well as on ■ Phonetic pronunciations: Easy-to-learn phonetic pro- the instructor resource Web site): nunciations are spelled out in the narrative, appearing > Building Understanding: Includes fi ll-in-the-blank, in parentheses directly following many terms—no need matching, and multiple choice questions that test for students to understand dictionary-style diacritical factual recall. marks. (See the “Guide to Pronunciation” below.) > Understanding Concepts: Includes short-answer ■ Special interest boxes: Each chapter contains three special questions (defi ne, describe, compare/contrast) that interest boxes focusing on topics that augment chapter test and reinforce understanding of concepts. content. The book includes fi ve kinds of boxes altogether: > Conceptual Thinking: Includes short-essay questions > Disease in Context Revisited: Traces the outcome of that promote critical thinking skills. New in this edi- the medical story that opens each chapter and show tion are thought questions related to the Disease in how the cases relate to material in the chapter and to Context case stories. others in the book. > A Closer Look: Provides additional in-depth scientifi c PASSport to Success® for detail on topics in or related to the text. > Clinical Perspective: Focuses on diseases and disor- Students ders relevant to the chapter, exploring what happens to the body when the normal structure–function rela- tionship breaks down. > Hot Topic: Focuses on current trends and research, Look for this icon throughout the book for reinforcing the link between anatomy and physiology pertinent supplementary material on the com- and related news coverage that students may have seen. panion Web site and student resource DVD > Health Maintenance: Offers supplementary informa- tion on health and wellness issues. The PASSport to Success® is a practical system that lets ■ Figures: The art program includes full-color anatomic line students learn faster, remember more, and achieve success. art, some new or revised, with a level of detail that matches Students discover their unique learning styles—visual, audi- that of the narrative. Photomicrographs, radiographs, and tory, or kinesthetic—with a simple online assessment, then other scans give students a preview of what they might see choose from a wealth of resources for each learning style, in real-world healthcare settings. Supplementary fi gures including animations, a pre-quiz, and 10 different types are available on the companion Web site as well as on the of online learning activities; an audio glossary; and other Student DVD included with this text. supplemental materials such as health professions career ■ Tables: The numerous tables in this edition summa- information, additional charts and images, answers to the rize key concepts and information in an easy-to-review “Questions for Study and Review” from the text, and study form. Additional summary tables are available on the and test-taking tips and resources. Throughout the text- companion Web site as well as on the Student DVD book, the graphic icon shown above alerts students to per- included with this text. tinent supplementary material. MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd vvii 1122//77//22001111 66::5588::4444 PPMM Preface vii The PASSport to Success® is available on the DVD bound Instructors also have access to all student ancillary into this textbook as well as on the book’s companion Web assets, including the PASSport to Success®, via thePoint site at http://thePoint.lww.com/MemmlerHumanBody12e. Web site. On the companion Web site, students can also access the fully searchable online version of the text. See the inside front cover of this text for the passcode you will need to Guide to Pronunciation gain access to the Web site, and see pages ix–xvii for details about the PASSport to Success® and a complete listing of The stressed syllable in each word is shown with capital student resources. letters. The vowel pronunciations are as follows: Any vowel at the end of a syllable is given a long sound, as follows: Instructor Ancillary a as in say Package e as in be i as in nice All instructor resources are available to approved adopting o as in go instructors and can be accessed online at http://thePoint. u as in true lww.com/MemmlerHumanBody12e: A vowel followed by a consonant and the letter e (as in ■ Instructor’s Manual is available in print format as well rate) also is given a long pronunciation. as online as a PDF. Any vowel followed by a consonant receives a short ■ Using the PASSport to Success® in Your Course provides pronunciation, as follows: practical tips for integrating this innovative approach. a as in absent ■ Brownstone Test Generator allows you to create cus- e as in end tomized exams from a bank of questions. i as in bin o as in not ■ PowerPoint Presentations include multiple choice and u as in up true/false questions for use with Student Response System technology. ■ Image Bank includes labels-on and labels-off options. Summary ■ Supplemental Image Bank with additional images can be used to enhance class presentations. The 12th edition of Memmler’s The Human Body in ■ Lesson Plans are organized around the learning objec- Health and Disease builds on the successes of the previous tives and include lecture notes, in-class activities, and 11 editions by offering clear, concise narrative into which assignments, including student activities from the accurate, aesthetically pleasing anatomic art has been PASSport to Success®. woven. We have made every effort to respond thoughtfully and thoroughly to reviewers’ and instructors’ comments, ■ Answers to “Questions for Study and Review” provide offering the ideal level of detail for students preparing for a responses to the quiz material found at the end of each career in the health professions and nursing and the peda- chapter in the textbook. gogic features that best support them. With the PASSport ■ Strategies for Effective Teaching provide sound, tried- to Success®, we have provided students with an integrated and-true advice for successful instruction. system for understanding and using their unique learning ■ WebCT/Blackboard/Angel Cartridge allows easy inte- styles—and ultimately succeeding in the course. We hope gration of the ancillary materials into learning manage- you will agree that the 12th edition of Memmler’s suits ment systems. your educational needs. MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd vviiii 1122//77//22001111 66::5588::4444 PPMM MMeemmmmlleerr''ss HHBBHHDD__FFMM..iinndddd vviiiiii 1122//77//22001111 66::5588::4444 PPMM