Cover
Advisement Page
Title Page
Contributors
Preface
1. Anatomy and Physiology
2. References
Acknowledgements
About the Editors
Prefixes, Suffixes
How to Use Your Textbook
1. Features Contained within Your Textbook
About the Companion Website
1 Basic Scientific Principles of Physiology
1. Introduction
2. Levels of Organisation
3. Characteristics of Life
4. Bodily Requirements
5. Life at the Chemical Level
6. Chemical Reactions and Chemical Bonds
7. Acids and Bases
8. Representing Chemical Reactions in Written Form: Chemical Equations
9. Organic Molecules
10. Homeostasis
11. Units of Measurement
12. Conclusion
13. Glossary
14. References
15. Activities
2 Cells, Cellular Compartments, Transport Systems, Fluid Movement Between Compartments
1. Introduction
2. Inside the Cell
3. Structure of the Cell Membrane
4. Transport of Substances Across the Cell Membrane
5. How Do Cells Communicate?
6. Fluid Compartments in the Body
7. The Composition of Body Fluids
8. Electrolyte and Water Balance
9. Fluid Movement Between Compartments
10. Bulk Transport Across the Cell Membrane
11. Conclusion
12. Glossary
13. References
14. Further Reading
15. Activities
16. Chemical Symbols
17. Conditions
3 Genetics
1. Anatomical Map
2. Introduction
3. Deoxyribonucleic Acid (DNA) and Ribonucleic Acid (RNA)
4. The DNA Double Helix
5. Chromosomes
6. From DNA to Proteins
7. Summary of Relationship Between DNA, RNA and Protein
8. The Transference of Genes
9. Inheritance
10. Spontaneous Mutation
11. Disorders of Chromosomes
12. Conclusion
13. Glossary
14. References
15. Further Reading
16. Activities
17. Conditions
4 Tissue
1. Introduction
2. Epithelial Tissue
3. Connective Tissue
4. Membranes
5. Muscle Tissue
6. Nervous Tissue
7. Tissue Repair
8. Conclusion
9. Glossary
10. References
11. Activities
5 Embryology
1. Introduction
2. Final Maturation of the Oocyte and Sperm
3. Day One: Fertilisation
4. Days 2–5: Pre‐Implantation Development
5. Day 6: Implantation
6. Week 2: Early Placental Formation
7. Week 3–8: Post‐Implantation Embryonic Development
8. Late Gestation and Birth: Gestational Weeks 13–40 (Embryonic Weeks 11–38)
9. Complications of Pregnancy
10. Conclusion
11. Glossary
12. References
13. Further Reading
14. Activities
6 The Muscular System
1. Body Map
2. Introduction
3. Types of Muscle Tissue
4. Functions of the Muscular System
5. Composition of Skeletal Muscle Tissue
6. Gross Anatomy of Skeletal Muscles
7. Microanatomy of Skeletal Muscle Fibre
8. Skeletal Muscle Contraction and Relaxation
9. Energy Sources for Muscle Contraction
10. Aerobic Respiration
11. Organisation of the Skeletal Muscular System
12. The Effects of Ageing
13. Conclusion
14. Glossary
15. References
16. Further Reading
17. Activities
7 The Skeletal System
1. Body Map
2. Introduction
3. Bone as a Tissue
4. Other Connective Tissues Closely Associated with the Skeletal System
5. Bone Formation
6. Bone Growth
7. Bone Remodelling
8. Bone Fractures
9. The Axial and Appendicular Skeleton
10. Bone Shapes
11. Joints
12. Conclusion
13. Glossary
14. References
15. Further Reading
16. Activities
17. Match Each Bone to its Correct Shape
18. Find Out More
19. Conditions
8 The Circulatory System
1. Body Map
2. Introduction
3. Components of Blood
4. Properties of Blood
5. Plasma
6. Functions of Blood
7. Formation of Blood Cells
8. Red Blood Cells
9. White Blood Cells
10. Platelets
11. Haemostasis
12. Coagulation
13. Blood Groups
14. Blood Vessels
15. Blood Pressure
16. Lymphatic System
17. Lymphatic Organs
18. Conclusion
19. Glossary
20. References
21. Further Reading
22. Activities
23. Conditions
9 The Cardiac System
1. Body Map
2. Introduction
3. Size and Location of the Heart
4. The Structures of the Heart
5. The Blood Supply to the Heart
6. Blood Flow Through the Heart
7. The Electrical Pathways of the Heart
8. The Cardiac Cycle
9. Factors Affecting Cardiac Output
10. Regulation of Stroke Volume
11. Regulation of Heart Rate
12. Conclusion
13. Glossary
14. References
15. Further Reading
16. Activities
17. Conditions
10 The Digestive System
1. Body Map
2. Introduction
3. The Activity of the Digestive System
4. The Organisation of the Digestive System
5. The Digestive System Organs
6. The Structure of the Digestive System
7. The Liver and Production of Bile
8. The Gallbladder
9. The Large Intestine
10. Digestive Tract Hormones
11. Nutrition, Chemical Digestion and Metabolism
12. Conclusion
13. Glossary
14. References
15. Further Reading
16. Activities
17. Conditions
11 The Renal System
1. Body Map
2. Introduction
3. Renal System
4. Functions of the Kidney
5. Blood Supply of the Kidney
6. Urine Formation
7. Selective Reabsorption
8. Hormonal Control of Tubular Reabsorption and Secretion
9. Composition of Urine
10. Ureters
11. Urinary Bladder
12. Urethra
13. Micturition
14. Conclusion
15. Glossary
16. References
17. Further Reading
18. Activities
19. Conditions
12 The Respiratory System
1. Body Map
2. Introduction
3. Organisation of the Respiratory System
4. The Upper Respiratory Tract
5. The Lower Respiratory Tract
6. Blood Supply
7. Respiration
8. Pulmonary Ventilation
9. Work of Breathing
10. Volumes and Capacities
11. Control of Breathing
12. External Respiration
13. Ventilation and Perfusion
14. Transport of Gases
15. Acid–Base Balance
16. Internal Respiration
17. Conclusion
18. Glossary
19. References
20. Further Reading
21. Activities
13 The Reproductive Systems
1. Body Map
2. Introduction
3. The Male Reproductive System
4. The Female Reproductive System
5. Conclusion
6. Glossary
7. References
8. Further Reading
9. Activities
10. Find Out More
11. Conditions
14 The Nervous System
1. Body Map
2. Introduction
3. Organisation of the Nervous System
4. Sensory Division of the Peripheral Nervous System
5. Central Nervous System
6. Motor Division of the Peripheral Nervous System
7. Neurotransmitters
8. Neuroglia
9. The Meninges
10. Cerebrospinal Fluid
11. The Brain
12. The Peripheral Nervous System
13. The Autonomic Nervous System
14. Conclusion
15. Glossary
16. References
17. Further Reading
18. Activities
15 The Senses
1. Introduction
2. The Chemical Senses
3. The Senses of Equilibrium and Hearing
4. The Sense of Sight
5. Conclusion
6. Glossary
7. References
8. Further Reading
9. Activities
16 The Endocrine System
1. Body Map
2. Introduction
3. The Endocrine Organs
4. Hormones
5. The Physiology of the Endocrine Organs
6. The Thyroid Gland
7. Glossary
8. References
9. Further Reading
10. Activities
17 The Immune System
1. Body Map
2. Introduction
3. Blood Cell Development
4. Organs of the Immune System
5. The Lymphatic System
6. Lymphoid Tissue
7. Types of Immunity
8. The Innate Immune System
9. Blood Cells
10. The Acquired Immune System
11. Immunoglobulins (Antibodies)
12. Natural Killer Cells
13. Primary and Secondary Response to Infection
14. Hypersensitivity
15. Anaphylaxis
16. Immunisations
17. Conclusion
18. Glossary
19. References
20. Further Reading
21. Activities
22. Conditions
18 The Skin
1. Body Map
2. Introduction
3. The Structure of Skin
4. The Epidermis
5. Layers of the Epidermis
6. The Dermis
7. The Papillary and Reticular Aspects
8. The Accessory Skin Structures
9. The Functions of the Skin
10. Synthesis of Vitamin D
11. Conclusion
12. Glossary
13. References
14. Further Reading
15. Activities
Normal Values
1. Haematology
2. White Cell Differential
3. Erythrocyte Sedimentation Rate
4. Coagulation Screen
5. Haematinics
6. Haemoglobin Electrophoresis
7. Chemistry
8. Urine
9. Lipids and Lipoproteins
10. Blood Gases (Breathing Air At Sea Level)
11. Carboxyhaemoglobin
12. Immunology/Rheumatology
13. Serum Immunoglobulins
14. Cerebrospinal Fluid
15. Urine
16. Faeces
Answers
1. Chapter 1 Basic Scientific Principles of Physiology
2. Chapter 2 Cells, Cellular Compartments, Transport Systems, Fluid Movement Between Compartments
3. Chapter 3 Genetics
4. Chapter 4 Tissue
5. Chapter 5 Embryology
6. Chapter 6 The Muscular System
7. Chapter 7 The Skeletal System
8. Chapter 8 The Circulatory System
9. Chapter 9 The Cardiac System
10. Chapter 10 The Digestive System
11. Chapter 11 The Renal System
12. Chapter 12 The Respiratory System
13. Chapter 13 The Reproductive Systems
14. Chapter 14 The Nervous System
15. Chapter 15 The Senses
16. Chapter 16 The Endocrine System
17. Chapter 17 The Immune System
18. Chapter 18 The Skin
Index
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List of Tables

Chapter 1
1. Table 1.1 The fundamental SI units.
2. Table 1.2 Other common SI units.
3. Table 1.3 Multiples of SI units.
4. Table 1.4 Measures of weight.
5. Table 1.5 Measures of volume.
6. Table 1.6 Measures of length.
7. Table 1.7 Measures of energy.
Chapter 2
1. Table 2.1 Important points of comparison between the ionic composition of intrace...
2. Table 2.2 Principal electrolytes and their functions.
3. Table 2.3 Homeostatic control mechanisms for the major body fluid ions and water.
Chapter 4
1. Table 4.1 The major primary blast cells and their connective tissue type.
2. Table 4.2 Types of connective tissue proper, their main constituents, functions a...
Chapter 5
1. Table 5.1 Pharmacological methods of pain relief during labour.
Chapter 6
1. Table 6.1 Different types of muscle tissue.
2. Table 6.2 Cellular components of a muscle fibre.
3. Table 6.3 Muscle names.
4. Table 6.4 Muscles of the head and neck.
5. Table 6.5 Muscles of the upper limbs (shoulder, arm and hand).
6. Table 6.6 Muscles of the trunk (thorax and abdomen).
7. Table 6.7 Muscles of the lower limbs (hip, pelvis/thigh and leg).
8. Table 6.8 Types of muscle movement.
Chapter 7
1. Table 7.1 Factors affecting bone density.
2. Table 7.2 The bones of the axial skeleton.
3. Table 7.3 The bones of the appendicular skeleton.
4. Table 7.4 Six types of joint.
Chapter 8
1. Table 8.1 Compositions of plasma and their functions.
2. Table 8.2 Blood clotting factors.
3. Table 8.3 Blood groups.
4. Table 8.4 Differences between arteries and veins.
Chapter 9
1. Table 9.1 Names of the coronary arteries, their major branches and the areas of t...
Chapter 10
1. Table 10.1 Summary of the role of the digestive system hormones.
2. Table 10.2 Vitamins summary.
3. Table 10.3 Minerals summary.
Chapter 11
1. Table 11.1 Summary of the functions of the kidneys.
2. Table 11.2 Summary of filtration, reabsorption and excretion in the nephron and c...
3. Table 11.3 Colours of urine.
Chapter 12
1. Table 12.1 Summary of important gas laws.
2. Table 12.2 The proportion of gases that constitute the atmosphere (partial pressu...
3. Table 12.3 Important lung volumes.
4. Table 12.4 Definitions of important gas transport terminology.
5. Table 12.5 The major types of hypoxia and their causes.
Chapter 13
1. Table 13.1 The layers of the uterus.
Chapter 14
1. Table 14.1 The cranial nerves.
2. Table 14.2 Effects of the parasympathetic and sympathetic divisions of the autono...
Chapter 16
1. Table 16.1 Nervous system versus endocrine system.
2. Table 16.2 Hormones released by the hypothalamus and the anterior pituitary gland...
Chapter 17
1. Table 17.1 Summary of blood cells and their roles within the immune system.
2. Table 17.2 Types of hypersensitivity disorders.
Chapter 18
1. Table 18.1 The layers of the epidermis.

List of Illustrations

Chapter 1
1. Figure 1.1 Levels of organisation of the body.
2. Figure 1.2 Schematic diagram of an atom.
3. Figure 1.3 The structure of some biologically important atoms.
4. Figure 1.4a The single electron in the outer shell of the sodium atom can be...
5. Figure 1.4b A chlorine atom needs only one electron to complete its outer sh...
6. Figure 1.4c The ionic bonding between a sodium and a chloride ion results in...
7. Figure 1.5 (a–e) Some covalently bonded substances, showing the sharing of e...
8. Figure 1.6 Water, a polar molecule, with its positive and negative poles sho...
9. Figure 1.7 Hydrogen bonds and water. The weak bonds between the hydrogen of ...
10. Figure 1.8 The pH scale.
11. Figure 1.9 The pH of some common household substances and some body fluids....
12. Figure 1.10 Pictorial depiction of the reaction between two hydrogen molecul...
13. Figure 1.11 The fatty acids palmitic acid and oleic acid, indicating the gen...
14. Figure 1.12 Triglyceride molecule.
15. Figure 1.13 Phospholipid molecule. This molecule has a ‘head’, where the pho...
Chapter 2
1. Figure 2.1 Examples of some cells of the human body.
2. Figure 2.2 Structure of a cell.
3. Figure 2.3 Cell membrane.
4. Figure 2.4 Diffusion in a fluid. At the beginning of our experiment, a cryst...
5. Figure 2.5 Simple diffusion.
6. Figure 2.6 (a–c) Osmotic effects of the concentration of a solution on a red...
7. Figure 2.7 Passive transport mechanisms.
8. Figure 2.8 The Na+/K+ pump.
9. Figure 2.9 Body fluid compartments.
10. Figure 2.10 Capillary hydrostatic and osmotic pressures.
11. Figure 2.11 Phagocytosis and pinocytosis.
12. Figure 2.12 Exocytosis. Proteins, lipids and other products produced in the ...
Chapter 3
1. Figure 3.1 (a–c) The cell nucleus.
2. Figure 3.2 A pictorial representation of a portion of the double helix.T...
3. Figure 3.3 DNA from double helix to chromosome.The combination of DNA an...
4. Figure 3.4 The chromosomes of a human male – a karyotype. Chromosomes only t...
5. Figure 3.5 The separation of DNA for transcription. A small segment of DNA c...
6. Figure 3.6 (a, b) Translation begins with the mRNA associating with the smal...
7. Figure 3.7 Summary of the movement of the ribosome along mRNA.
8. Figure 3.8 DNA replication. To make additional chromosomes to distribute to ...
9. Figure 3.9 The cell cycle.Note the indicated timing of each stage is a g...
10. Figure 3.10 The stages of the somatic cell cycle. Somatic cells are all the ...
11. Figure 3.11 Gene crossover (recombination). During meiosis I homologous chro...
12. Figure 3.12 Mendel’s laws of genetic inheritance. The two diagrams show the ...
13. Figure 3.13 Punnet squares are used to assess risk of offspring having a par...
14. Figure 3.14 Mendelian inheritance in human pedigrees. (a) Pedigree conventio...
15. Figure 3.15 Determination of gender in offspring.
16. Figure 3.16 X‐linked inheritance.
Chapter 4
1. Figure 4.1 Epithelial tissue is classified by shape and depth.
2. Figure 4.2 (a–c) Simple squamous epithelium forms the endothelial layer of b...
3. Figure 4.3 Simple cuboid epithelium forms part of the secretory portion of t...
4. Figure 4.4 Ciliated simple columnar epithelium lines the Fallopian tubes....
5. Figure 4.5 Non‐ciliated columnar epithelium lines the digestive tract.
6. Figure 4.6 Pseudostratified ciliated columnar epithelium lines the trachea....
7. Figure 4.7 Non‐keratinised stratified squamous epithelial tissue lines the v...
8. Figure 4.8 Cuboidal epithelial tissue is found in the oesophagus.
9. Figure 4.9 Transitional epithelium lines the bladder and allows for distensi...
10. Figure 4.10 Exocrine glands classified by shape, with examples of location....
11. Figure 4.11 Connective tissue reinforces epithelial tissue.
12. Figure 4.12 Constituents of connective tissue.
13. Figure 4.13 Where cartilage is found within the body.
14. Figure 4.14 Synovial membranes fill joint cavities.
15. Figure 4.15 The major muscle types with examples of their location: (a) skel...
16. Figure 4.16 An example of nervous tissue.
Chapter 5
1. Figure 5.1 The early embryo develops from a simple group of cells into compl...
2. Figure 5.2 Hormones of the menstrual cycle.
3. Figure 5.3 Sperm approaching the ovum.
4. Figure 5.4 (a) and (b): Spermatozoon passing through cumulus cells and meetin...
5. Figure 5.5 The continuation of meiosis II and a zygote becoming a morula and...
6. Figure 5.6 Implantation.
7. Figure 5.7 The placenta.
8. Figure 5.8 Gastrulation.
9. Figure 5.9 The fate of the three germ layers.
10. Figure 5.10 Neurulation.
11. Figure 5.11 Fourth week embryo: lateral aspect of the fourth week embryo wit...
12. Figure 5.12 Embryonic and foetal periods: The scale, in weeks, shows how ges...
13. Figure 5.13 The essential features of Down syndrome.
14. Figure 5.14 Antenatal screening: nuchal translucency describes the space bet...
Chapter 6
1. Figure 6.1 Gross anatomy of a skeletal muscle.
2. Figure 6.2 Diagram showing a skeletal muscle fibre.
3. Figure 6.3 Motor unit.
4. Figure 6.4 Summary of muscle contraction and relaxation.
5. Figure 6.5 (a–c) Sources of ATP for muscle energy.
6. Figure 6.6 (a, b) Head and neck muscles.
7. Figure 6.7 (a–g) Muscles of the upper limbs (shoulder, arm and hand)....
8. Figure 6.8 Trunk (thorax and abdomen).
9. Figure 6.9 (a–f) Muscles of the lower limbs (hip, pelvis/thigh and leg)....
10. Figure 6.10 Anterior view of the major muscles of the body.
11. Figure 6.11 Posterior view of the major muscles of the body.
Chapter 7
1. Figure 7.1 Compact and spongy bone, and their blood supply.
2. Figure 7.2 Endochondral ossification of the tibia.
3. Figure 7.3 Long bones grow in length from the cartilaginous epiphyseal plate...
4. Figure 7.4 Bones increase in width but maintain the same proportion of compa...
5. Figure 7.5 The stages of fracture healing in bone.
6. Figure 7.6 The human skeleton (a) anterior view, (b) posterior view. Axial s...
7. Figure 7.7 Parts of a long bone.
8. Figure 7.8 The tarsal bones – short bones.
9. Figure 7.9 Examples of flat bones: in (a) the sternum and in (b) the scapula...
10. Figure 7.10 (a, b) The vertebrae – irregular bones.
11. Figure 7.11 A sesamoid bone, the patella – shown in lateral view, in the ten...
Chapter 8
1. Figure 8.1 Components of blood.
2. Figure 8.2 Cells of the blood.
3. Figure 8.3 Formed elements of blood.
4. Figure 8.4 Red blood cells.
5. Figure 8.5 Haemoglobin molecule.
6. Figure 8.6 Negative feedback for erythropoiesis.
7. Figure 8.7 Destruction of the red blood cell.
8. Figure 8.8 Neutrophil.
9. Figure 8.9 Eosinophil.
10. Figure 8.10 Basophil.
11. Figure 8.11 Monocytes.
12. Figure 8.12 Lymphocyte.
13. Figure 8.13 ABO blood groups.
14. Figure 8.14 Blood vessels.
15. Figure 8.15 (a–e) Layers of a blood vessel.
16. Figure 8.16 Artery and vein.
17. Figure 8.17 Capillary.
18. Figure 8.18 Lymphatic system.
19. Figure 8.19 Lymphatic capillaries.
20. Figure 8.20 Lymphatic circulation.
21. Figure 8.21 A lymph node.
Chapter 9
1. Figure 9.1 Location of the heart.
2. Figure 9.2 Heart wall.
3. Figure 9.3 Cardiac muscle cells (cardiac myocytes).
4. Figure 9.4 Cardiac action potential.
5. Figure 9.5 The chambers of the heart.
6. Figure 9.6 Auscultation sites for heart sounds.
7. Figure 9.7 Coronary arteries.
8. Figure 9.8 Cardiac catheterisation.
9. Figure 9.9 Percutaneous coronary intervention.
10. Figure 9.10 A simplified diagram of the flow of blood though the heart.
11. Figure 9.11 Anatomical view of the blood flow through the heart.
12. Figure 9.12 Conduction system of the heart.
13. Figure 9.13 Normal electrical conduction.
14. Figure 9.14 Pacemaker.
15. Figure 9.15 Chest lead placement for a 12‐lead ECG.
16. Figure 9.16 The cardiac cycle.
17. Figure 9.17 Normal ECG of one cycle of the heart.
18. Figure 9.18 Baroreceptor reflex.
Chapter 10
1. Figure 10.1 The digestive system.
2. Figure 10.2 The oral cavity.
3. Figure 10.3 (a, b) Teeth.
4. Figure 10.4 Salivary glands.
5. Figure 10.5 (a, b) Swallowing.
6. Figure 10.6 Peristalsis in the oesophagus.
7. Figure 10.7 Structure of the digestive tract.
8. Figure 10.8 The stomach.
9. Figure 10.9 Gastric glands and cells.
10. Figure 10.10 Phases of gastric juice secretion.
11. Figure 10.11 The small intestine.
12. Figure 10.12 The cells within the villi of the small intestine.
13. Figure 10.13 The liver, gallbladder and pancreas.
14. Figure 10.14 Liver lobule.
15. Figure 10.15 The large intestine.
16. Figure 10.16 The food pyramid.
Chapter 11
1. Figure 11.1 Organs of the renal system.
2. Figure 11.2 External layers of the kidney.
3. Figure 11.3 (a, b) Internal structures showing blood vessels.
4. Figure 11.4 Internal structures.
5. Figure 11.5 Nephron.
6. Figure 11.6 Bowman’s capsule.
7. Figure 11.7 Nephron with capillaries.
8. Figure 11.8 Common iliac vessels and ureter.
9. Figure 11.9 Layers of the urinary bladder.
10. Figure 11.10 Male urethra.
11. Figure 11.11 Location of female urethra.
Chapter 12
1. Figure 12.1 Major structures of the upper and lower respiratory tract.
2. Figure 12.2 Structures of the upper respiratory tract.
3. Figure 12.3 Gross anatomy of the lower respiratory tract.
4. Figure 12.4 Anatomy of the larynx.
5. Figure 12.5 The bronchial tree.
6. Figure 12.6 Microscopic anatomy of a lobule.
7. Figure 12.7 The flow of blood between the lungs, the heart and the body.
8. Figure 12.8 Boyle’s law: the volume of a gas varies inversely with its press...
9. Figure 12.9 The muscles involved in pulmonary ventilation.
10. Figure 12.10 Movements of inspiration and expiration.
11. Figure 12.11 Diagrammatic description of the major lung volumes and capaciti...
12. Figure 12.12 The respiratory centres of the brainstem.
13. Figure 12.13 External respiration: exchange of oxygen and carbon dioxide wit...
14. Figure 12.14 The oxyhaemoglobin dissociation curve: (a) at normal body tempe...
15. Figure 12.15 (a, b) External and internal respiration: oxygen and carbon dio...
Chapter 13
1. Figure 13.1 The male reproductive system.
2. Figure 13.2 The scrotum and testes.
3. Figure 13.3 A testicle demonstrating seminiferous tubules.
4. Figure 13.4 Stages of spermatogenesis.
5. Figure 13.5 Components of a sperm.
6. Figure 13.6 The anatomy of the penis.
7. Figure 13.7 Negative feedback system associated with the control of testoste...
8. Figure 13.8 The female reproductive system.
9. Figure 13.9 Oogenesis.
10. Figure 13.10 (a–f) The developmental sequences associated with maturation of...
11. Figure 13.11 The uterus and associated structures.
12. Figure 13.12 An IUD device in situ.
13. Figure 13.13 The breast.
14. Figure 13.14 The ovarian and uterine cycles.
Chapter 14
1. Figure 14.1 Organisation of the nervous system.
2. Figure 14.2 Motor neurone.
3. Figure 14.3 Action potential.
4. Figure 14.4 Neuroglia.
5. Figure 14.5 The meninges.
6. Figure 14.6 The ventricles (right lateral view of the brain).
7. Figure 14.7 Circle of Willis.
8. Figure 14.8 The structures of the brain.
9. Figure 14.9 Right cerebral hemisphere.
10. Figure 14.10 Functions of cranial nerves.
11. Figure 14.11 The spinal cord.
12. Figure 14.12 The spinal cord and spinal nerves.
13. Figure 14.13 The spinal nerves and their areas of innervations.
14. Figure 14.14 A typical spinal nerve (CNS: central nervous system).
15. Figure 14.15 Sympathetic nervous system.
16. Figure 14.16 Parasympathetic nervous system.
Chapter 15
1. Figure 15.1 (a, b) Gross and microscopic anatomy of olfaction.
2. Figure 15.2 Olfactory pathway.
3. Figure 15.3 Tongue and the location of the papillae.
4. Figure 15.4 Cross‐section of part of the tongue and microscopic view of a ta...
5. Figure 15.5 Structure of the ear.
6. Figure 15.6 Inner ear.
7. Figure 15.7 (a, b) Ampulla at rest and in response to movement.
8. Figure 15.8 Hair cells and otolith.
9. Figure 15.9 Action of gravity on the otolith.
10. Figure 15.10 Cross‐section of the cochlea (highlighted section is shown in d...
11. Figure 15.11 Cochlea showing the continuous nature of the vestibular and tym...
12. Figure 15.12 Organ of Corti.
13. Figure 15.13 Accessory structures of the eye.
14. Figure 15.14 Anatomy of the eye.
15. Figure 15.15 Cross‐section of the retina.
16. Figure 15.16 Refraction of light passing from air (less dense) to water (den...
17. Figure 15.17 Focal length.
18. Figure 15.18 Accommodation to (a) far and (b) near objects.
19. Figure 15.19 (a) Myopic eye uncorrected and (b) corrected by a concave lens....
20. Figure 15.20 (a) Hyperopic eye uncorrected and (b) corrected by a convex len...
21. Figure 15.21 Snellen chart.
Chapter 16
1. Figure 16.1 Location of the endocrine organs.
2. Figure 16.2 Transportation of hormones in the blood.
3. Figure 16.3 Endocrine, paracrine and autocrine.
4. Figure 16.4 Target cell and non‐target cell.
5. Figure 16.5 The negative feedback system.
6. Figure 16.6 The hypothalamus and pituitary gland.
7. Figure 16.7 (a, b) Position of the thyroid gland and parathyroid glands.
8. Figure 16.8 Negative feedback control of thyroid hormone production.
9. Figure 16.9 Position of the adrenal glands.
10. Figure 16.10 Figure 16.10 Cross‐section of an adrenal gland.
11. Figure 16.11 Cross‐section of the adrenal cortex.
12. Figure 16.12 Control of aldosterone secretion.
13. Figure 16.13 Response of the endocrine system to stress.
14. Figure 16.14 Effects of insulin and glucagon on blood glucose concentrations...
Chapter 17
1. Figure 17.1 The development of blood cells.
2. Figure 17.2 Position of the thymus within the body.
3. Figure 17.3 Principal components of the lymphatic system.
4. Figure 17.4 Structure of a lymph node.
5. Figure 17.5 Phagocytosis (stage 1).
6. Figure 17.6 Phagocytosis (stage 2).
7. Figure 17.7 Phagocytosis (stage 3).
8. Figure 17.8 Phagocytes migrate from blood to the site of tissue injury.
9. Figure 17.9 Development and types of T‐cell lymphocytes.
10. Figure 17.10 Cellular and humoral immune responses.
11. Figure 17.11 (a–c) Process of teaching T‐cells and B‐cells to recognise path...
12. Figure 17.12 (a, b) Model of an antibody (IgG).
13. Figure 17.13 Model of an antigen showing the epitopes (receptors).
14. Figure 17.14 Antibody responses to an infection.
Chapter 18
1. Figure 18.1 (a–d) The types of cells in the epidermis.
2. Figure 18.2 A microscopic perspective of the skin with the various strata....
3. Figure 18.3 Three layers of skin: the epidermis, the dermis and subcutaneous...
4. Figure 18.4 A pilosebaceous unit.
5. Figure 18.5 A sweat gland.
6. Figure 18.6 The nail.

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Edition History [2e, 2016]

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Library of Congress Cataloging‐in‐Publication Data

Title: Fundamentals of anatomy and physiology for nursing and healthcare students / edited by Ian Peate, Suzanne Evans.
Description: Third edition. | Hoboken, NJ : Wiley‐Blackwell, 2020. | Includes bibliographical references and index. | Summary: “The third edition of Fundamentals of Anatomy and Physiology is a concise yet comprehensive introduction to the structure and function of the human body. Written with the needs of nursing and healthcare students in mind, this bestselling textbook incorporates clinical examples and scenarios throughout to illustrate how the topics covered are applied in daily practice. Hundreds of full‐colour illustrations complement numerous case studies encompassing all fields of nursing practice, alongside learning outcomes, self‐assessment tests, chapter summaries, and other effective learning tools”– Provided by publisher.
Identifiers: LCCN 2020017960 (print) | LCCN 2020017961 (ebook) | ISBN 9781119576488 (paperback) | ISBN 9781119576495 (adobe pdf) | ISBN 9781119576518 (epub)
Subjects: MESH: Anatomy | Physiological Phenomena
Classification: LCC QP34.5 (print) | LCC QP34.5 (ebook) | NLM QS 4 | DDC 612–dc23
LC record available at https://lccn.loc.gov/2020017960
LC ebook record available at https://lccn.loc.gov/2020017961

Cover Design: Wiley
Cover Image: © SCIEPRO/Getty Images

Contributors

Carl Clare
RN, DipN, BSc (Hons), MSc (Lond), PGDE (Lond)
Carl began his nursing a career in 1990 as a Nursing Auxiliary. He later undertook three years student nurse training at Selly Oak Hospital (Birmingham), moving to The Royal Devon and Exeter Hospitals, then Northwick Park Hospital, and finally The Royal Brompton and Harefield NHS Trust as a Resuscitation Officer and Honorary Teaching Fellow of Imperial College (London). Since 2006 he has worked at the University of Hertfordshire as a Senior Lecturer in Adult Nursing. His key areas of interest are long term illness, physiology, sociology, and cardiac care. Carl has previously published work in cardiac care, resuscitation and pathophysiology.

Suzanne Evans
PhD
Suzanne gained her PhD in neuroscience at the University of Wales in 1989 and has been researching and teaching in universities in the UK, USA, the Caribbean, New Zealand and Australia ever since, receiving numerous teaching awards along the way. She has taught human physiology, pathophysiology and pharmacology at undergraduate and postgraduate level for many years and her special interest is teaching and assessing these subjects in health professional degrees.

Noleen Jones
RN, RNT, Adv. Dip Leadership and Management, BSc (Nursing), FHEA
Noleen’s background in nursing is mainly in critical care, where she worked first as a staff nurse, and then as ward manager for a total of 26 years. A subsequent move into practice development identified an interest and aptitude for nursing, health and social care education. Noleen is currently teaching on the Gibraltar BSc (Hons) Adult, BSc (Hons) Mental Health and DipHE nursing programmes.

Jacinta Hope Martin
PhD B. Biotechnology (Honours Class I)
Jacinta’s research career began in 2015 following her completion of a Bachelor of Biotechnology Honours program which she followed up with a Doctor of Philosophy (completed in 2019) at the University of Newcastle Australia. She later undertook a role as a research associate at the Hunter Medical Research Institute (also in Newcastle) and has since to McGill University as a Post‐Doctoral Research scholar in Montreal, Canada. Jacinta’s research interests surround oocyte and embryo development, fertilization, pathophysiological pregnancies and DNA quality.

Karen Mate
BSc (Hons), PhD
Karen started her professional career as a researcher in the area of reproductive physiology; focused on gamete formation, fertilisation, development of assisted reproductive technologies and contraceptive tools for Australian marsupials. After taking a break to spend time with her young family, Karen returned to work as a teaching‐focused academic with a research interest in primary care of older adults, dementia and quality use of medicines. Over the past 10 years she has taught human physiology, genetics and biochemistry to a wide range of students in the health professions, including nursing, medicine, pharmacy, physiotherapy, nutrition and dietetics, speech pathology and podiatry.

Louise Mcerlean
RGN, BSc (Hons), MA (Herts)
Louise commenced her nursing career in Glasgow in 1986 and specialised in intensive care nursing. She worked as a Staff Nurse in intensive care and then as a Sister in London. A move to nurse education followed in 2005. Louise has focused on adult nursing and the nursing associate programme and her interests include physiology, clinical skills, simulation and nurse education.

Janet G. Migliozzi
RGN, BSc (Hons), MSc (London), PGDEd., PGCMed.Sim, FHEA, OMS
Janet completed her initial training in London and commenced her career in 1988. She has worked at a variety of hospitals across London, predominately in vascular, orthopaedic and high dependency surgery before specialising in infection prevention and control and communicable disease. Janet has worked in higher education since 1999 and is involved in teaching across a range of healthcare professions programmes both at an undergraduate and post graduate level. She is also involved in the research supervision of students undertaking advanced clinical practice pathways. Her key interests include clinical microbiology, particularly in relation to healthcare associated infections, global communicable disease and public health. Patient safety at a local and global level are also an area of interest. Janet has published in journals and books in areas including immunology, minimising risk in relation to healthcare associated infection and pathophysiology.

Karen Nagalingam
Senior Nurse Lecturer, RN, MSc (Ed), BA (Hons), Pg cert.
Karen qualified as a nurse in 2000 from Sheffield Hallam University. She went on to specialise in renal nursing with experience in inpatients, outpatients, dialysis, transplantation and acute kidney injury. In 2007 she became an Acute Dialysis Nurse Practitioner which involved implementing new innovations, developing the acute kidney injury service as well as managing acutely ill adults.
Karen currently works at the University of Hertfordshire as a Senior Lecturer where she leads modules at undergraduate and post graduate levels relating to the acutely ill adult. Her interests are acute kidney injury, sepsis and simulation. She also has works clinically as an Acute Kidney Injury Nurse Specialist and undertakes acute dialysis. She has published work in various journals and has presented at several conferences.

Jessie Maree Sutherland
PhD (Biological Science), B. Science (Biology Major) Hons Class I
The Sutherland lab research programme incorporates the dissection of the molecular pathways responsible for egg and ovary development in the context of improving the diagnosis of female infertility. Jessie has a strong background in reproduction and fertility, with expertise spanning across the areas of ovarian and testis biology, reproductive toxicology, sexual health, and developmental biology. Jessie’s impact in her field has been recognised with the award of a prestigious NHMRC Peter Doherty Biomedical Research Fellowship and the David Healey Award by the Australasian Society of Reproductive Biology. Jessie has an exceptional record in obtaining competitive funding, with more than $1m awarded as a principal investigator since the award of her PhD in 2015. The influence of her research is further recognised through an impressive 30 peer‐reviewed publications in esteemed multidisciplinary journals.

Jude Weidenhofer
PhD
Jude begun her career as a laboratory‐based medical researcher focusing on understanding the biology of cancer following the completion of her PhD investigating the cellular biology of schizophrenia in 2006. Jude’s enthusiasm for education lead her to include the teaching of genetics, biochemistry and cellular biology for undergraduate and post‐graduate students alongside her research activities. Since 2014, Jude has focused on the education of nursing and other health professional students in fundamental physiology and biology. Jude has published research findings in both scholarly and laboratory research and is dedicated to improving university education.

Anthony Wheeldon
MSc (Lond), PGDE, BSc(Hons), DipHE, RN
Anthony began his nursing career at Barnet College of Nursing and Midwifery. After qualification in 1995, he worked as a staff nurse and senior staff nurse in the Respiratory Directorate at the Royal Brompton and Harefield NHS Trust in London. In 2000, he started teaching on post‐registration cardio‐respiratory courses before moving into full‐time nurse education at Thames Valley University in 2002. Anthony has a wide range of nursing interests including cardio‐respiratory nursing, anatomy and physiology, respiratory assessment, nurse education and the application of bioscience in nursing practice. In 2006, Anthony joined the University of Hertfordshire where he has taught on both pre and post registration nursing courses. He is currently an Associate Subject Group Lead for Adult Nursing.

Preface

Being asked to write a third edition of the well‐received Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students is an honour. The second edition of the text has received approval by the student community and academics preparing students from the fields of nursing and other healthcare arenas for their careers as healthcare providers.

The third edition of Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students has retained many of the attributes in the popular second edition as well as a whole range of new features in this book and also through the companion websites.

For this third edition, those contributing to the text have come from the UK and Australia and are all committed to the provision of high‐quality, safe and effective care to a range of communities. The authors are all experienced academics working in higher education, with many years of clinical and educational experience, knowledge and skills, teaching a variety of multidisciplinary student groups at various academic levels. After you have gained a sound understanding of anatomy and physiology we are positive that you will be able to understand better the needs of those people who you have the privilege to offer care to. The provision of high‐quality, safe and effective care for all is what each one of us should be striving to provide; however, this will be challenging if we do not fully understand and acknowledge the person in a holistic manner. Those who offer people care and support have to take into consideration the anatomical and physiological elements; they must also, however, take into consideration the psychosocial aspects of the person and their family, addressing the needs of the whole being, the whole person and where appropriate the whole community. We have devised this text in such a way as to encourage learning, understanding and integration. As with previous editions of the text, we hope that you enjoy reading it, and importantly that you are keen to learn more, that you will be interested in delving deeper as you grow and develop into becoming a provider of healthcare that is world class, safe and effective.

We have learnt much from our readers as we have adapted this new edition. We have listened to their comments and responded by making changes and retained those features that are most popular.

The companion to this book, Fundamentals of Applied Pathophysiology: An Essential Guide for Nursing and Healthcare Students (Peate, 2017a), also in its third edition, along with the Fundamentals of Anatomy and Physiology Workbook: A Study Guide for Nursing and Healthcare Students (Peate 2017b) will help in your development and understanding. Within any programme of study that is related to the provision of care, it is important that you are confident and competent with regards to pathophysiology and anatomy and physiology. It is not enough that you remember all of the facts (of which there are many) that are related to anatomy and physiology; you must also relate these to the people you offer care and support to. Some of those people may be vulnerable and they may be at risk of harm, and it is your responsibility to ensure that you are well informed and that you appreciate the complexities of care provision. This new edition of Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students can help you.

It is a requirement of several programmes of study that lead to registration with a professional body that you demonstrate competence and proficiency in a number of areas, and this includes anatomy and physiology.

The human body is as beautiful on the inside as it is on the outside; when synchronised, the mind and body is an astonishing mechanism that has the amazing ability to perform a multitude of astonishingly complex things. Healthcare students practise and study in a variety of healthcare settings, in the hospital and the primary‐care setting/pre‐hospital care setting and in a person’s own home where they are certain to meet and care for people who will have a variety of anatomical and physiological problems. By using a fundamental approach with a sound anatomical and physiological understanding, this has the potential to help the healthcare student grow in confidence and competence.

Anatomy and Physiology

In its simplest form, anatomy can be defined as the science related to the study of the structure of biological organisms; there are dictionaries that use such a definition. Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students focuses on human anatomy, and the definition of anatomy for the purposes of this text is that it is a study of the structure of the human body. This acknowledges function and also structure; in all biological organisms, structure and function are closely interrelated. The human body will only perform effectively through interrelated systems.

The term anatomy is Greek in origin, meaning ‘to cut up’ or ‘to dissect’. The first scientifically based anatomical studies (attributed to Vesalius, the sixteenth‐century Flemish anatomist, doctor and artist) were based on observations of cadavers (dead bodies). More up to date approaches to human anatomy differ, however, as they include other ways of observation; such as the use of a microscope and other complex and technologically advanced imaging tools. Subdivisions are now associated within the broader field of anatomy, with the word anatomy often preceded with an adjective identifying the method of observation; for example, gross anatomy (the study of body parts that are visible to the naked eye, such as the heart or the bones) or microanatomy (where body parts such as cells or tissues are only visible with the use of a microscope).

Living systems can be defined from a number of perspectives:

At the smallest of levels, the chemical level, atoms, molecules and the chemical bonds connecting atoms provide the structure on which living activity is grounded.
The cell is the smallest unit of life. Specialised bodies – organelles – within the cell undertake specific cellular functions. Cells can be specialised, such as bone cells and muscle cells. Tissue is a group of cells that are alike, performing a common function. Muscle tissue, for example, is made up of muscle cells.
Organs are groups of different types of tissues that work together to perform a specific activity. The stomach, is an organ that is made up of muscle, nerve and tissues.
A system is two or more organs working in unison to carry out a particular activity. The digestive system is an example, it comprises the coordinated activities of a number of organs, these include the stomach, intestines, pancreas and liver.
Another system having the characteristics of living things is an organism; this has the capacity to obtain and process energy, the ability to react to changes in the environment and the ability to reproduce.

Anatomy is associated with the function of a living organism and because of this it is almost always inseparable from physiology. Physiology can be described as the science that deals with the study of the function of cells, tissues, organs and organisms. Physiology is involved with how an organism carries out its various activities, considering how it moves, how it is nourished, how it adapts to environments that change – human and animal, hostile and friendly. It is in principle the study of life.

Physiology is the foundation upon which we build our knowledge of what life is; it can assist us in deciding how to treat disease as well as helping us to adapt and manage changes that are imposed on our bodies by new and changing surroundings – internal and external. Studying physiology can help in understanding disease (pathophysiology) arising from this; physiologists working with others are able to develop new ways to treat diseases.

There are a number of branches of anatomical study and so too are there a number of physiological branches that can be studied, such as endocrinology, neurology and cardiology.

There are now 18 chapters in this new edition, we have included a new chapter that focuses on embryology. It is not proposed that the text is to be read from cover to cover; however, you may find reading Chapters 1 to 5 first will help you get to grips with some of the more complex concepts; we would encourage you to dip in and out of the book. The chapters use simple and generously sized full‐colour artwork to assist you in your understanding and comprehension of the complexities that are associated with the human body from an anatomical and physiological perspective. There are several features contained within each chapter that will assist you to build upon and develop your knowledge base.

The text takes the reader from the microscopic to macroscopic level in the study of anatomy and physiology. The contents demonstrate the movement from cells and tissues through to systems. This approach to learning and teaching is a tried‐and‐tested approach, especially when helping a learner understand a topic area that may sometimes be seen as complex.

References

Peate, I. (2017a) Fundamentals of Applied Pathophysiology: An Essential Guide for Nursing and Healthcare Students, 3^rd edn. Oxford: John Wiley & Sons, Ltd.
Peate I. (2017b) Fundamentals of Anatomy and Physiology Workbook: A Study Guide for Nursing and Healthcare Students. Oxford: John Wiley & Sons, Ltd.

For Nursing and Healthcare Students

Anatomy and Physiology

References