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Fundamentals of Anatomy & Physiology
Seventh Edition
Frederic H. Martini, Ph.D.
with
William C. Ober, M.D.
Art Coordinator and Illustrator
Claire W. Garrison, R.N.
Illustrator
Kathleen Welch, M.D.
Clinical Consultant
Ralph T. Hutchings
Biomedical Photographer
San Francisco Boston New York
Cape Town Hong Kong London Madrid Mexico City
Montreal Munich Paris Singapore Sydney Tokyo Toronto
Publisher: Daryl Fox
Executive Editor: Leslie Berriman
Project Editor: Nicole George
Development Manager: Claire Alexander
Development Editor: Alan Titche
Assistant Editor: Michael Roney
Editorial Assistant: Blythe Robbins
Director of Media Development: Lauren Fogel
Media Producer: Heather Steil
Media Editor: Kim Neumann
Managing Editor: Deborah Cogan
Production Management: Elm Street Publishing Services, Inc.
Design Manager: Mark Ong
document.doc 5
Compositor: Preparé, Inc.
Interior Designer: Kathleen Cunningham Design
Cover Designer: Yvo Riezebos
Photo Researcher: Maureen Spuhler
Senior Manufacturing Buyer: Stacey Weinberger
Executive Marketing Manager: Lauren Harp
Cover Photo Credit: Lois Greenfield Photography
Notice: Our knowledge in clinical sciences is constantly changing. The author and the
publisher of this volume have taken care that the information contained herein is accurate
and compatible with the standards generally accepted at the time of the publication.
Nevertheless, it is difficult to ensure that all information given is entirely accurate for all
circumstances. The author and the publisher disclaim any liability, loss, or damage incurred
as a consequence, directly or indirectly, of the use and application of any of the contents of
this volume.
Library of Congress Cataloging-in-Publication Data Martini, Frederic.
Fundamentals of anatomy & physiology / Frederic H. Martini, with William C. Ober…[et
al.].—7th ed.
p. cm.
Includes index.
ISBN 0-8053-7298-9
1. Human physiology. 2. Human anatomy. I. Title: Fundamentals of anatomy and
physiology. II. Ober, William C.
III. Title.
QP34.5.M27 2006
612—dc22 2004022401
Copyright © 2006 by Frederic H. Martini, Inc. Published by Pearson Education, Inc.,
publishing as Benjamin Cummings, 1301 Sansome St., San Francisco, CA 94111. All
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rights reserved. Manufactured in the United States of America. This publication is
protected by Copyright and permission should be obtained from the publisher prior to any
prohibited reproduction, storage in a retrieval system, or transmission in any form or by
any means, electronic, mechanical, photocopying, recording, or likewise. To obtain
permission(s) to use material from this work, please submit a written request to Pearson
Education, Inc., Permissions Department, 1900 E. Lake Ave., Glenview, IL 60025. For
information regarding permissions, call (847) 486-2635.
Many of the designations used by manufacturers and sellers to distinguish their products
are claimed as trademarks. Where those designations appear in this book, and the publisher
was aware of a trademark claim, the designations have been printed in initial caps or all
caps.
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1—DOW—08 07 06 05 04
ISBN 0-8053-7298-9
www.aw-bc.com
Text and Illustration Team
Frederic (Ric) H. Martini, Ph.D.
Author
Dr. Frederic H. Martini received his Ph.D. from Cornell University in comparative and
functional anatomy for work on the comparative pathophysiology of stress. His
publications include journal articles, technical reports, magazine articles, and a book for
naturalists about the biology and geology of tropical islands. He is the coauthor of seven
other undergraduate texts on anatomy and physiology or anatomy. He is on the faculty of
the University of Hawaii— Hilo and remains affiliated with the Shoals Marine Laboratory,
a joint venture between Cornell University and the University of New Hampshire. Dr.
Martini is President-Elect of the Human Anatomy and Physiology Society, and he is a
member of the American Physiological Society, the American Association of Anatomists,
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the Society for Integrative and Comparative Biology, the Western Society of Naturalists,
and the International Society of Vertebrate Morphologists.
William C. Ober, M.D.
Art Coordinator and Illustrator
Dr. William C. Ober received his undergraduate degree from Washington and Lee
University and his
M.D. from the University of Virginia. While in medical school, he also studied in the
Department of Art as Applied to Medicine at Johns Hopkins University. After graduation,
Dr. Ober completed a residency in Family Practice and later was on the faculty at the
University of Virginia in the Department of Family Medicine. He is an Instructor in the
Division of Sports Medicine at the University of Virginia and is part of the Core Faculty at
Shoals Marine Laboratory, where he teaches Biological Illustration every summer. The
textbooks illustrated by his company, Medical & Scientific Illustration, have won
numerous design and illustration awards.
Claire W. Garrison, R.N.
Illustrator
Claire W. Garrison, R.N., B.A., practiced pediatric and obstetric nursing before turning to
medical illustration as a full-time career. She returned to school at Mary Baldwin College,
where she received her degree with distinction in studio art. Following a five-year
apprenticeship, she has worked as Dr. Ober’s partner in Medical & Scientific Illustration
since 1986. She is on the Core Faculty at Shoals Marine Laboratory and co-teaches the
Biological Illustration course with Dr. Ober.
Kathleen Welch, M.D.
Clinical Consultant
Dr. Kathleen Welch received her M.D. from the University of Washington in Seattle and
did her residency at the University of North Carolina in Chapel Hill. For two years, she
served as Director of Maternal and Child Health at the LBJ Tropical Medical Center in
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American Samoa and subsequently was a member of the Department of Family Practice at
the Kaiser Permanente Clinic in Lahaina, Hawaii. She has been in private practice since
1987. Dr. Welch is a Fellow of the American Academy of Family Practice and a member
of the Hawaii Medical Association, the Maui County Medical Society, and the Human
Anatomy and Physiology Society. She is coauthor of the A&P Applications Manual and an
undergraduate textbook on health and disease.
Ralph T. Hutchings
Biomedical Photographer
Ralph T. Hutchings was associated with the Royal College of Surgeons for 20 years. An
engineer by training, he has focused for years on photographing the structure of the human
body. The result has been a series of color atlases, including the Color Atlas of Human
Anatomy, the Color Atlas of Surface Anatomy, and The Human Skeleton (all published by
Mosby-Yearbook Publishing). For his anatomical portrayal of the human body, the
International Photographers Association has chosen Mr. Hutchings as the best
photographer of humans in the twentieth century. He lives in North London, where he tries
to balance the demands of his photographic assignments with his hobbies of early motor
cars and airplanes.
Brief Contents
UNIT 1:LEVELS OF ORGANIZATION
Chapter 1 An Introduction to Anatomy and Physiology 3
Chapter 2 The Chemical Level of Organization 26
Chapter 3 The Cellular Level of Organization 62
Chapter 4 The Tissue Level of Organization 106
UNIT 2:SUPPORT AND MOVEMENT
Chapter 5 The Integumentary System 153
Chapter 6 Osseous Tissue and Bone Structure 179
Chapter 7 The Axial Skeleton 205
Chapter 8 The Appendicular Skeleton 238
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Chapter 9 Articulations 258
Chapter 10 Muscle Tissue 283
Chapter 11 The Muscular System 326
UNIT 3:CONTROL AND REGULATION
Chapter 12 Neural Tissue 379
Chapter 13 The Spinal Cord, Spinal Nerves, and Spinal Reflexes 421
Chapter 14 The Brain and Cranial Nerves 451
Chapter 15 Neural Integration I: Sensory Pathways and the Somatic Nervous System
495
Chapter 16 Neural Integration II: The Autonomic Nervous System and Higher-Order
Functions 517
Chapter 17 The Special Senses 549
Chapter 18 The Endocrine System 590
UNIT 4:FLUIDS AND TRANSPORT
Chapter 19 Blood 639
Chapter 20 The Heart 669
Chapter 21 Blood Vessels and Circulation 708
Chapter 22 The Lymphatic System and Immunity 763
UNIT 5:ENVIRONMENTAL EXCHANGE
Chapter 23 The Respiratory System 813
Chapter 24 The Digestive System 862
Chapter 25 Metabolism and Energetics 915
Chapter 26 The Urinary System 951
Chapter 27 Fluid, Electrolyte, and Acid–Base Balance 994
UNIT 6:CONTINUITY OF LIFE
Chapter 28 The Reproductive System 1029
Chapter 29 Development and Inheritance 1074 Contents
Preface xxx
UNIT 1:LEVELS OF ORGANIZATION
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Chapter 1
An Introduction to Anatomy and Physiology 3
An Introduction to Studying the Human Body 4
The Relationship between Anatomy and Physiology 4
Anatomy 5
Physiology 5
Levels of Organization 6
Homeostasis 11
The Role of Negative Feedback in Homeostasis 12
Systems Integration, Equilibrium,
and Homeostasis 14
Frames of Reference for Anatomical Studies 15
Superficial Anatomy 15
Sectional Anatomy 18
Body Cavities 19
Chapter Review 23
Chapter 2
The Chemical Level of Organization 26
Atoms, Molecules, and Bonds 27
Atomic Structure 27
Chemical Bonds 30
Chemical Notation 34
Chemical Reactions 35
Basic Energy Concepts 35
Types of Chemical Reactions 35
Reversible Reactions 36
Enzymes, Energy, and Chemical Reactions 36
Inorganic Compounds 37
Water and its Properties 37
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Inorganic Acids and Bases 41
Salts 41
Buffers and pH Control 41
Organic Compounds 42
Carbohydrates 42
Lipids 44
Proteins 49
Nucleic Acids 54
High-Energy Compounds 56
Chemicals and Cells 57
Chapter Review 58
Chapter 3
The Cellular Level of Organization 62
An Introduction to Cells 63
The Cell Membrane 63
Membrane Lipids 66
Membrane Proteins 66
Membrane Carbohydrates 67
The Cytoplasm 68
The Cytosol 68
The Organelles 68
The Nucleus 77
Contents of the Nucleus 78
Information Storage in the Nucleus 79
Gene Activation and Protein Synthesis 80
How the Nucleus Controls Cell Structure and Function 84
How Things Get Into and Out of Cells 84
Diffusion 85
Carrier-Mediated Transport 89
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Vesicular Transport 92
The Transmembrane Potential 94
The Cell Life Cycle 95
Interphase 95
Mitosis 96
Cytokinesis 98
The Mitotic Rate and Energy Use 98
Regulation of the Cell Life Cycle 99
Cell Division and Cancer 99
Cell Diversity and Differentiation 100
Chapter Review 101
Chapter 4
The Tissue Level of Organization 106
Tissues of the Body: An Introduction 107
Epithelial Tissue 107
Functions of Epithelial Tissue 107
Specializations of Epithelial Cells 108
Maintaining the Integrity of Epithelia 108
Classification of Epithelia 111
Glandular Epithelia 114
Connective Tissues 118
Classification of Connective Tissues 118
Connective Tissue Proper 119
Fluid Connective Tissues 123
Supporting Connective Tissues 125
Membranes 129
Mucous Membranes 129
Serous Membranes 129
The Cutaneous Membrane 130
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Synovial Membranes 131
The Connective Tissue Framework of the Body 131
Muscle Tissue 132
Skeletal Muscle Tissue 132
Cardiac Muscle Tissue 134
Smooth Muscle Tissue 134
Neural Tissue 134
Tissue Injuries and Repair 135
Inflammation and Regeneration 135
Aging and Tissue Structure 137
Aging and Cancer Incidence 137
Chapter Review 138
SYSTEMS OVERVIEW 142
UNIT 2:SUPPORT AND MOVEMENT
Chapter 5
The Integumentary System 153
The Integumentary System:
An Overview 154
The Epidermis 155
Layers of the Epidermis 155
The Basis of Skin Color 158
The Epidermis and Steroid Production 159
The Roles of Epidermal Growth Factor 161
The Dermis 161
Dermal Organization 161
The Subcutaneous Layer 163
Accessory Structures 164
Hair and Hair Follicles 164
Glands in the Skin 167
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Nails 169
The Response of the Integument to Injury 170
Repair of Localized Injuries to the Skin 170
Aging and the Integumentary System 173
Integration with Other Systems 174
Clinical Patterns 174
Chapter Review 174
Chapter 6
Osseous Tissue and Bone Structure 179
An Introduction to the Skeletal System 180
The Gross Anatomy of Bones 180
Bone Shapes 180
Bone Markings (Surface Features) 181
Bone Structure 183
Bone Histology 183
The Matrix of Bone 184
The Cells of Bone 184
The Structure of Compact Bone 185
The Structure of Spongy Bone 185
The Periosteum and Endosteum 188
Bone Formation and Growth 189
Endochondral Ossification 189
Intramembranous Ossification 192
The Blood and Nerve Supplies 193
The Dynamic Nature of Bone 194
Effects of Exercise on Bone 194
Hormonal and Nutritional Effects on Bone 194
The Skeleton as a Calcium Reserve 196
Fracture Repair 198
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Aging and the Skeletal System 199
Types of Fractures 200
Chapter Review 201
Chapter 7
The Axial Skeleton 205
The Axial Division of the Skeletal System 206
The Skull 206
The Individual Bones of the Skull 212
Summary: Foramina and Fissures of the Skull 220
The Orbital and Nasal Complexes 220
The Skulls of Infants and Children 222
The Vertebral Column 224
Spinal Curvature 224
Vertebral Anatomy 225
Vertebral Regions 226
The Thoracic Cage 231
The Ribs 233
The Sternum 234
Chapter Review 235
Chapter 8
The Appendicular Skeleton 238
The Pectoral Girdle and Upper Limbs 240
The Pectoral Girdle 240
The Upper Limbs 242
The Pelvic Girdle and Lower Limbs 245
The Pelvic Girdle 245
The Lower Limbs 249
Individual Variation in the Skeletal System 253
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Chapter Review 255
Chapter 9
Articulations 258
The Classification of Joints 259
Synarthroses (Immovable Joints) 260
Amphiarthroses (Slightly Movable Joints) 260
Diarthroses (Freely Movable Joints) 260
Form and Function of Synovial Joints 263
Describing Dynamic Motion 263
Types of Movements at Synovial Joints 264
A Structural Classification of Synovial Joints 267
Representative Articulations 269
Intervertebral Articulations 269
The Shoulder Joint 272
The Elbow Joint 273
The Hip Joint 274
The Knee Joint 276
Aging and Articulations 278
Integration with Other Systems 278
Clinical Patterns 278
Chapter Review 280
Chapter 10
Muscle Tissue 283
Skeletal Muscle Tissue and the Muscular System 284
Functional Anatomy of Skeletal Muscle 284
Organization of Connective Tissues 284
Blood Vessels and Nerves 285
Skeletal Muscle Fibers 286
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Sliding Filaments and Muscle Contraction 291
The Contraction of Skeletal Muscle 292
The Control of Skeletal Muscle Activity 293
Excitation–Contraction Coupling 295
Relaxation 298
Tension Production 300
Tension Production by Muscle Fibers 300
Tension Production by Skeletal Muscles 304
Energy Use and Muscular Activity 308
ATP and CP Reserves 309
ATP Generation 309
Energy Use and the Level of Muscular Activity 310
Muscle Fatigue 310
The Recovery Period 312
Hormones and Muscle Metabolism 312
Muscle Performance 313
Types of Skeletal Muscle Fibers 313
Muscle Performance and the Distribution of Muscle Fibers 314
Muscle Hypertrophy and Atrophy 314
Physical Conditioning 315
Cardiac Muscle Tissue 316
Structural Characteristics of Cardiac Muscle Tissue 316
Functional Characteristics of Cardiac Muscle Tissue 317
Smooth Muscle Tissue 318
Structural Characteristics of Smooth Muscle Tissue 319
Functional Characteristics of Smooth Muscle Tissue 319
Chapter Review 321
Chapter 11
The Muscular System 326
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Muscle Organization and Function 327
Organization of Skeletal Muscle Fibers 327
Levers 328
Muscle Terminology 330
Origins and Insertions 330
Actions 330
Names of Skeletal Muscles 331
Axial and Appendicular Muscles 333
The Axial Muscles 336
Muscles of the Head and Neck 336
Muscles of the Vertebral Column 344
Oblique and Rectus Muscles 346
Muscles of the Pelvic Floor 348
The Appendicular Muscles 350
Muscles of the Shoulders and Upper Limbs 351
Muscles of the Pelvis and Lower Limbs 363
Aging and the Muscular System 371
Integration with Other Systems 372
Chapter Review 374
UNIT 3:CONTROL AND REGULATION
Chapter 12
Neural Tissue 379
An Overview of the Nervous System 380
The Anatomical Divisions of the Nervous System 380
The Functional Divisions of the Nervous System 380
Neurons 380
The Structure of Neurons 381
The Classification of Neurons 383
Neuroglia 384
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Neuroglia of the Central Nervous System 384
Neuroglia of the Peripheral Nervous System 387
Neural Responses to Injuries 387
Ion Movements and Electrical Signals 390
The Transmembrane Potential 390
Changes in the Transmembrane Potential 394
Graded Potentials 396
Action Potentials 398
Synaptic Activity 404
General Properties of Synapses 404
Cholinergic Synapses 405
The Activities of Other Neurotransmitters 408
Neuromodulators 408
How Neurotransmitters and Neuromodulators Work 409
Information Processing by Individual Neurons 412
Postsynaptic Potentials 412
Presynaptic Inhibition and Presynaptic Facilitation 414
The Rate of Generation of Action Potentials 415
Chapter Review 416
Chapter 13
The Spinal Cord, Spinal Nerves, and Spinal Reflexes 421
General Organization of the Nervous System 422
Gross Anatomy of the Spinal Cord 423
Spinal Meninges 425
Sectional Anatomy of the Spinal Cord 427
Spinal Nerves 429
Peripheral Distribution of Spinal Nerves 430
Nerve Plexuses 431
Principles of Functional Organization 437
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Neuronal Pools 438
An Introduction to Reflexes 439
Spinal Reflexes 441
Monosynaptic Reflexes 441
Polysynaptic Reflexes 443
Integration and Control of Spinal Reflexes 445
Voluntary Movements and Reflex Motor Patterns 445
Reinforcement and Inhibition 445
Chapter Review 447
Chapter 14
The Brain and Cranial Nerves 451
An Introduction to the Organization of the Brain 452
A Preview of Major Regions and Landmarks 452
Embryology of the Brain 452
Ventricles of the Brain 453
Protection and Support of the Brain 455
The Cranial Meninges 455
Cerebrospinal Fluid 456
The Blood Supply to the Brain 458
The Medulla Oblongata 459
The Pons 462
The Cerebellum 462
The Mesencephalon 464
The Diencephalon 465
The Thalamus 466
The Hypothalamus 467
The Limbic System 469
The Cerebrum 470
The Cerebral Cortex 470
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The White Matter of the Cerebrum 472
The Basal Nuclei 472
Motor and Sensory Areas of the Cortex 474
Cranial Nerves 480
Cranial Reflexes 490
Chapter Review 491
Chapter 15
Neural Integration I: Sensory Pathways and the Somatic Nervous System 495
An Overview of Sensory Pathways and the Somatic Nervous System 496
Sensory Receptors and Their Classification 496
Sensory Receptors 497
The General Senses 498
The Organization of Sensory Pathways 503
Somatic Sensory Pathways 503
Visceral Sensory Pathways 507
The Somatic Nervous System 508
The Corticospinal Pathway 509
The Medial and Lateral Pathways 511
The Basal Nuclei and Cerebellum 511
Levels of Processing and Motor Control 513
Chapter Review 514
Chapter 16
Neural Integration II: The Autonomic Nervous System and Higher-Order Functions
517
An Overview of the ANS 518
Divisions of the ANS 519
The Sympathetic Division 521
Organization and Anatomy of the Sympathetic Division 522
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Sympathetic Activation Neurotransmitters and Sympathetic 524
Function 525
Summary: The Sympathetic Division 526
The Parasympathetic Division 527
Organization and Anatomy of the Parasympathetic Division 528
Parasympathetic Activation Neurotransmitters and Parasympathetic 529
Function 529
Summary: The Parasympathetic Division 530
Interactions between the Sympathetic and Parasympathetic Divisions 531
Anatomy of Dual Innervation 531
Autonomic Tone 533
Integration and Control of Autonomic Functions 534
Visceral Reflexes 535
Higher Levels of Autonomic Control 535
The Integration of SNS and ANS Activities 536
Higher-Order Functions 537
Memory 537
States of Consciousness 540
Brain Chemistry and Behavior 541
Aging and the Nervous System 542
Integration with Other Systems 543
Clinical Patterns 543
Chapter Review 545
Chapter 17
The Special Senses 549
An Introduction to the Special Senses 550
Olfaction 550
Olfactory Receptors 551
Olfactory Pathways 551
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Olfactory Discrimination 551
Gustation 552
Taste Receptors 553
Gustatory Pathways 553
Gustatory Discrimination 553
Vision 554
Accessory Structures of the Eye 554
The Eye 557
Visual Physiology 566
The Visual Pathway 571
Equilibrium and Hearing 573
Anatomy of the Ear 573
Equilibrium 576
Hearing 579
Chapter Review 586
Chapter 18
The Endocrine System 590
Intercellular Communication 591
An Overview of the Endocrine System 593
Classes of Hormones 593
Secretion and Distribution of Hormones 595
Mechanisms of Hormone Action 595
Control of Endocrine Activity 599
The Pituitary Gland 600
The Anterior Lobe 601
The Posterior Lobe 604
Summary: The Hormones of the Pituitary Gland 605
The Thyroid Gland 606
Thyroid Follicles and Thyroid Hormones 606
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Functions of Thyroid Hormones 610
The C Cells of the Thyroid Gland and Calcitonin 610
The Parathyroid Glands 611
The Adrenal Glands 613
The Adrenal Cortex 613
The Adrenal Medulla 615
The Pineal Gland 616
The Pancreas 616
The Pancreatic Islets 617
Insulin 617
Glucagon 619
The Endocrine Tissues of Other Systems 620
The Intestines 621
The Kidneys 621
The Heart 622
The Thymus 622
The Gonads 623
Adipose Tissue 624
Patterns of Hormonal Interaction 624
Role of Hormones in Growth 624
The Hormonal Responses to Stress 626
The Effects of Hormones on Behavior 628
Aging and Hormone Production 628
Integration with Other Systems 628
Clinical Patterns 628
Chapter Review 631
UNIT 4:FLUIDS AND TRANSPORT
Chapter 19
Blood 639
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The Cardiovascular System: An Introduction 640
The Nature of Blood 640
Plasma 642
Plasma Proteins 642
Red Blood Cells 643
Abundance of RBCs 644
Structure of RBCs 644
Hemoglobin 644
RBC Formation and Turnover 646
RBC Production 648
Blood Types 650
White Blood Cells 654
WBC Circulation and Movement 654
Types of WBCs 655
The Differential Count and Changes
in WBC Profiles 657
WBC Production 657
Platelets 660
Platelet Functions 660
Platelet Production 660
Hemostasis 661
The Vascular Phase 661
The Platelet Phase 661
The Coagulation Phase 662
Fibrinolysis 664
Chapter Review 665
Chapter 20
The Heart 669
The Organization of the Cardiovascular System 670
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Anatomy of the Heart 670
The Pericardium 671
Superficial Anatomy of the Heart 672
The Heart Wall 673
Internal Anatomy and Organization 674
Connective Tissues and the Fibrous Skeleton 680
The Blood Supply to the Heart 680
The Heartbeat 684
Cardiac Physiology 684
The Conducting System 684
The Electrocardiogram 687
Contractile Cells 688
The Cardiac Cycle 690
Cardiodynamics 695
Overview: The Control of Cardiac Output 697
Factors Affecting the Heart Rate 697
Factors Affecting the Stroke Volume 699
Summary: The Control of Cardiac Output 702
The Heart and the Cardiovascular System 703
Chapter Review 703
Chapter 21
Blood Vessels and Circulation 708
The Anatomy of Blood Vessels 709
The Structure of Vessel Walls 709
Differences between Arteries and Veins 709
Arteries 710
Capillaries 712
Veins 716
The Distribution of Blood 717
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Cardiovascular Physiology 718
Pressure 719
Resistance 719
An Overview of Cardiovascular Pressures 720
Capillary Pressures and Capillary Exchange 723
Cardiovascular Regulation 725
Autoregulation of Blood Flow within Tissues 726
Neural Mechanisms 727
Hormones and Cardiovascular Regulation 730
Patterns of Cardiovascular Response 732
Exercise and the Cardiovascular System 732
Cardiovascular Response to Hemorrhaging 733
Special Circulation 735
The Distribution of Blood Vessels: An Overview 736
The Pulmonary Circuit 737
The Systemic Circuit 738
Systemic Arteries 738
Systemic Veins 745
Fetal Circulation 753
Placental Blood Supply 753
Circulation in the Heart and Great Vessels 753
Cardiovascular Changes at Birth 754
Aging and the Cardiovascular System 756
Integration with Other Systems 756
Clinical Patterns 756
Chapter Review 758
Chapter 22
The Lymphatic System and Immunity 763
An Overview of the Lymphatic System and Immunity 764
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Organization of the Lymphatic System 764
Functions of the Lymphatic System 764
Lymphatic Vessels 765
Lymphocytes 768
Lymphoid Tissues 769
Lymphoid Organs 770
The Lymphatic System and Body Defenses 775
Nonspecific Defenses 775
Physical Barriers 775
Phagocytes 777
Immunological Surveillance 778
Interferons 779
Complement 779
Inflammation 781
Fever 782
Specific Defenses: An Overview of the Immune Response 782
Forms of Immunity 782
Properties of Immunity 783
An Introduction to the Immune Response 784
T Cells and Cell-Mediated Immunity 784
Antigen Presentation 784
Antigen Recognition 786
Activation of CD8 T Cells 787
Activation of CD4 T Cells 788
B Cells and Antibody-Mediated Immunity 789
B Cell Sensitization and Activation 789
Antibody Structure 790
Primary and Secondary Responses to Antigen Exposure 793
Summary of the Immune Response 795
Normal and Abnormal Resistance 796
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The Development of Immunological Competence 796
Hormones of the Immune System 798
Immune Disorders 800
Stress and the Immune Response 801
Aging and the Immune Response 802
Integration with Other Systems 802
Clinical Patterns 802
Chapter Review 805
UNIT 5:ENVIRONMENTAL EXCHANGE
Chapter 23
The Respiratory System 813
The Respiratory System: An Introduction 814
Functions of the Respiratory System 814
Organization of the Respiratory System 814
The Upper Respiratory System 817
The Nose and Nasal Cavity 817
The Pharynx 819
The Larynx 819
Cartilages and Ligaments of the Larynx 819
Sound Production 821
The Laryngeal Musculature 821
The Trachea and Primary Bronchi 821
The Trachea 821
The Primary Bronchi 822
The Lungs 824
Lobes and Surfaces of the Lungs 824
The Bronchi 824
The Bronchioles 826
Alveolar Ducts and Alveoli 826
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The Blood Supply to the Lungs 829
The Pleural Cavities and Pleural Membranes 829
An Overview of Respiratory Physiology 830
Pulmonary Ventilation 830
The Movement of Air 831
Pressure Changes during Inhalation and Exhalation 833
The Mechanics of Breathing 835
Respiratory Rates and Volumes 837
Gas Exchange 839
The Gas Laws 839
Diffusion and Respiratory Function 840
Gas Pickup and Delivery 842
Oxygen Transport 842
Carbon Dioxide Transport 845
Summary: Gas Transport 846
Control of Respiration 847
Local Regulation of Gas Transport and Alveolar Function 848
The Respiratory Centers of the Brain 848
Respiratory Reflexes 850
Voluntary Control of Respiration 852
Changes in the Respiratory System at Birth 853
Aging and the Respiratory System 853
Integration with Other Systems 854
Clinical Patterns 856
Chapter Review 856
Chapter 24
The Digestive System 862
The Digestive System: An Overview 863
Functions of the Digestive System 863
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The Digestive Organs and the Peritoneum 864
Histological Organization of the Digestive Tract 866
The Movement of Digestive Materials 868
Control of Digestive Function 868
The Oral Cavity 870
The Tongue 871
Salivary Glands 871
The Teeth 873
The Pharynx 875
The Esophagus 875
Histology of the Esophagus 876
Swallowing 876
The Stomach 877
Anatomy of the Stomach 877
Regulation of Gastric Activity 881
Digestion and Absorption in the Stomach 883
The Small Intestine and Associated Glandular Organs 884
The Small Intestine 884
Histology of the Small Intestine 885
Intestinal Movements 887
The Pancreas 888
The Liver 890
The Gallbladder 894
The Coordination of Secretion and Absorption 895
The Large Intestine 896
The Cecum 897
The Colon 897
The Rectum 899
Histology of the Large Intestine 899
Physiology of the Large Intestine 899
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Digestion and Absorption 902
The Processing and Absorption of Nutrients 902
Carbohydrate Digestion and Absorption 902
Lipid Digestion and Absorption 905
Protein Digestion and Absorption 905
Water Absorption 906
Ion Absorption 906
Vitamin Absorption 907
Aging and the Digestive System 907
Integration with Other Systems 908
Clinical Patterns 908
Chapter Review 910
Chapter 25
Metabolism and Energetics 915
An Overview of Metabolism 916
Carbohydrate Metabolism 918
Glycolysis 918
Mitochondrial ATP Production 920
Energy Yield of Glycolysis and Cellular Respiration 924
Gluconeogenesis 926
Lipid Metabolism 927
Lipid Catabolism 927
Lipid Synthesis 927
Lipid Transport and Distribution 927
Protein Metabolism 930
Amino Acid Catabolism 930
Protein Synthesis 933
Metabolic Interactions 933
Diet and Nutrition 936
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Food Groups and Food Pyramid 936
Nitrogen Balance 937
Minerals 937
Vitamins 938
Diet and Disease 940
Energy Gains and Losses 941
The Energy Content of Food 941
Metabolic Rate 942
Thermoregulation 942
Chapter Review 946
Chapter 26
The Urinary System 951
An Overview of the Urinary System 952
The Kidneys 952
Sectional Anatomy of the Kidneys 953
Blood Supply and Innervation of the
Kidneys 953
The Nephron 956
Principles of Renal Physiology 961
Basic Processes of Urine Formation 961
An Overview of Renal Function 963
Renal Physiology: Filtration at the Glomerulus 965
Filtration Pressures 966
The Glomerular Filtration Rate 967
Control of the GFR 967
Renal Physiology: Reabsorption and Secretion 969
Reabsorption and Secretion at the PCT 970
The Loop of Henle and Countercurrent Multiplication 970
Reabsorption and Secretion at the DCT 973
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Reabsorption and Secretion along the Collecting System 975
The Control of Urine Volume and Osmotic Concentration 976
The Function of the Vasa Recta 978
The Composition of Normal Urine 978
Summary: Renal Function 980
Urine Transport, Storage, and Elimination 982
The Ureters 983
The Urinary Bladder 984
The Urethra 985
The Micturition Reflex and Urination 986
Aging and the Urinary System 987
Integration with Other Systems 988
Clinical Patterns 988
Chapter Review 988
Chapter 27
Fluid, Electrolyte, and Acid–Base Balance 994
Fluid, Electrolyte, and Acid–Base Balance: An Overview 995
An Introduction to Fluid and Electrolyte Balance 996
The ECF and the ICF 996
Basic Concepts in the Regulation of Fluids and
An Overview of the Primary Regulatory
The Interplay between Fluid Balance and Electrolyte
Electrolytes 998
Hormones 998
Balance 999
Fluid Balance 999
Fluid Movement within the ECF 1000
Fluid Gains and Losses 1000
Fluid Shifts 1001
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Electrolyte Balance 1002
Sodium Balance 1002
Potassium Balance 1004
Balance of Other Electrolytes 1005
Acid–Base Balance 1007
The Importance of pH Control 1008
Mechanisms of pH Control 1009
Maintenance of Acid–Base Balance 1012
Types of Acids in the Body 1008
Disturbances of Acid–Base Balance 1014
Respiratory Acidosis 1015
Respiratory Alkalosis 1017
Metabolic Acidosis 1017
Metabolic Alkalosis 1018
The Detection of Acidosis and Alkalosis 1019
Aging and Fluid, Electrolyte, and Acid–Base Balance 1019
Chapter Review 1021
UNIT 6:CONTINUITY OF LIFE
Chapter 28
The Reproductive System 1029
Introduction to the Reproductive System 1030
The Reproductive System of the Male 1030
The Testes 1030
Spermatogenesis 1036
The Anatomy of a Spermatozoon 1038
The Male Reproductive Tract 1040
The Accessory Glands 1041
Semen 1043
The External Genitalia 1044
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Hormones and Male Reproductive Function 1045
The Reproductive System of the Female 1048
The Ovaries 1049
The Uterine Tubes 1052
The Uterus 1053
The Vagina 1057
The External Genitalia 1058
The Mammary Glands 1059
Hormones and the Female Reproductive Cycle 1061
Summary: Hormonal Regulation of the Female Reproductive Cycle 1062
The Physiology of Sexual Intercourse 1065
Male Sexual Function 1065
Female Sexual Function 1066
Aging and the Reproductive System 1066
Menopause 1066
The Male Climacteric 1067
Integration with Other Systems 1067
Clinical Patterns 1067
Chapter Review 1068
Chapter 29
Development and
Inheritance 1074
An Overview of Topics in Development 1075
Fertilization 1075
The Oocyte at Ovulation 1076
Oocyte Activation 1077
The Stages of Prenatal Development 1077
The First Trimester 1078
Cleavage and Blastocyst Formation 1078
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Implantation 1079
Placentation 1082
Embryogenesis 1085
The Second and Third Trimesters 1089
Pregnancy and Maternal Systems 1089
Structural and Functional Changes in the Uterus 1091
Labor and Delivery 1092
Stages of Labor 1092
Premature Labor 1093
Difficult Deliveries 1094
Multiple Births 1094
Postnatal Development 1094
The Neonatal Period, Infancy, and Childhood 1094
Adolescence and Maturity 1097
Senescence 1098
Genetics, Development, and Inheritance 1098
Genes and Chromosomes 1098
Patterns of Inheritance 1099
Sources of Individual Variation 1102
Sex-Linked Inheritance 1103
The Human Genome Project 1104
Chapter Review 1105
Appendices A-1
I Answers to Concept Check and End-of-Chapter Questions A-1
II Weight and Measures A-36
III Periodic Table A-39
IV Normal Physiological Values A-40
V 100 Keys A-42
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Glossary G-1
Credits C-1
Index I-1
Preface
TO THE INSTRUCTOR
You may or may not be familiar with earlier editions of this book, so I will focus on things
that I’d want to know if I were considering a text for use in one of my classes.
What Sets This Text Apart from the Others?
I have often heard people say, “All A&P books are the same.” Well, certainly the available
texts are about the same size and length, and they all have a similar organization, feature
colorful illustrations, and include an assortment of supplements. But they differ widely in
the way they organize information and present complex concepts. I will cite four specifics
that set this text apart from all that are available:
#1: The Consistent and Highly-Effective Art Program
Most texts are illustrated by a dozen or more different artists and studios, all working in
relative isolation. There are no common conventions, no consistent presentation or theme.
This is the only text that has all of the art done by a pair of medical illustrators—William
C. Ober, M.D., and Claire W. Garrison, R.N. (see the biographical notes on p. vii). Bill and
Claire have worked with me since the start of the First-Edition illustration program in
1986. They know the material, they know the text, and, as they work, they know how they
will illustrate related topics in later chapters. As a result, the art flows as smoothly as the
text. Please turn to the Visual Introduction (pp. xxiv–xxxiv) for an illustrated tour of the art
program, including details on how figures have been enhanced for the Seventh Edition.
#2: The Clear and Direct Narrative Style
I believe that it is important to organize material so that it can easily be studied,
understood, and reviewed for exams. This is not a novel that will be read for fun. This
textbook is a resource that helps students accomplish a specific task—mastering the
material—as efficiently as possible. The narrative in this new edition has been revised with
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special attention paid to those features that have proven to aid in the actual learning
process:
← • Overviews that help students see the big picture
← • Navigator Figures that provide a road map through complex discussions
← • Lists that make it easier to organize information and focus on key facts and
concepts
← • Tables that summarize information concisely, in a format that makes it easy
to memorize when memorization is required
#3: The Thorough and Time-Saving Pedagogical Framework
This focus on the needs of students is reflected in many pedagogical devices used
throughout the text:
← • Students can check their progress periodically by answering short Concept
Check questions at the ends of major sections.
← • When material relates to topics presented earlier, Concept Links signaled
with icons l provide specific page numbers that facilitate review.
← • The end-of-chapter Study Outlines are unusually comprehensive.
← • The end-of-chapter Review Questions are organized in increasing levels of
difficulty and sophistication, so that students can test their mastery first of facts and
terminology, then of concepts, and finally of critical thinking and clinical
applications.
← • A new feature called 100 Keys has been added. These are basic concepts
and principles that I would like students to remember five years after the course is
over, regardless of their ultimate career paths. Signaled with icons, the keys are
factual statements that function as organizers of central information in A&P.
#4: The Helpful and Practical Ancillaries Provided with the Text
Today, no single text, no matter how good or how comprehensive, can provide all the
resources that students should be able to draw on for help in mastering this demanding
subject. Accordingly, this book has been designed as the central component of a fully
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integrated learning system that includes both media and print components. The complete
package includes five additional components, all of which are automatically packaged with
new copies of the text:
← • InterActive Physiology® CD-ROM, a media program that has helped
thousands of students improve their grades in A&P with animations, tutorials, and
quizzes to teach the most difficult physiological concepts.
← • The A&P Applications Manual, organized to parallel the text, and
including discussions of clinically important disorders for each of the body’s organ
systems, together with information about the relevant diagnostic techniques,
laboratory tests, and treatment options.
← • Martini’s Atlas of the Human Body, expanded and enhanced, now with 252
photographs, clinical images, and scans, including anatomical photographs by
Ralph T. Hutchings, a renowned biomedical photographer.
• New Anatomy 360 ™ CD-ROM, featuring three-dimensional rotatable and layered
visualizations derived from the Visible Human Project, along with labeling activities,
interactive exercises, and self-review questions.
• A Student Access Kit for MyA&P™, an online resource site where students will
find a variety of interactive exercises and self-quizzes for each chapter.
All of these components are completely integrated with the text through icons and specific
references that appear both within the chapters and in the Chapter Reviews. More complete
descriptions appear in the Visual Introduction section (pp. xxiv–xxxiv).
What’s Different about the Seventh Edition?
The basic chapter sequence and organization of the text remain largely unchanged.
However, you will find several new organizational features within the narrative, as well as
refinements to (and more generous use of) features that have been highly praised by
students and instructors, including Navigator Figures, the Systems Overview section, and
integrative sections that discuss the interactions among the various organ systems.
#1: Improvements to Text Readability
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A thorough and complete line-by-line edit was applied to the entire book to tighten the
writing and improve the consistency and coordination between the text prose and the art
figures. The combination of more succinct writing, a noticeably larger text font size, and a
fresh clear, and open design provides students with a more inviting, “readable” textbook.
#2: Enhancements to the Art Program
Bill Ober and Claire Garrison have made substantial improvements to the already superb
art program of previous editions. Virtually every figure has been altered to some degree to
make the use of colors, arrow conventions, and design features consistent at all levels.
Please turn to the Visual Introduction (pp. xxiv–xxxiv) for an illustrated overview of the
upgraded “Stepped” Art Figures, Macro-to-Micro Views, Compound Art, and Navigator
figures.
#3: Re-Organization of the Clinical Material
The clinical material has been further integrated within the text to increase its pedagogical
value. Short Clinical Notes deal with pathologies that shed light on the principles of normal
physiological function. Longer, boxed versions of the Clinical Notes deal with topics of
particular medical or social importance (such as cancer and AIDS) that require more
extended exploration.
The revised A&P Application Manual contains an abundance of supplementary clinical
material, including a number of topics that were previously included in the text. It includes
authoritative discussions of a broad range of diseases with extensive information about
relevant laboratory tests, diagnostic procedures, and treatments. With an organization that
parallels the text, system by system and chapter by chapter, the A&P Application Manual
can be used as a supplement to the text, as a reference, or as a resource for those students
who want to learn more about clinical topics. See the Visual Introduction (pp. xxiv–xxxiv)
for an illustrated presentation of the clinical material in the program.
#4: Improved Pedagogy and Media References
Along with the new 100 Keys feature (see page xxvi in the Visual Introduction), new labels
and design improvements have been added to the Concept Check, Clinical Notes, Systems
Overview, and System in Perspective features. The Seventh Edition makes it easier than
ever to connect the two accompanying CD-ROMs and the website with the core material in
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the text. The InterActive Physiology® CD-ROM, Anatomy 360 ™. CDROM, the
MyA&P™ online course management system and website are referenced with distinctive
icons at appropriate points throughout the book.
To let me know what you think of the Seventh Edition or give suggestions to be considered
for the Eighth Edition, please e-mail me at the following address.
Frederic H. Martini
TO THE STUDENT
How to Get the Most Out of This Program
You probably have several reasons for taking this course. You might have questions about
your own body and its functions. You may be curious about the origins of health problems
or diseases. Perhaps you need a course in anatomy and physiology to further your career
plans.
If you are like most college students, you have two short-term goals in mind: (1) to learn
and understand the material, and (2) to be able to demonstrate your mastery to the
satisfaction of the instructor. I’ve tried to build features into the text that will help you
reach both of these goals. In many respects, I’ve assembled this text like an owner’s
manual for the human body—it not only has the important information, but it is also
designed to help you find that information quickly. As a result, you may find that it is
different from the texts you’ve used for other classes. In this section, I’ve tried to give you
some advice on how to use the features and unique organization of this text to your
advantage. If you charge off into the text without reading further, you may miss some
suggestions that could help you succeed.
Learn the TerminologyYou will find that there are a lot of new words to learn. The faster you can learn the
terminology, the easier it will be for you to master the concepts. Throughout the text, the
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most important terms appear in boldface print so they are easy to spot. Any time there’s a
chance of confusion regarding how a new term is pronounced, I’ve included a
pronunciation guide. Accented syllables are in capital letters, and for the vowels:
as in tray a as in track
as in tree e as in help
as in spine i as in ink
as in bone o as in Tom
as in use u as in run
Witch the Big PictureAlthough there is a lot of detailed information in anatomy and physiology, don’t lose sight
of the big picture.
← • Each chapter begins with an outline. Use it to get a sense of the scope and
organization of the chapter as a whole.
← • Each of the major sections in the chapter starts with a list of Objectives. The
list will give you a preview of the main points that you can expect to learn as you
work through the material in the section.
← • Many of the chapters include Navigator Figures, clearly labeled as such,
which function as a kind of road map. Use them to help keep track of where you are
in a complex discussion without getting lost in the details.
← • Many of the chapters include Summary Tables that integrate large blocks of
information in a format that makes the material easier to review. Make sure you
understand the information before moving ahead in the chapter.
Organize Important InformationYou’ve got to have a study plan and a method of organizing your notes. Don’t try to
memorize everything. Organize the material, focus on the key points, and look for common
themes and patterns.
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← • Take advantage of the many lists in the text as well as the abundance of
tables. Both of these formats summarize important information in a way that will
make it easier for you to grasp and memorize.
← • The material in each chapter builds on the material presented in earlier
chapters. Often you will want to review the relevant discussions. To make this
easier, I’ve inserted a symbol with a page reference: l p. 000. To help you proceed
directly to the proper page, you will find that the page numbers appear in bold in
the upper margin of each page of narrative, or at the bottom margin of each page of
artwork.
Keep an Eye on the ArtI’ve provided a lot of visual support in this package because, whether you are considering
processes or structures, you need to be able to visualize what’s being described in the
narrative.
← • There are a LOT of illustrations in the text, and I work closely with the
artists, an M.D. and an R.N., who review the text before creating the images.
Because the text and art are developed together, you will find yourself moving back
and forth between the text and the art as you read the chapter. At each spot in the
narrative where you are sent to the art, a red dot serves as a place holder—use it to
help you find your way back to the point in the text that you left.
← • Many of the figures show dynamic processes underway in a series of steps;
these same steps are also clearly identified and explained in the narrative. Breaking
a complex process into stages is one way to make it easier to follow and understand.
← • Some figures are accompanied by an ATLAS citation, which directs you to
another view of the same structure in Martini’s Atlas of the Human Body, packaged
with your text. You’ll find that looking at a single anatomical feature from different
perspectives or visualized using different techniques is a powerful way of
enhancing your understanding of what you are seeing.
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Consider What the Information MeansYou probably would not be taking this course if you did not have at least some interest in
health and medicine. The text and its ancillaries contain a wealth of clinical material,
organized so that you can easily focus on precisely what is relevant to your own or your
instructor’s concerns:
← • Short Clinical Notes embedded in the text deal with many kinds of
pathologies. These topics have been selected to help you understand the principles
of normal function by showing what happens when something goes wrong.
← • Topics of great general importance or that require more extended treatment
are considered in longer boxed Clinical Notes.
← • Information about a variety of diseases not discussed in the text, as well as
additional details about many that are, can be found in the A&P Applications
Manual that came with your new text, together with information about the
diagnosis and treatment of these conditions. The A&P Applications Manual is
organized in exactly the same way as the text to make it as easy as possible for you
to consult. Use it as a supplement to the text, as a reference, or just to satisfy your
individual curiosity. Look for the red icon, AM, that will direct you to relevant
topics in the A&P Applications Manual.
Put It All TogetherThe human body is an integrated whole, not a collection of isolated systems, so it’s
important that you be able to see information pertaining to specific systems in a larger
context.
← • For each body system, you’ll find a System in Perspective art figure that
focuses on its interactions with every other body system and outlines relevant
clinical aspects of the system. These figures can be an important part of your study,
because they integrate the contents of the entire book.
← • You will find 100 important concepts and principles flagged in the text.
These concepts are identified by the icon . Commit the 100 Keys to long-term
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memory, as many of them will prove useful in your studies as well as in your daily
life.
Pace YourselfIt is usually a bad idea to read a chapter in this textbook as if it were a chapter in a novel—
from beginning to end, with no breaks. It’s much more efficient to pace yourself and take a
few pauses along the way to test your understanding of the material presented thus far. You
are building your knowledge base, and there’s no use reading the next section until you
understand what was covered in this section.
← • At the end of each major section, you will find a few short review questions
in the Concept Check section. Take a moment to answer them. If you find them
easy to answer, you can go on to the next section. If you find them difficult to
answer, go back and reread the material. It’s like building a house—it’s not wise to
start working on the second floor if the first floor is shaky.
• Throughout the chapter are references to tutorials or three-dimensional anatomical
views on the InterActive Physiology® CD-ROM or the Anatomy 360 ™ CD-ROM, which
are packaged with your text. Don’t hesitate to take advantage of these resources if you feel
that you need to reinforce or deepen your understanding of the material you have just
covered.
Review the Chapter after You Complete ItIt might take you a week to work through a chapter, and by the time you reach the end, you
may not have a clear perspective on the presentation as a whole. That’s the time to review
the end-of-chapter material.
• The Study Outline at the end of each chapter gives you an opportunity to review all
the chapter’s key information and concepts. You can also use it as a jumping-off point for
the CD-based tutorials and visualizations referenced within the chapter (InterActive
Physiology® and Anatomy 360 ™), because those references are repeated here.
• The Review Questions are organized so that you can assess your mastery of the
chapter on three levels. You can test your grasp of facts and terminology (Level 1), your
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understanding of concepts (Level 2), and your ability to apply the material to realistic
clinical situations (Level 3). If you need additional practice, there are more self-assessment
quizzes in various formats at MyA&P (http://www.myaandp.com) or on the Anatomy and
Physiology Place Website (www.anatomyandphysiology.com).
I wrote this book to give you the information you need as clearly as possible. If you find
certain sections especially difficult, if you don’t find information that you or your
instructor would really like to cover, or if you have other comments or suggestions for
future editions, please let me know using the e-mail address below.
Good luck and best wishes, Ric
Visual IntroductionTHE ART PROGRAM
An Award-Winning Presentation of Anatomy & Physiology
Compound Art
pairs an artist’s drawing with a photograph to encourage students to compare a detailed
rendering with the “real thing” as they would see it in a laboratory.
Martini's Atlas of the Human Body is packaged with every new book, and references to it
are marked with an "ATLAS."
Navigator Figures
present a “big picture” overview at the beginning of complex discussions and are repeated
at appropriate intervals with specific details highlighted to break the material into smaller,
clearer units.
NEW! Navigator Figures are now called out with a Navigator heading and a compass icon
so students can clearly see that the figure relates to later figures.
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“Stepped”Art Figures
break down multifaceted processes into step-by-step illustrations that coordinate with the
author’s narrative descriptions.These easy-to-follow sequences in the book are also
featured in the new Media Manager CD-ROMs for instructors to use in classroom
presentations.
NEW! Re-designed “Stepped”Art Figures provide clearer step headings to help students
follow the sequence of events.
Macro-to-Micro Views
bridge the gap between familiar and unfamiliar structures of the body by illustrating
smaller anatomical structures within larger ones.A large-scale orienting image is followed
by corresponding smaller-scale sectional views.
NEW! Macro-to-Micro Views have been substantially re-designed and re-arranged to
present a more intuitive “flow,” and arrows are more strongly used to show progressions.
TEXT FEATURES
Save Time and Raise Test Scores!
NEW! 100 Keys
offer 100 important concepts and principles over the course of the chapters. Signaled with
an icon, the Keys are factual statements that function as organizers of central information
in anatomy & physiology.
Concept Check Questions
appear at the end of chapter sections and help students test their comprehension before
moving on to the next topic.
Concept Links
are used when material relates to topics presented earlier and offer specific page numbers
to facilitate review.
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Figure Locator Dots
appear with every figure reference in the narrative and function as placeholders to help
students return to reading after viewing a figure.
Learn Applications to the Real World!
An A&P Applications Manual that extends the clinical information in the chapters is
packaged with every new book, and references to it are marked with an "AM."
Clinical Notes
present relevant clinical information throughout the text.Those embedded in the narrative
deal with pathologies and their relation to normal physiological function, while the larger
boxed versions address important medical or social topics.
NEW! Core clinical topics are now more prominent in the chapters.
Focus Boxes
include concentrated coverage of a particular topic with clear text explanations and many
illustrations or photographs.
TEXT FEATURES
See the Big Picture!
Systems Overview Section
appears between Chapters 4 and 5—after the introductory material on chemical, cellular,
and tissue levels of organization—to prepare students for the body systems chapters and to
serve as a convenient “big picture” summary for easy reference.
System in Perspective Summaries
provide an excellent, illustrated review of the basic functions of each body system and help
students understand that the body functions as an integrated unit rather than as a set of
isolated, independent systems.
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INSTRUCTOR SUPPLEMENTS
Dynamic Lectures in Half the Time!
NEW! Media Manager
combines all instructor and student media for Fundamentals of Anatomy & Physiology,
Seventh Edition into the ultimate chapter-by-chapter resource.The package includes seven
CDs plus a foldout Quick Reference Guide.The CDs contain all of the art from the book. A
special collection of Precision Art has Figure Edit and Text Edit capabilities that allow
instructors to customize the art and labels to the needs of their students. Other resources
include powerful animations, three-dimensional images and movies, links to the InterActive
Physiology® and Anatomy 360º ™ media programs, PowerPoint® lecture presentations, the
Test Bank, and much more!
MEDIA MANAGER INCLUDES CUSTOMIZABLE ART!
Precision Art
lets you tailor the art from the book to your classroom needs in two ways:
Figure Edit art facilitates step-by-step presentation of complex topics.
Text Edit art allows you to edit terms and labels in the figure.
In addition to the features displayed on this screen, the Media Manager offers:
← • All images from the text, in labeled, unlabeled, and leadered-only versions
← • Over 120 animations
← • More than 50 three-dimensional anatomical presentations with peel-away,
flythrough, and panoramic views
← • Chapter-specific links to the InterActive Physiology and Anatomy 360º
media programs
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← • Active Lecture Questions, for in-class projection, that students can respond
to using personal response systems (in H-ITT or PRS formats), for easy checking of
comprehension
← • An Additional Resources section, including MRI and CT Scans, Histology
images, the Instructor’s Manual, the A&P Applications Manual, and more.
INSTRUCTOR SUPPLEMENTS
Everything You Need to Teach Your Course Your Way
Transparency Acetates
package includes more than 800 high-quality acetates with all of the art from the text in
enhanced colors with enlarged figure labels for use in lecture halls.
Instructor’s Manual
includes lecture sugges tions, vocabulary aids, applications, and classroom demonstrations
to help you prepare for the classroom.A chapter-by-chapter Quick Reference Guide of all
available media helps you organize your presentations.
Test Bank and Computerized Test Bank
include more than 3,000 questions organized into the text's three-level learning system for
designing a variety of tests and quizzes. Available in both a print version and TestGen
software.
MyA&P,™WebCT,™ and Blackboard
provide ready-to-as-sign materials in the most widely used course management systems.
See the very beginning pages of this text for an overview of MyA&P. ™
Instructor's Visual Guide
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lets you see all of the art and PowerPoint® slides that are available on the Media Manager
CD-ROMs in a convenient printed reference guide that you can use when selecting visuals
for classroom presentation.
STUDENT SUPPLEMENTS
A Superb Student Learning Package
Included with every new copy of the text:
← • InterActive Physiology® CD-ROM
← • Anatomy 360º ™ CD-ROM
← • MyA&P™
← • Martini’s Atlas of the Human Body
← • A&P Applications Manual
See descriptions of these components on the inside front cover of this text.
Study Guide
by Charles Seiger provides additional review of basic facts and concepts and practice for
developing problem-solving skills.A wide variety of questions, including labeling and
concept mapping, are keyed to every learning objective in the textbook and are organized
around the text’s three-level learning system.
ISBN: 0-8053-7294-6
The Anatomy Coloring Book
by Wynn Kapit and Lawrence M. Elson helps students memorize structures of the body by
coloring in line drawings. Use of the coloring book sharpens concentration and increases
attention to detail, thereby aiding students in retention of material.
ISBN: 0-8053-7282-2
FOR THE LAB
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Manuals That Meet Your Needs
Benjamin Cummings publishes a variety of best-selling laboratory manuals to meet the
diverse needs of lab courses.
Laboratory Manual for Anatomy & Physiology
by Michael G.Wood This full-color lab manual has been designed to complement
Fundamentals of Anatomy & Physiology, Seventh Edition and includes much of the same
high-quality art by illustrators Bill Ober and Claire Garrison.
← • Main Version,Third Edition ISBN: 0-8053-7368-3
← • Cat Version,Third Edition ISBN: 0-8053-7369-1
← • Pig Version,Third Edition ISBN: 0-8053-7370-5
Human Anatomy & Physiology Laboratory Manual
by Elaine N. Marieb
This full-color lab manual guides students through well-planned
lab activities to aid in mastery of the subject.
← • Main Version, Seventh Edition Update ISBN: 0-8053-5514-6
← • Cat Version, Eighth Edition Update ISBN: 0-8053-5516-2
← • Pig Version, Eighth Edition Update ISBN: 0-8053-5518-9
Integrate
Create your own A&P laboratory manual tailored to your specific needs on the Integrate
database, which includes all of the Benjamin Cummings laboratory manuals from which
you can select the individual laboratory exercises you want. Your own laboratory exercises
can also be added to your custom-built laboratory manual.
Acknowledgments
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This textbook is not the product of any single individual. It represents a group effort, and
the members of the group deserve to be acknowledged.
Foremost on my thank you list are the instructors who reviewed the published text of the
Sixth Edition and the manuscript for the Seventh Edition to offer the suggestions that
helped guide me through the revision process. To them, I express my sincere thanks and
best wishes:
Mary E. Allen-Martin, San Antonio College
Nishi Bryska, University of North Carolina—Charlotte
Sarah Caruthers Jackson, Florida Community College—Jacksonville
Clifford L. Fontenot, Southeastern Louisiana University
Karen Hart, Peninsula College
Martin F. Hicks, Community College of Southern Nevada
Bonnie Kalison, Mesa Community College
Marie L. Kotter, Weber State University Circle
Charles Matsuda, Kapi’olani Community College
Karen McCourt, El Paso Community College
Robert McMullen, Pikes Peak Community College
Colin A. Morris, Pensacola Junior College
Christopher Nicolay, University of North Carolina—Asheville
Amy Griffin Ouchley, University of Louisiana—Monroe
Chuck Robinson, Mississippi Gulf Coast Community College
Dee Sato, Goldenwest College
Tamara McNutt Scott, Clemson University
Robert R. Speed, Wallace Community College
Ralph W. Stevens III, Old Dominion University
Janis G. Thompson, D.V.M., Lorain County Community College
Don Wager, Broome Community College
Jyoti R. Wagle, Houston Community College—Central
David Ward, Modesto Junior College
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After the initial drafts were completed, five dedicated instructors functioned as technical
editors, assisting with the review and correction of page proofs. They have been immensely
helpful to me during the revision of this edition:
Gillian Bice, Michigan State University
Kelly J. Johnson, University of Kansas
Alan Magid, Durham Technical Community College
Judi Nath, Lourdes College
Marilyn Shannon, Indiana University—Purdue University Indianapolis
Focus groups and meetings with students helped me concentrate on students’ needs. Every
day I receive e-mails from faculty members and students who have comments, questions,
and suggestions. Their interest in the subject, concern for the accuracy and method of
presentation, and wide range of abilities and backgrounds made the revision process an
engaging and educational experience for me.
Over time, a textbook evolves. As with organisms, each evolutionary step builds on a
preexisting framework. Thus, I also thank the individuals who helped with the
development of previous editions:
Maxine A’Hearn, Prince George’s Community College
Shylaja Akkaraju, College of DuPage
Ahmed Naguy Ali, Alexandria, Egypt
John Aliff, Georgia Perimeter College
Steven Amdur, Nassau Community College
Paul Anderson, Massachusetts Bay Community College
Karen Apel, University of Wisconsin—Milwaukee
Timothy Alan Ballard, University of North Carolina—Wilmington
Debra Joan Barnes, Contra Costa College
Edwin Bartholomew, Lahainaluna High School
CeCe Barto, Tomball College
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Steven Bassett, Southeast Community College
Robert Bauman, Jr., Amarillo College
Dean Beckwith, Illinois Central College
Doris Benfer, Montgomery Community College
Michèle Bertholf, Metropolitan State College and Front Range Community College
Latsy Best, Palm Beach Community College—North
Alfred Beulig, University of South Florida at New College
Charles Biggers, University of Memphis
Greg Bohm, Hillsborough Community College
Mark Bolke, Clark College
Michael Bonnert, University of Toronto
Cynthia Bottrell, Scott Community College
Spencer R. Bowers, Oakton Community College
Mimi Bres, Prince George’s Community College
Alan Bretag, University of South Australia School of Pharmacy
C. David Bridges,Purdue University
Sandra Bruner, Polk Community College
Gene Carella, Niagara County Community College
Robert M. Carey, University of Arizona
Wayne Carley, Lamar University
Leslie Carlson, Iowa State University
Catherine Carter, Georgia Perimeter College
Lucia Cepriano, SUNY Farmingdale
William M. Chamberlain, Indiana State University
William D. Chapple, University of Connecticut
Beng Cheah, University of Newcastle
Anthony Chee, Houston Community College
Suzzette Chopin, Texas A & M University—Corpus Christi
Chin Moi Chow, Cumberland College of Health Sciences, University of Sydney
Ana Christensen, Lamar University
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O. D. Cockrum,Texas State Technical College
Kim Cooper, Arizona State University
Richard Coppings, Chattanooga State College
William F. Crowley, Harvard Medical School
Grant Dahmer, University of Arizona
Charles Daniels, Kapiolani Community College
Darrell Davies, Kalamazoo Valley Community College
Mary Dawson, Kingsborough Community College
Brent DeMars, Lakeland Community College
Danielle Desroches, William Paterson University
Eric Dewar, Lansing Community College
Charles Dick, Pasco-Hernando Community College
Gerald R. Dotson, Front Range Community College
Ellen Dupre, Indian River Community College
John Dziak, Community College of Allegheny County
Paul Emerick, Monroe Community College
Lee Famiano, Cuyahoga Community College
Lee Farello, Niagara County Community College
Marion Fintel, Jefferson State Community College
Kathleen A. Flickinger, Maui Community College
Ruby Fogg, New Hampshire Tech
Mildred Fowler, Tidewater Community College
Sharon Fowler, Dutchess Community College
Ralph Fregosi, University of Arizona
Denise Friedman, Hudson Valley Community College
Ann Funkhouser, University of the Pacific
Mildred Galliher, Cochise College
Paul Garcia, Houston Community College
Lori K. Garrett, Danville Area Community College
Anthony J. Gaudin, Ivy Tech State College
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Michelle Geremia, Quinnipiac University
Jeff Gerst, North Dakota State University
Louis Giacinti, Milwaukee Area Technical College
Delaine Gilcrease, Mesa Community College
Linda Gingerich, St. Petersburg College
Freda Glaser, University of Maryland—Baltimore County
Kathleen M. Gorczyca, North Shore Community College
Bonnie Gordon, Memphis State University
Susan Grigsby, Houston Community College
Mac E. Hadley, University of Arizona
William Hairston, Harrisburg Area Community College
Cecil Hampton, Jefferson College
Ernest Harber, San Antonio College
Jobn P. Harley, Eastern Kentucky University
Ann Harmer, Orange Coast Community College
Linden Haynes, Hinds Community College
Ruth Lanier Hays, Clemson University
Mary Healey, Springfield College
Jean Helgeson, Collin County Community College
Vickie S. Hennessy, Sinclair Community College
Timothy Henry, University of Texas—Arlington
Cynthia Herbrandson, Kellogg Community College
Donna Hoel, Stark Community College
Elvis J. Holt, Purdue University
Jacqueline A. Homan, South Plains College
James Horowitz, Palm Beach Community College
Beth Howard, Rutgers University
Yvette Huet-Hudson, University of North Carolina—Charlotte
Angie Huxley, Pima Community College
George A. Jacob, Xavier University
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Renu Jain, Houston Community College
Aaron James, Gateway Community College
Desiree Jett, Essex County College
Kelly Johnson, University of Kansas
Drusilla Jolly, Forsyth Technical Community College
David Kalichstein, Ocean County College
Eileen Kalmar, St. John Fisher College
George Karleskint, St. Louis Community College
Nancy G. Kincaid, Troy State University Montgomery
C. Ward Kischer, University of Arizona
Frank Kitakis, Wayne County Community College
William Kleinelp, Middlesex County College
Michael Kokkinn, University of South Australia School of Pharmacy
Carissa Krane, University of Dayton
Bob Kucera, University of Newcastle
Jerry K. Lindsey, Tarrant County Junior College
Mary Lockwood, University of New Hampshire
Susan Lustick, San Jacinto College—North
Greg Maravellas, Bristol Community College
Dan Mark, Penn Valley Community College
Jane Marks, Scottsdale Community College
Cris Martin, University of Maryland
William Mautz, University of Hawaii—Hilo
Alice Gerke McAfee, University of Toledo Technical College
Thomas W. McCort, Cuyahoga Community College
Mike McCusker, Eastern College
Robert McDonough, Georgia Perimeter College
Ruth McFarland, Mt. Hood Community College
Paul McGrath, University of Newcastle
Michael P. McKinley, Glendale Community College
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Eddie McNack, Houston Community College
Roberta Meehan, University of North Carolina
Judy Megaw, Indian River Community College
Richard F. Meginniss, College of Lake County
Beta Meyer, Mount San Antonio College
Ann Miller, Middlesex Community College
Leslie Miller, Iowa State University
Alice Mills, Middle Tennessee State University
Melvin Mills, Scottsdale Community College
Ron Mobley, Wake Technical Community College
Rose Morgan, Minot State University
Aubrey Morris, Pensacola Junior College
Robert L. Moskowitz, Community College of Philadelphia
Richard Mostardi, Akron University
Mahtas Moussavi, Houston Community College
Ann Murphy, Sydney University
Judi Nath, Lourdes College
Elizabeth Naugle, Lane Community College
Martha Newsome, Tomball College
Bill Nicholson, University of Arizona
Auguste Nioupin, Houston Community College
Richard Northrup, Delta College
Erik Nyholm, Umea University
Claire R. Oakley, Rocky Mountain College
John M. Olson, Villanova University
Joyce Ono, California State University—Fullerton
Betty Orr, Sinclair Community College
Mary Theresa Ortiz, Kinsborough Community College
Betsy Ott, Tyler Junior College
Michael Palladino, Monmouth University
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David L. Parker, Northern Virginia Community College
Mark Paulissen, Slippery Rock University
Brian K. Paulsen, California University of Pennsylvania
Lois Peck, Philadelphia College of Pharmacy
Philip Penner, Borough of Manhattan Community College
Beverly Perry, Houston Community College
Ingrid Persson, Umea University
Ed Pivorum, Clemson University
Clifford Pohl, Duquesne University
Robert Pollack, Nassau Community College
Dan Porter, Amarillo College
Linda Powell, Community College of Philadelphia
Robert L. Preston, Illinois State University
Gary Quick, Paradise Valley Community College
Anil Rao, Metropolitan State College
Joel Reicherter, SUNY Farmingdale
Peta Reid, Faculty of Nursing, University of Sydney
Jackie Reynolds, Richland College
Chris Riegle, Irvine Valley College
Jean Rigden, Scottsdale Community College
Todd Rimkus, Marymount University
John M. Ripper, Butler County Community College
Carolyn J. Rivard, Fanshawe College
Carolyn C. Robertson, Tarrant County Junior College
Nidia Romer, Miami Dade Community College
Kevin Ryan, Stark Technical College
Kristi Sather-Smith, Hinds Junior College
Frank Schwartz, Cuyahoga Community College
Charles Seiger, Atlantic Community College
Judith Shardo, University of South Alabama
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Mark Shoop, Macon College
Marilyn Shopper, Johnson County Community College
Milton Shult, Houston Community College
Sherrie Shupe, Delaware Technical and Community College
Carl Shuster, Amarillo College
P. George Simone, Eastern Michigan University
Sharon Simpson, Broward Community College
Robert A. Sinclair, San Antonio College
Tom Smeaton, University of South Australia School of Pharmacy
David S. Smith, San Antonio College
Jeffery Smith, Delgado Community College
Philip Sokolove, University of Maryland—Baltimore County
Michael Soules, University of Washington
Thomas S. Spurgeon, Colorado State University
Sandra Stewart, Vincennes University
Ann Stoeckmann, Pennsylvania State University—Worthington Scranton
Dennis Strete, Houston Community College
Kris Stuempfle, Gettysburg College
Jenna Sullivan, University of Arizona
Eric Sun, Macon College
P. Swaroop, Houston Community College
Richard Symmons, California State University—Hayward
Robert Tallitsch, Augustana College
Dennis Taylor, Hiram College
Kathy Taylor, University of Arizona
Mark Taylor, Baylor University
Jay Templin, Widener University
Diane G. Tice, SUNY Morrisville
Caryl Tickner, Stark State Technical College
Marge Torode, Cumberland College of Health Sciences, University of Sydney
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Lucia Tranel, St. Louis Community College and St. Louis College
Steve Trautwein, Southeast Missouri State University
Pat Turner, Howard Community College
Kent M. Van De Graaff, Brigham Young University
Sheila Van Holst, Faculty of Nursing, University of Sydney
Michael Vennig, University of South Australia School of Pharmacy
Connie Vinton-Schoepske, Iowa Central Community College
Jyoti Wagle, Houston Community College
Jane Wallace, Chattanooga State Technical Community College
Cheryl Watson, Central Connecticut State University
Eva Weinreb, Community College of Philadelphia
Mary Weis, Collin County Community College
Debra A. Wellner, Wichita State University
Mary Pat Wenderoth, University of Washington
Rosamund Wendt, Community College of Philadelphia
Shirley Whitescarver, Lexington Community College
Vernon Wiersema, Houston Community College
J. Wilkinson, School of Biological Sciences, University of Sydney
Stephen Williams, Glendale Community College
Bruce Wingerd, San Diego State University
Eric Wise, University of California—Santa Barbara
Michael G. Wood, Del Mar College
Jamie Young, Chattanooga State Technical Community College
Nancy L. Young, Seattle Pacific University
The accuracy and currency of the clinical material in this edition of the textbook and in the
A&P Applications Manual in large part reflect the work of my wife, Kathleen Welch, M.D.
Her professionalism and concern for practicality and common sense make the clinical
information especially relevant for today’s students.
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Virtually without exception, reviewers stressed the importance of accurate, integrated, and
visually attractive illustrations in helping students understand the content of anatomy and
physiology. The revision of the art program was directed by William C. Ober, M.D., and
Claire W. Garrison,
R.N. Their suggestions about topics of clinical importance, presentation sequence, and
revisions to the proposed art were of incalculable value to me and the project. The
illustration program for this edition was further enhanced by the efforts of two other
talented individuals. Jim Gibson designed most of the new features in the art program and
consulted on the design and layout of individual figures. His talents have helped produce
an illustration program that is attractive, cohesive, and easy to understand. Anita Hylton
helped to create the new photo/art combinations which provide a greater sense of realism in
important anatomical figures.
Many of the text’s illustrations include color photographs or micrographs collected from a
variety of sources. The striking anatomical photos in the text, in Martini’s Atlas of the
Human Body, and in the Laboratory Manual for Anatomy & Physiology by Michael G.
Wood are the work of Ralph T. Hutchings, whose efforts on this project are deeply
appreciated. Dr. Eugene C. Wasson III and the staff of Maui Radiology Consultants, Inc.,
provided valuable assistance in the selection and printing of many of the CT and MRI scans
included in the revised Atlas.
I also express my appreciation to the editors and support staff at Benjamin Cummings. First
on the list is Nicole George, Project Editor for my texts, who somehow managed to handle
every crisis and kept things moving in the right direction. Her support, hard work, and
patience are deeply appreciated.
I owe special thanks to my editor, Leslie Berriman, for her creativity and dedication. Her
vision helped shape this book in countless ways. I also owe thanks to Kim Neumann for
her creative efforts on the media supplements and for generating new media components
for incorporation into the MyA&P course management program, the Media Manager
instructor presentation CDs, and the Anatomy and Physiology Place website for Martini.
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Alan Titche, my Development Editor, played a vital role in fashioning the Seventh Edition.
I could not have survived this process without him, and his unfailing attention to detail and
quality made a tremendous difference in the final package.
Thanks are also due to the rest of the editorial team, including Michael Roney and Blythe
Robbins, for their assistance with the integrated supplements package.
This book would not exist without the extraordinary dedication of the production team,
including Debbie Cogan, Corinne Benson, and Heather Johnson, who solved many
problems under pressure with unfailing good cheer.
Thanks to Mark Ong, Kathleen Cunningham, and Yvo Riezebos for this edition’s stunning
and effective interior and cover designs. I am grateful to Lillian Carr, Creative Director, for
her spectacular designs of the media packages and this book’s Visual Introduction. I would
also like to express my gratitude to Linda Davis, President of Benjamin Cummings; Daryl
Fox, Publisher; Lauren Fogel, Director of Media Development and Publishing Technology;
Stacy Treco, Director of Marketing; and Lauren Harp, Executive Marketing Manager, for
their continuing support of this project.
No one person could expect to produce a flawless textbook of this scope and complexity.
Any errors or oversights are strictly my own rather than those of the reviewers, artists, or
editors. To help improve future editions, I encourage you to send any pertinent
information, suggestions, or comments about the organization or content of this textbook to
me directly, using the following e-mail address. I will deeply appreciate any and all
comments and suggestions and will carefully consider them in the preparation of the Eighth
Edition.
Frederic H. Martini
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