Anatomy and physiology for the manual therapies

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Anatomy and physiology for the manual therapies

Andrew J. Kuntzman, Gerard J. Tortora

John Wiley & Sons, c2010

  • : hbk

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Includes index

Description and Table of Contents

Description

Anatomy & Physiology for the Manual Therapies 1e is designed to meet the specific needs of students preparing for careers in the manual therapies, such as massage therapy and careers as physical therapy assistants. This book provides the most appropriate depth of coverage for each body system -- in both narrative and visuals -- and by including relevant applications linking the content to situations they will face in their careers. Specially written applications with a focus on massage and physical therapy are included. An outstanding illustration program is also integrated to highlight important concepts and special diagrams are presented that point to origin, insertion, and innervation of muscles. This is crucial knowledge for massage therapists, physical therapists, and occupational therapists.

Table of Contents

1.ORGANIZATION OF THE HUMAN BODY 1 1.1 Anatomy and Physiolo Defined 2 1.2 Levels of Organization and Body Systems 2 1.3 Life Processes 6 1.4 Homeostasis: Maintain Limits 8 Control of Homeostasis: Feedback Systems 8 Homeostasis and Good Health 9 1.5 Aging and Homeostasis 12 1.6 Anatomical Terms 12 Names of Body Regions 12 Directional Terms 12 Exhibit 1.1 Directional Terms 14 Planes and Sections 16 1.7 Body Cavities 17 Abdominopelvic Regions and Quadrants 18 1.8 Medical Imaging 20 Key Medical Terms Associated with the Organization of the Human Body 24 MANUAL THERAPY APPLICATIONS Touch 7 Assessment 11 CLINICAL CONNECTIONS Diagnosis of Disease 11 Autopsy 20 Study Outline 24 Self-Quiz Questions 25 Critical Thinking Questions 27 Answers to Figure Questions 27 2 INTRODUCTORY CHEMISTRY 28 2.1 Introduction to Chemistry 29 Chemical Elements and Atoms 29 Ions, Molecules, and Compounds 30 Chemical Bonds 31 Chemical Reactions 34 2.2 Chemical Compounds and Life Processes 35 Inorganic Compounds 35 Organic Compounds 36 Carbohydrates 36 Lipids 38 Proteins 41 Nucleic Acids 43 Adenosine Triphosphate 43 MANU AL THERAPY APPLICATIONS Hydrotherapy 35 Anabolic Steroids: Performance-Enhancing Drugs 41 CLINICAL CONNECTIONS Antioxidants 31 Essential Fatty Acids 39 Lactose Intolerance 43 Study Outline 44 Self-Quiz Questions 45 Critical Thinking Questions 46 Answers to Figure Questions 46 3 CELLS 47 3.1 A Generalized View of the Cell 48 3.2 Plasma Membrane 49 3.3 Transport Across the Plasma Membrane 50 Passive Processes 51 Active Processes 54 3.4 Cytoplasm 57 Cytosol 57 Organelles 57 3.5 Nucleus 63 3.6 Gene Action: Protein Synthesis 64 Transcription 66 Translation 66 3.7 Somatic Cell Division 68 Interphase 68 Mitotic Phase 68 3.8 Cancer 70 Growth and Spread of Cancer 70 Causes of Cancer 70 Carcinogenesis: A Multistep Process 71 Treatment of Cancer 71 3.9 Aging and Cells 72 Key Medical Terms Associated with Cells 72 MANU AL THERAPY APPLICATION Massage of Cancer Patients 71 CLINICAL CONNECTIONS Smooth ER and Drug Tolerance 60 Mitochondrial Cytophathies 63 Study Outline 73 Self-Quiz Questions 75 Critical Thinking Questions 76 Answers to Figure Questions 76 4 TISSUES 77 4.1 Types of Tissues 78 4.2 Cell Junctions 78 4.3 Epithelial Tissue 79 General Features of Epithelial Tissue 80 Covering and Lining Epithelium 80 Glandular Epithelium 88 4.4 Connective Tissue 89 General Features of Connective Tissue 90 Connective Tissue Cells 90 Connective Tissue Extracellular Matrix 91 Classification of Connective Tissues 92 Types of Mature Connective Tissue 92 Connective Tissues: Diverse and Dynamic 100 4.5 Membranes 101 Mucous Membranes 101 Serous Membranes 101 Synovial Membranes 101 4.6 Musular Tissue 102 4.7 Nervous Tissue 104 4.8 Tissue Repair: Restoring Homeostasis 105 4.9 Aging and Tissues 106 Excess Adiposity 106 Key Medical Terms Associated with Tissues 106 MANUAL THERAPY APPLICATION How Massage Affects Connective Tissues 100 CLINICAL CONNECTIONS Pap Smear 82 Marfan Syndrome 91 Tissue Engineering 99 Adhesions 105 Study Outline 106 Self-Quiz Questions 108 Critical Thinking Questions 110 Answers to Figure Questions 110 5 THE INTEGUMENTARY SYSTEM 111 5.1 Structure of the Skin 112 Epidermis 113 Keratinization and Growth of the Epidermis 116 Dermis 116 Skin Color 117 5.2 Accessory Structures of the Skin 118 Hair 118 Skin Glands 121 Nails 122 5.3 Types of Skin 123 5.4 Functions of the Skin 124 5.5 Maintaining Homeostasis: Skin Wound Healing 125 Epidermal Wound Healing 125 Dermal Wound Healing 125 5.6 Skin Conditions Important to Therapists 127 Skin Cancer 127 Burns 128 Pressure Ulcers 129 5.7 Aging and the Integumentary System 130 Key Medical Terms Associated with the Integumentary System 130 Exhibit 5.1 The Integumentary System and Homeostasis 131 MANUAL THERAPY APPLICATIONS Physiological Effects of Massage 127 Assessing Skin Lesions 129 CLINICAL CONNECTIONS Skin Grafts 115 Skin and Mucous Membrane Color as a Diagnostic Clue 118 Study Outline 132 Self-Quiz Questions 133 Critical Thinking Questions 134 Answers to Figure Questions 134 6.BONE TISSUE 135 6.1 Functions of Bone and the Skeletal System 136 6.2 Structure of Bone 136 6.3 Histology of Bone Tissue 138 Compact Bone Tissue 139 Spongy Bone Tissue 139 6.4 Blood and Nerve Supply of Bone 141 6.5 Bone Formation 142 Intramembranous Ossification 142 Endochondral Ossification 142 6.6 Bone Growth 145 Growth in Length 145 Growth in Thickness 146 6.7 Bones and Homeostasis 147 Bone Remodeling 147 Factors Affecting Bone Growth and Bone Remodeling 148 Fracture and Repair of Bone 148 Bone's Role in Calcium Homeostasis 151 6.8 Aging and Bone Tissue 152 Key Medical Terms Associated with Bone Tissue 154 MANU AL THERAPY APPLICATIONS Treatments for Fractures 151 Effects of Exercise on Bone 152 CLINICAL CONNECTIONS Bone Scan 141 Remodeling and Orthodontics 147 Rickets and Osteomalacia 148 Hormonal Abnormalities that Affect Height 148 Osteoporosis 153 Study Outline 154 Self-Quiz Questions 155 Critical Thinking Questions 157 Answers to Figure Questions 158 7 THE SKELETAL SYSTEM:THE AXIAL SKELETON 159 7.1 Divisions of the Skeletal System 160 7.2 Types of Bones 160 7.3 Bone Surface Markings 162 7.4 Skull 162 General Features and Functions 163 Cranial Bones 164 Facial Bones 170 Nasal Septum 173 Orbits 174 Foramina 174 Unique Features of the Skull 174 7.5 Hyoid Bone 177 7.6 Vertebral Column 177 Normal Curves of the Vertebral Column 179 Intervertebral Discs 179 Parts of a Typical Vertebra 179 Regions of the Vertebral Column 180 7.7 Thorax 186 Sternum 186 Ribs 186 7.8 Disorders of the Axial Skeleton 189 Abnormal Curves of the Vertebral Column 189 Spina Bifida 190 Key Medical Terms Associated with Axial Skeleton 191 MANU AL THERAPY APPLICATIONS Treatment for Frontal Headaches 165 Sinusitis 175 Herniated (Slipped) Disc 179 Rib Fractures,Dislocations, and Separations 189 Treatment of Scoliosis 190 CLINICAL CONNECTIONS Cleft Palate and Cleft Lip 172 Temporomandibular Joint Syndrome 173 Fractures of the Vertebral Column 191 Study Outline 191 Self-Quiz Questions 192 Critical Thinking Questions 193 Answers to Figure Questions 193 8 THE SKELETAL SYSTEM:THE APPENDICULAR SKELETON 195 8.1 Pectoral (Shoulder) Girdle 196 Clavicle 196 Scapula 197 8.2 Upper Limb (Extremity) 199 Humerus 199 Ulna and Radius 201 Carpals,Metacarpals, and Phalanges 202 8.3 Pelvic (Hip) Girdle 205 Ilium 206 Ischium 206 Pubis 207 False and True Pelves 207 8.4 Comparison of Female and Male Pelves 209 8.5 Comparison of Pectoral and Pelvic Girdles 210 8.6 Lower Limb (Extremity) 211 Femur 211 Patella 213 Tibia and Fibula 214 Tarsals, Metatarsals, and Phalanges 215 Arches of the Foot 217 Exhibit 8.1 The Skeletal System and Homeostasis 218 Key Medical Terms Associated with Appendicular Skeleton 219 MANUAL THERAPY APPLICATION Patellofemoral Stress Syndrome 213 CLINICAL CONNECTIONS Fractured Clavicle 197 Cartilage Implants 215 Flatfoot and Clawfoot 217 Study Outline 219 Self-Quiz Questions 219 Critical Thinking Questions 220 Answers to Figure Questions 220 9 JOINTS 221 9.1 Joint Classifications 222 9.2 Fibrous Joints 222 Sutures 222 Syndesmoses 224 Interosseous Membranes 224 9.3 Cartilaginous Joints 224 Synchondroses 224 Symphyses 224 9.4 Synovial Joints 225 Structure of Synovial Joints 225 Bursae and Tendon Sheaths 227 Types of Synovial Joints 227 9.5 Types of Movements at Synovial Joints 230 Gliding 230 Angular Movements 230 Rotation 233 Special Movements 234 9.6 Selected Joints of the Body 236 Exhibit 9.1 Temporomandibular Joint 238 Exhibit 9.2 Shoulder Joint 240 Exhibit 9.3 Elbow Joint 243 Exhibit 9.4 Hip Joint 244 Exhibit 9.5 Knee Joint 246 Exhibit 9.6 Ankle Joint 249 9.7 Factors Affecting Contact and Range of Motion at Synovial Joints 251 9.8 Arthroplasty 252 9.9 Aging and Joints 253 Key Medical Terms Associated with Joints 253 MANU AL THERAPY APPLICATIONS Movement at Sutures 222 Torn Cartilage and Arthroscopy 226 Sprain and Strain 250 Improving Joint Movements through Manual Therapies 251 CLINICAL CONNECTIONS Aspiration of Synovial Fluid 226 Double-Jointedness 230 Dislocated Mandible 238 Shoulder Joint Injuries 242 Dislocation of the Radial Head 243 Knee Injuries 248 Rheumatism and Arthritis 251 Ankylosing Spondylitis 253 Study Outline 253 Self-Quiz Questions 254 Critical Thinking Questions 255 Answers to Figure Questions 256 10 MUSCULAR TISSUE 257 10.1 Overview of Muscular Tissue 258 Types of Muscular Tissue 258 Functions of Muscular Tissue 258 Properties of Muscular Tissue 259 10.2 Skeletal Muscle Tissue 259 Connective Tissue Components 259 Nerve and Blood Supply 261 Histology 261 10.3 Contraction and Relaxation of Skeletal Muscle Fibers 263 Sliding Filament Mechanism 263 Neuromuscular Junction 263 Physiology of Contraction 264 Relaxation 266 Muscle Tone 268 10.4 Metabolism of Skeletal Muscle Tissue 268 Energy for Contraction 268 Muscle Fatigue 268 Oxygen Consumption after Exercise 270 10.5 Control of Muscle Tension 270 Twitch Contraction 270 Frequency of Stimulation 271 Motor Unit Recruitment 271 Types of Skeletal Muscle Fibers 271 Isometric and Isotonic Contractions 272 10.6 Muscle Spasms 273 10.7 Exercise and Skeletal Muscle Tissue 277 Effective Stretching 277 Strength Training 277 10.8 Cardiac Muscle Tissue 277 10.9 Smooth Muscle Tissue 278 10.10 Aging and Muscular Tissue 279 Key Medical Terms Associated with Muscular Tissue 280 MANUAL THERAPY APPLICATIONS Muscular Atrophy and Hypertrophy 263 Lactic Acid Fuels Intensive Exercise 268 Treatment of Muscle Spasms 276 CLINICAL CONNECTIONS Fibromyalgia 261 Muscular Dystrophy 261 Myasthenia Gravis 264 Abnormal Contractions of Skeletal Muscle 274 Study Outline 280 Self-Quiz Questions 282 Critical Thinking Questions 283 Answers to Figure Questions 283 CLINICAL CONNECTIONS McBurney's Point 320 The Six-Pack 320 Injury of Levator Ani and Urinary Stress Incontinence 325 Study Outline 334 Self-Quiz Questions 334 Critical Thinking Questions 335 Answers to Figure Questions 335 11 THE MUSCULAR SYSTEM: THE MUSCLES OF THE HEAD AND NECK 284 11.1 How Skeletal Muscles Produce Movement 285 Muscle Attachment Sites: Origin and Insertion 285 Lever Systems and Leverage 285 Effects of Fascicle Arrangement 288 Coordination within Muscle Groups 288 11.2 How Skeletal Muscles Are Named 289 11.3 Principal Skeletal Muscles of the Head and Neck 289 Exhibit 11.1 Muscles of Facial Expression 294 Exhibit 11.2 Muscles that Move the Eyeballs and Upper Eyelids (Extrinsic Eye Muscles) 300 Exhibit 11.3 Muscles that Move the Mandible and Assist in Mastication (Chewing) and Speech 302 Exhibit 11.4 Muscles of the Anterior Neck that Assist in Deglutition (Swallowing) and Speech 304 Exhibit 11.5 Muscles of the Anterior Neck that Assist in Elevating the Ribs or Flexing the Neck and Head 307 Exhibit 11.6 Muscles of the Lateral Neck that Move the Head 310 MANU AL THERAPY APPLICATIONS Sternocleidomastoid (SCM) as an Example of Referred Trigger Points 310 Whiplash Injuries 312 CLINICAL CONNECTIONS Bell's Palsy 298 Gravity and the Mandible 302 Study Outline 314 Self-Quiz Questions 314 Critical Thinking Questions 315 Answers to Figure Questions 315 12 THE MUSCULAR SYSTEM:THE MUSCLES OF THE TORSO 316 Exhibit 12.1 Muscles of the Abdoman that Act on the Abdominal Wall 317 Surface Features of the Abdomen and Pelvis 320 Exhibit 12.2 Muscles of the Thorax Used in Breathing 324 Exhibit 12.3 Muscles of the Pelvic Diaphragm and Perineum that Support the Pelvic Viscera 325 Exhibit 12.4 Muscles of the Neck and Back that Act on the Posterior Head, Posterior Neck, Back, and Vertebral Column 328 Suboccipital Muscles 332 MANUAL THERAPY APPLICATIONS The Quadratus Lumborum and "Short Leg" Syndrome 319 Back Injuries and Heavy Lifting 332 CLINICAL CONNECTIONS McBurney's Point 320 The Six-Pack 320 Injury of Levator Ani and Urinary Stress Incontinence 325 Study Outline 334 Self-Quiz Questions 334 Critical Thinking Questions 335 Answers to Figure Questions 335 13 THE MUSCULAR SYSTEM:THE MUSCLES OF THE UPPER LIMB 336 Exhibit 13.1 Muscles of the Thorax that Move the Pectoral Girdle 337 Movements of the Scapula 340 Exhibit 13.2 Muscles of the Thorax and Shoulder that Move the Humerus 341 Surface Features of the Shoulder 341 Surface Features of the Armpit 341 Surface Features of the Back 346 Exhibit 13.3 Muscles of the Arm that Move the Radius and Ulna 347 Surface Features of the Arm and Elbow 352 Exhibit 13.4 Muscles of the Forearm that Move the Wrist, Hand, and Digits 354 Exhibit 13.5 Muscles of the Palm that Move the Digits-Intrinsic Muscles of the Hand 362 Surface Features of the Hand 366 MANU AL THERAPY APPLICATIONS Structural and Functional Analysis 340 Tenosynovitis 352 Repetitive Strain Injuries 359 CLINICAL CONNECTION Rotator Cuff Injuries and Impingement Syndrome 345 Study Outline 367 Self-Quiz Questions 367 Critical Thinking Questions 368 Answers to Figure Questions 368 14 THE MUSCULAR SYSTEM: THE MUSCLES OF THE TORSO 316 Exhibit 12.1 Muscles of the Abdoman that Act on the Abdominal Wall 317 Surface Features of the Abdomen and Pelvis 320 Exhibit 12.2 Muscles of the Thorax Used in Breathing 324 Exhibit 12.3 Muscles of the Pelvic Diaphragm and Perineum that Support the Pelvic Viscera 325 Exhibit 12.4 Muscles of the Neck and Back that Act on the Posterior Head, Posterior Neck, Back, and Vertebral Column 328 Suboccipital Muscles 332 MANU AL THERAPY APPLICATIONS The Quadratus Lumborum and "Short Leg" Syndrome 319 Back Injuries and Heavy Lifting 332 MUSCLES OF THE LOWER LIMB 369 14.1 Introduction to the Muscles of the Lower Limb (Extremity) 370 Exhibit 14.1 Muscles of the Gluteal Region that Move the Femur 371 Surface Features of the Buttock 378 Exhibit 14.2 Muscles of the Thigh that Move on the Femur, Tibia, and Fibula 380 Surface Features of the Thigh and Knee 383 Exhibit 14.3 Muscles of the Leg that Move the Foot and Toes 386 Surface Features of the Leg, Ankle, and Foot 391 Exhibit 14.4 Intrinsic Muscles of the Foot that Move the Toes 393 14.2 Muscle Interactions 398 The Interconnectedness of the Whole Body 398 Posture and Interactions between Muscles 398 Exhibit 14.5 Contributions of the Muscular System to Homeostasis 400 MANUAL THERAPY APPLICATIONS Groin Pull (Strain) and RICE Therapy 379 Pes Anserinus 385 Running-Related Injuries and Shin Splints 392 Plantar Fasciitis 397 CLINICAL CONNECTIONS Compartment Syndrome 370 Pulled Hamstrings 385 Study Outline 401 Self-Quiz Questions 401 Critical Thinking Questions 402 Answers to Figure Questions 402 15 NERVOUS TISSUE 403 15.1 Overview of the Nervous System 404 Structures of the Nervous System 404 Functions of the Nervous System 404 Organization of the Nervous System 405 15.2 Histology of Nervous Tissue 407 Neurons 407 Myelination 409 Gray and White Matter 411 Neuroglia 411 15.3 Electrical Signals in Neurons 413 Action Potentials 413 Conduction of Nerve Impulses 417 Effect of Axon Diameter 418 15.4 Synaptic Transmission 418 Events at a Synapse 418 Neurotransmitters 420 15.5 Regeneration and Repair of Nervous Tissue 421 Neurogenesis in the CNS 421 Damage and Repair in the PNS 421 Key Medical Terms Associated with Nervous Tissue 422 MANUAL THERAPY APPLICATIONS Physiological Effects of Appropriate Massage on Nervous Tissue 406 Repair of Damaged Nerves 422 CLINICAL CONNECTIONS Multiple Sclerosis 410 Epilepsy 417 Depression 420 Neurotransmitters and Food 420 Study Outline 423 Self-Quiz Questions 424 Critical Thinking Questions 425 Answers to Figure Questions 425 16 THE SPINAL CORD AND SPINAL NERVES 426 16.1 Spinal Cord Anatomy 427 Protective Structures 427 External Anatomy of the Spinal Cord 427 Internal Anatomy of the Spinal Cord 429 16.2 Spinal Nerves 430 Connective Tissue Coverings of Spinal Nerves 432 Distribution of Spinal Nerves 433 Exhibit 16.1 Cervical Plexus 434 Exhibit 16.2 Brachial Plexus 436 Exhibit 16.3 Lumbar Plexus 440 Exhibit 16.4 Sacral and Coccygeal Plexuses 442 Dermatomes 444 16.3 Spinal Cord Physiology 444 Sensory and Motor Tracts 445 Reflexes and Reflex Arcs 449 Reflexes and Diagnosis 457 16.4 Traumatic Injuries of the Spinal Cord 458 Key Medical Terms Associated with the Spinal Cord and Spinal Nerves 458 MANUAL THERAPY APPLICATIONS Thoracic Outlet Syndrome 436 Injuries to the Roots of the Brachial Plexus 439 Spinal Tap 443 Sciatic Nerve Injury 444 Working with Patients with Paralysis 449 CLINICAL CONNECTIONS Spinal Nerve Root Damage 432 Shingles 444 Study Outline 459 Self-Quiz Questions 460 Critical Thinking Questions 462 Answers to Figure Questions 462 17 THE BRAIN AND CRANIAL NERVES 463 17.1 The Brain 464 Major Parts and Protective Coverings 464 Brain Blood Supply and the Blood-Brain Barrier 464 Cerebrospinal Fluid 464 Brain Stem 468 Diencephalon 469 Cerebellum 471 Cerebrum 471 Hemispheric Lateralization 476 Memory 476 Electroencephalogram (EEG) 476 17.2 Cranial Nerves 477 17.3 Aging and the Nervous System 479 Key Medical Terms Associated with the Brain 479 MANUAL THERAPY APPLICATION Parkinson Disease 472 CLINICAL CONNECTIONS Cerebrovascular Accident and Transient Ischemic Attack 464 Injury to the Medulla 468 Ataxia 471 Aphasia 476 Alzheimer Disease 476 Study Outline 480 Self-Quiz Questions 481 Critical Thinking Questions 482 Answers to Figure Questions 482 18 THE AUTONOMIC NERVOUS SYSTEM 483 18.1 Introduction to the Autonomic Nervous System 484 18.2 Comparison of Somatic and Autonomic Nervous Systems 484 18.3 Structure of the Autonomic Nervous System 486 Organization of the Sympathetic Division 486 Organization of the Parasympathetic Division 488 18.4 Functions of the Autonomic Nervous System 491 ANS Neurotransmitters 491 Activities of the ANS 491 18.5 Integration and Control of Autonomic Functions 492 Autonomic Reflexes 492 Autonomic Control by Higher Centers 494 Key Medical Terms Associated with the Autonomic Nervous System 494 MANUAL THERAPY APPLICATION Mind-Body Exercise: An Antidote to Stress 492 CLINICAL CONNECTIONS Autonomic Dysreflexia 488 Raynaud Phenomenon 492 Study Outline 495 Self-Quiz Questions 495 Critical Thinking Questions 497 Answers to Figure Questions 497 19 SOMATIC AND SPECIAL SENSES 498 19.1 Overview of Sensations 499 Definition of Sensation 499 Characteristics of Sensations 499 Types of Sensory Receptors 499 19.2 Somatic Senses 500 Tactile Sensations 500 Thermal Sensations 501 Pain Sensations 502 Proprioceptive Sensations 503 19.3 Special Senses and Olfaction: Sense of Smell 504 Structure of the Olfactory Epithelium 504 Stimulation of Olfactory Receptors 505 The Olfactory Pathway 505 19.4 Gustation: Sense of Taste 506 Structure of Taste Buds 506 Stimulation of Gustatory Receptors 506 The Gustatory Pathway 506 19.5 Vision 507 Accessory Structures of the Eye 507 Layers of the Eyeball 509 Interior of the Eyeball 511 Image Formation and Binocular Vision 512 Stimulation of Photoreceptors 514 The Visual Pathway 514 19.6 Hearing and Equilibrium 515 Anatomy of the Ear 515 Physiology of Hearing 518 Auditory Pathway 519 Deafness 519 Physiology of Equilibrium 519 Equilibrium Pathways 519 Reflexology via the Ear 519 19.7 Aging and the Special Senses 521 Key Medical Terms Associated with Somatic and Special Senses 522 Exhibit 19.1 Contributions of the Nervous System to Homeostasis 523 MANU AL THERAPY APPLICATION Reducing Pain through Massage 503 CLINICAL CONNECTIONS Phantom Limb Sensation 501 Analgesia 502 Night Blindness and Color Blindness 514 Study Outline 522 Self-Quiz Questions 525 Critical Thinking Questions 526 Answers to Figure Questions 526 20 THE ENDOCRINE SYSTEM 527 20.1 Endocrine Glands 528 20.2 Hormone Action 528 Target Cells and Hormone Receptors 528 Chemistry of Hormones 528 Mechanisms of Hormone Action 528 Control of Hormone Secretions 528 20.3 Hypothalamus and Pituitary Gland 530 Anterior Pituitary Hormones 531 Posterior Pituitary Hormones 533 20.4 Thyroid Gland 535 Actions of Thyroid Hormones 535 Control of Thyroid Hormone Secretion 536 Calcitonin 537 20.5 Parathyroid Glands 538 20.6 Pancreatic Islets 539 Actions of Glucagon and Insulin 540 20.7 Adrenal Glands 542 Adrenal Cortex Hormones 543 Adrenal Medulla Hormones 545 20.8 Ovaries and Testes 545 20.9 Pineal Gland 545 20.10 Other Hormones 546 Hormones from Other Endocrine Cells 546 Prostaglandins and Leukotrienes 546 20.11 The Stress Response 547 20.12 Aging and the Endocrine System 547 Key Medical Terms Associated with the Endocrine System 548 Exhibit 20.1 Contributions of the Endocrine System to Homeostasis 549 MANUAL THERAPY APPLICATIONS Effects of Massage on the Diabetic Patient 542 Seasonal Affective Disorder 546 CLINICAL CONNECTIONS Pituitary Gland Disorders 532 Thyroid Disorders 537 Parathyroid Gland Disorders 539 Pancreatic Islet Disorders 541 Adrenal Gland Disorders 544 Congenital Adrenal Hyperplasia 545 Posttraumatic Stress Disorder 547 Study Outline 548 Self-Quiz Questions 551 Critical Thinking Questions 552 Answers to Figure Questions 552 21 THE CARDIOVASCULAR SYSTEM: THE BLOOD 553 21.1 Functions of Blood 554 21.2 Components of Whole Blood 554 Blood Plasma 554 Formed Elements 554 21.3 Hemostasis 563 Vascular Spasm 564 Platelet Plug Formation 564 Blood Clotting 564 Hemostatic Control Mechanisms 566 Clotting in Blood Vessels 566 21.4 Blood Groups and Blood Types 566 ABO Blood Group 567 Rh Blood Group 567 Transfusions 568 Key Medical Terms Associated with Blood 568 MANUAL THERAPY APPLICATION Effects of Massage on Blood 562 CLINICAL CONNECTIONS Bone Marrow Transplant 557 Anemia 557 Blood Doping 558 Sickle-Cell Disease 560 Leukemia 562 Anticoagulants 566 Hemophilia 566 Hemolytic Disease of the Newborn 567 Study Outline 568 Self-Quiz Questions 569 Critical Thinking Questions 570 Answers to Figure Questions 570 22 THE CARDIOVASCULAR SYSTEM: THE HEART 571 22.1 Structure and Organization of the Heart 572 Location and Coverings of the Heart 572 Heart Wall 575 Chambers of the Heart 575 Great Vessels of the Heart 577 Valves of the Heart 577 22.2 Blood Flow and Blood Supply of the Heart 579 Blood Flow through the Heart 579 Blood Supply of the Heart 579 Myocardial Ischemia and Infarction 580 22.3 Conduction System of the Heart 581 22.4 Electrocardiogram 583 Arrhythmias 583 22.5 The Cardiac Cycle 584 Pressure and Volume Changes during the Cardiac Cycle 584 Heart Sounds 586 22.6 Cardiac Output 586 Regulation of Stroke Volume 586 Regulation of Heart Rate 589 22.7 Exercise and the Heart 590 Key Medical Terms Associated with the Heart 590 CLINICAL CONNECTIONS Pedicarditis 575 Regeneration of Heart Cells 575 Heart Valve Disorders 579 Artificial Pacemakers 582 Heart Murmurs 586 Congestive Heart Failure 586 Study Outline 591 Self-Quiz Questions 592 Critical Thinking Questions 593 Answers to Figure Questions 593 23 THE CARDIOVASCULAR SYSTEM: BLOOD VESSELS AND CIRCULATION 594 23.1 Blood Vessel Structure and Function 595 Arteries and Arterioles 595 Capillaries 595 Venules and Veins 597 23.2 Blood Flow Through Blood Vessels 599 Blood Pressure 599 Resistance 600 Regulation of Blood Pressure and Blood Flow 600 23.3 Checking Circulation 603 Pulse 603 Measurement of Blood Pressure 603 23.4 Circulatory Routes 603 Systemic Circulation 603 Pulmonary Circulation 605 Exhibit 23.1 The Aorta and Its Branches 606 Exhibit 23.2 The Arch of the Aorta 608 Exhibit 23.3 Arteries of the Pelvis and Lower Limbs 610 Exhibit 23.4 Veins of the Systemic Circulation 612 Exhibit 23.5 Veins of the Head and Neck 614 Exhibit 23.6 Veins of the Upper Limbs 615 Exhibit 23.7 Veins of the Lower Limbs 617 Hepatic Portal Circulation 619 Fetal Circulation 620 23.5 Aging and the Cardiovascular System 620 Exhibit 23.8 Contributions of the Cardiovascular System to Homeostasis 622 Key Medical Terms Associated with Blood Vessels 623 MANUAL THERAPY APPLICATION Arising Slowly from a Massage Therapy Session 601 CLINICAL CONNECTIONS Aneurysm 595 Shock 599 Hypertension 603 Reversing Arterial Plaque Buildup 605 Study Outline 623 Self-Quiz Questions 624 Critical Thinking Questions 625 Answers to Figure Questions 625 24 THE LYMPHATIC SYSTEM AND IMMUNITY 627 24.1 Overview of Immunity 628 24.2 Lymphatic System Structure and Function 628 Lymphatic Vessels and Lymph Circulation 628 Lymphatic Organs and Tissues 631 24.3 Innate Immunity 634 First Line of Defense: Skin and Mucous Membranes 634 Second Line of Defense: Internal Defenses 634 24.4 Adaptive Immunity 636 Maturation of T cells and B cells 637 Types of Adaptive Immune Responses 637 Antigens and Antibodies 637 Processing and Presenting Antigens 638 T Cells and Cell-Mediated Immunity 639 B Cells and Antibody-Mediated Immunity 642 Immunological Memory 643 24.5 Aging and the Immune System 645 Exhibit 24.5 Contributions of the Lymphatic System and Immunity to Homeostasis 646 Key Medical Terms Associated with the Lymphatic System 647 MANU AL THERAPY APPLICATIONS Edema and Lymphedema 630 Metastasis 632 CLINICAL CONNECTIONS Lymphomas 632 Ulcer 636 Infectious Mononucleosis 639 AIDS: Acquired Immunodeficiency Syndrome 642 Allergic Reactions 645 Study Outline 647 Self-Quiz Questions 648 Critical Thinking Questions 649 Answers to Figure Questions 650 25 THE RESPIRATORY SYSTEM 651 25.1 Overview of the Respiratory System 652 25.2 Organs of the Respiratory System 653 Nose 653 Pharynx 654 Larynx 654 Trachea 656 Bronchi and Bronchioles 656 Lungs 657 25.3 Pulmonary Ventilation 660 Muscles of Inhalation and Exhalation 661 Pressure Changes During Ventilation 662 Lung Volumes and Capacities 662 Breathing Patterns and Modified Respiratory Movements 664 25.4 Exchange of Oxygen and Carbon Dioxide 664 External Respiration: Pulmonary Gas Exchange 665 Internal Respiration: Systemic Gas Exchange 665 25.5 Transport of Respiratory Gases 667 Oxygen Transport 667 Carbon Dioxide Transport 667 25.6 Control of Respiration 667 Respiratory Center 668 Regulation of the Respiratory Center 669 25.7 Exercise and the Respiratory System 671 25.8 Aging and the Respiratory System 671 Exhibit 25.1 Contributions of the Respiratory System to Homeostasis 672 Key Medical Terms Associated with the Respiratory System 673 MANUAL THERAPY APPLICATION Postural Drainage of the Lungs 657 CLINICAL CONNECTIONS Cough Reflex 654 Asthma 657 Cigarette Smoking 660 High Altitude Sickness 665 Carbon Monoxide Poisoning 667 Chronic Obstructive Pulmonary Disease 671 Study Outline 673 Self-Quiz Questions 675 Critical Thinking Questions 676 Answers to Figure Questions 676 26 THE DIGESTIVE SYSTEM 677 26.1 Overview of the Digestive System 678 26.2 Layers of the GI Tract and the Peritoneum 679 26.3 Mouth 681 Tongue 681 Salivary Glands 682 Teeth 682 Digestion in the Mouth 683 26.4 Pharynx and Esophagus 683 26.5 Stomach 685 Structure of the Stomach 686 Digestion and Absorption in the Stomach 687 26.6 Pancreas 688 Structure of the Pancreas 688 Pancreatic Juice 688 26.7 Liver and Gallbladder 688 Structure of the Liver and Gallbladder 688 Blood Supply of the Liver 690 Bile 690 Functions of the Liver 691 26.8 Small Intestine 692 Structure of the Small Intestine 692 Intestinal Juice 694 Mechanical Digestion in the Small Intestine 694 Chemical Digestion in the Small Intestine 694 Absorption in the Small Intestine 695 26.9 Large Intestine 697 Structure of the Large Intestine 697 Digestion and Absorption in the Large Intestine 700 The Defecation Reflex 700 26.10 Phases of Digestion 700 Cephalic Phase 700 Gastric Phase 700 Intestinal Phase 701 26.11 Aging and the Digestive System 701 Exhibit 26.1 The Digestive System and Homeostasis 702 Key Medical Terms Associated with the Digestive System 703 MANUAL THERAPY APPLICATION Abdominal Massage 697 CLINICAL CONNECTIONS Heartburn 685 Peptic Ulcer Disease 686 Pancreatic Cancer 688 Gallstones 691 Hepatitis 691 Colon Pathologies 698 Study Outline 703 Self-Quiz Questions 705 Critical Thinking Questions 706 Answers to Figure Questions 706 27 NUTRITION AND METABOLISM 707 27.1 Nutrients 708 Guidelines for Healthy Eating 708 Minerals 709 Vitamins 710 27.2 Metabolism 711 Carbohydrate Metabolism 714 Lipid Metabolism 716 Protein Metabolism 718 27.3 Metabolism and Body Heat 719 Measuring Heat 719 Body Temperature Homeostasis 719 Regulation of Body Temperature 720 Key Medical Terms Associated with Nutrition and Metabolism 722 MANU AL THERAPY APPLICATION Carbohydrate Loading: Great for Marathoners 716 CLINICAL CONNECTIONS Diets 709 Supplements 711 Ketosis 717 Exercise Training and Metabolism 722 Study Outline 723 Self-Quiz Questions 724 Critical Thinking Questions 725 Answers to Figure Questions 725 28 THE URINARY SYSTEM 726 28.1 Overview of the Urinary System 727 28.2 Structure of the Kidneys 728 External Anatomy of the Kidneys 728 Internal Anatomy of the Kidneys 728 Renal Blood Supply 728 Nephrons 729 28.3 Functions of the Nephron 732 Glomerular Filtration 732 Tubular Reabsorption and Secretion 734 Components of Urine 736 28.4 Transportation, Storage, and Elimination of Urine 737 Ureters 737 Urinary Bladder 737 Urethra 737 Micturition 738 28.5 Aging and the Urinary System 739 Key Medical Terms Associated with the Urinary System 739 Perineum and Vulva 756 Mammary Glands 758 29.4 Female Reproductive Cycle 759 Hormonal Regulation of the Female Reproductive Cycle 759 Phases of the Female Reproductive Cycle 759 29.5 Aging and the Reproductive Systems 763 Exhibit 28.1 The Urinary System and Homeostasis 740 Exhibit 29.1 The Reproductive Systems and Homeostasis 765 MANUAL THERAPY APPLICATION Massage and the Kidney 728 Key Medical Terms Associated with the Reproductive Systems 766 CLINICAL CONNECTIONS Kidney Transplant 729 Number of Nephrons 730 Oliguria and Anuria 733 Glucosuria and Polyuria 734 Urinalysis 734 Diuretics 736 Study Outline 741 Self-Quiz Questions 741 Critical Thinking Questions 743 Answers to Figure Questions 743 29 THE REPRODUCTIVE SYSTEMS 744 29.1 Introduction to the Reproductive Systems 745 29.2 Male Reproductive System 745 Scrotum 745 Testes 745 Ducts 749 Accessory Sex Glands 750 Penis 752 29.3 Female Reproductive System 752 Ovaries 752 Uterine Tubes 755 Uterus 755 Vagina 756 MANU AL THERAPY APPLICATION Benefits of Massage During Pregnancy 764 CLINICAL CONNECTIONS Cryptorchidism 745 Vasectomy 750 Prostate Disorders 750 Circumcision 752 Ovarian Cancer 754 Hysterectomy 755 Episiotomy 757 Breast Cancer 758 Premenstrual Syndrome 761 The Female Athlete Triad-Disordered Eating, Amenorrhea, and Premature Osteoporosis 763 Study Outline 766 Self-Quiz Questions 767 Critical Thinking Questions 769 Answers to Figure Questions 769 APPENDIX A: MEASUREMENTS A1 B: PERIODIC TABLE B3 C: ANSWERS C4 GLOSSARY G1 CREDITS CR1 INDEX I1

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