Anatomy, Physiology, and Disease

Bruce Colbert is the Director of the Allied Health Department at the University of Pittsburgh at Johnstown. He holds a Master’s in Health Education and Administration, has authored four books, written several articles, and given over 175 invited lectures and workshops at both the regional and national level. Many of his workshops provide teacher training involving techniques to make the health sciences engaging and relevant to today’s students. In addition, he does workshops on developing effective critical and creative thinking, stress and time management, and study skills. He is an avid basketball player, even after three knee surgeries, which may indicate he has some learning difficulties.   Jeff Ankney is the Director of Clinical Education for the University of Pittsburgh at Johnstown Respiratory Care program where he is responsible for the development and evaluation of hospital clinical sites. In the past, Jeff has served as a public school teacher, Assistant Director of Cardiopulmonary Services, Program Coordinator of Pulmonary Rehabilitation, and a member of hospital utilization review and hospital policy committees. He is a consultant on hospital management and pulmonary rehabilitation concerns. Jeff was also the recipient of the American Cancer Society Public Education Award.   Karen Lee is an Associate Professor in the Biology Department at the University of Pittsburgh at Johnstown, where she teaches all the anatomy courses, including Anatomy and Physiology for Nursing and Allied Health students. She presents regularly at scientific conferences and has published several articles on crustacean physiology and behavior. An active member of the Council on Undergraduate Research, she is also the chair of the University of Pittsburgh at Johnstown’s annual undergraduate symposium.

Introduction xii
Preview of the Teacher’s Wraparound Edition xiii
Chapter 1 Anatomy, Physiology and Disease: 
Learning the Language 1
Chapter 2 The Human Body: Reading the 
What Is Anatomy and Physiology? 2
Anatomy 2
Physiology 3
Putting It All Together 3 
What Is Disease? 4
The Language 5
Medical Terminology 6
Abbreviations 9
Te Metric System 11
Anatomy, Physiology, and Disease 
Concepts You Will Encounter 
on Your Journey 11
Metabolism 11
Homeostasis 12
Disease Concepts 15
The Body’s Defense System 18
Body Barriers 18
Understanding Routes of Transmission 19
Standard Precautions 20
Summary 23
Case Study 24
Review Questions 26
Career Connections 28
Anatomy, Physiology, and Disease 
in Action 29
Map 31
The Map of the Human Body 32
Body Positions 32
Pathology Connection: Body Positions 
and A&P Changes 34
Body Planes and Directional Terms 35
Additional Directional Terms 37
Body Cavities 40
Body Regions 41
Radiology: The Science of Viewing 
the Body 46
X-rays (Radiograph or Roentgenogram) 46
Computerized Tomography (CT or CAT 
Scan) 48
Magnetic Resonance Imaging (MRI) 48
Ultrasound (Sonography) 48
Summary 50
Case Study 51
Review Questions 52
Career Connections 54
Anatomy, Physiology, and Disease 
in Action 54
iv • CONTENTS
Chapter 3 Biochemistry: The Basic Ingredients 
of Life 55
Atoms, Elements, and Ions 56
Acids and Bases 58
Bonding 60
Water 61
Solutions 62
Biological Molecules 63
Metabolism 67
Enzymes: Making Reactions Happen 67
Summary 70
Case Study 71
Review Questions 71
Career Connections 73
Anatomy, Physiology, and Disease 
in Action 74
Chapter 4 The Cells: The Raw Materials and 
Pathology Connection: Organelle 
Disorders 92
Pathology Connection: Diabetes 
Mellitus (Revisited): A Disorder Tied to 
Cellular Respiration 93
Pathology Connection: PKU, an Enzyme 
Disorder 94
Mitosis 95
Cellular Reproduction 95
Te Cell Cycle 96
Pathology Connection: Cancer: Mitosis 
Run Amok 98
Microorganisms 99
Bacteria 99
Viruses 100
Fungi 101
Protozoa 101
Pathology Connection: How 
Microorganisms Cause Disease 103
Summary 106
Case Study 107
Review Questions 108
Career Connections 110
Anatomy, Physiology, and Disease 
in Action 110
Building Blocks 75
Overview of Cells 76
Cell Structure 77
Cell Membrane 78
Transport Methods 79
Passive Transport 79
Pathology Connection: Cystic 
Fibrosis (CF): A Membrane Channel 
Abnormality 82
Pathology Connection: Diabetes 
Mellitus: A Disorder of Facilitated 
Diffusion 83
Active Transport 84
Pathology Connection: Familial 
Hypercholesterolemia: A Disorder 
of Endocytosis 86
Cellular Components 87
Cytoplasm 87
Nucleus and Nucleolus 87
Ribosomes 88
Centrosomes 89
Mitochondria 89
Endoplasmic Reticulum 90
Golgi Apparatus 90
Lysosomes 91
Other Interesting Parts 91
Chapter 5 Tissues and Systems: The Inside 
Story 111
Overview of Tissues 112
Tissue Types 112
Pathology Connection: Blood Sugar and 
Tissue Damage 120
Organs 121
Systems 122
Skeletal System 124
Muscular System 125
Integumentary System 126
Nervous System 127
Endocrine System 128
Cardiovascular System 129
Pathology Connection: Septicemia 130
Respiratory System 130
Lymphatic and Immune System 131
Gastrointestinal (Digestive) System 132
Contents • v
Pathology Connection: Body Image: 
Obesity and Anorexia 134
Urinary System 135
Reproductive System 136
Summary 138
Case Study 138
Review Questions 140
Career Connections 142
Anatomy, Physiology, and Disease 
in Action 142
Chapter 7 The Muscular System: Movement 
Chapter 6 The Skeletal System: The 
Framework 143
System Overview: More Than the “Bare 
Bones” About Bones 144
General Bone Classifcation 144
Basic Bone Anatomy 145
Bone Tissue 147
Surface Structures of Bones 148
Bone Growth and Repair 149
Pathology Connection: 
Osteoporosis 151
Cartilage 153
Joints and Ligaments 154
Movement Classifcation 156
Pathology Connection: Common Joint 
Disorders 158
The Skeleton 160
Special Regions of the Skeletal System 160
Pathology Connection: Spinal Column 
Abnormalities 165
Pathology Connection: Bone Fractures 
and Healing 168
Maintaining Good Bone Health 169
A Quick Trip Through Some Diseases of 
the Skeletal System 171
Pharmacology Corner 175
Summary 176
Case Study 177
Review Questions 178
Career Connections 180
Anatomy, Physiology, and Disease 
in Action 180
for the Journey 181
Overview of the Muscular System 182
Types of Muscles 182
Pathology Connection: Myopathy 184
Skeletal Muscles 185
Pathology Connection: Strains and 
Tears 185
Skeletal Muscle Injuries 188
Pathology Connection: Fibromyalgia 
Syndrome 192
Skeletal Muscle Movement 192
Contraction and Relaxation 192
Movement Terminology 194
Muscular Movement at the Cellular 
Level 196
Te Functional Unit of the Muscle 196
Pathology Connection: Duchenne’s 
Muscular Dystrophy (DMD) 199
Pathology Connection: Myasthenia 
Gravis (MG) 199
Pathology Connection: Tetanus 201
Muscular Fuel 202
Visceral or Smooth Muscle 203
Cardiac Muscle 204
A Quick Trip Through Diseases and 
Conditions of the Muscular System 205
Pharmacology Corner: Skeletal Muscle 
Drugs 207
Summary 208
Case Study 209
Review Questions 210
Career Connections 212
Anatomy, Physiology, and Disease 
in Action 213
Chapter 8 The Integumentary System: The 
Protective Covering 215
System Overview 216
Integumentary System Functions 216
Te Skin 217
Pathology Connection: Skin Color 
and Disease 219
Pathology Connection: Infections 
of the Skin 221
vi • CONTENTS
How Skin Heals 225
Pathology Connection: Burns 227
Nails 230
Hair 232
Pathology Connection: Lice 
and Scabies 234
Temperature Regulation 235
Pathology Connection: Skin Lesions 237
A Quick Trip Through Some Diseases 
of the Integumentary System 238
Pharmacology Corner 244
Summary 244
Case Study 245
Review Questions 246
Career Connections 248
Anatomy, Physiology, and Disease 
in Action 249
Chapter 9 The Nervous System: The Body’s 
Pathology Connection:
Brain Injury 280
Cerebrospinal Fluid and Ventricles 288
Cranial Nerves 288
Pathology Connection: Alzheimer’s 
Disease 288
Pathology Connection: 
Hydrocephalus 291
The Big Picture: Integration of Brain, 
Spinal Cord, and PNS 292
Te Somatic Sensory System 292
Te Motor System 294
Pathology Connection: Motor 
Pathologies 296
The Autonomic Nervous
System 298
Te Sympathetic Branch 299
Te Parasympathetic Branch 300
A Quick Trip Through Diseases 
of the Nervous System 302
Pharmacology Corner 304
Summary 305
Case Study 306
Review Questions 307
Career Connections 310
Anatomy, Physiology, and Disease 
in Action 310
Control Center 251
Overview 252
Te Parts and Basic Operation 
of the Nervous System 252
Nervous Tissue 255
Neuroglia 255
Neurons 256
How Neurons Work 257
Excitable Cells 257
Action Potentials 258
Local Potentials 258
Impulse Conduction 259
Pathology Connection: Myelin 
Disorders 261
How Synapses Work 262
Spinal Cord and Spinal Nerves 265
External Anatomy of the Spinal Cord 265
Internal Anatomy of the Spinal Cord 267
Pathology Connection: Polio and Post- Polio Syndrome 271
Pathology Connection: Peripheral 
Neuropathy and Spinal Cord Injury 272
The Brain and Cranial Nerves 276
Te Brain’s External Anatomy 276
Internal Anatomy of the Brain 279
Chapter 10 The Endocrine System: The Body’s 
Other Control Center 311
Organization of the Endocrine 
System 312
Endocrine Organs 312
Hormones 314
Control of Endocrine Activity 315
Homeostasis and Negative Feedback 315
Sources of Control of Hormone Levels 317
The Major Endocrine Organs 319
Te Hypothalamus 319
Te Pituitary 320
Pathology Connection: Posterior 
Pituitary and Antidiuretic Hormone 322
Pathology Connection: Anterior 
Pituitary 323
Te Tyroid Gland 324
Contents • vii
Te Tymus Gland 325
Te Pineal Gland 325
Te Pancreas 325
Pathology Connection: The Thyroid 
Gland 326
Te Adrenal Glands 329
Pathology Connection: Diabetes 
Mellitus 331
Pathology Connection: Steroid-Related 
Conditions 334
Cortisol and the Stress Response 335
The Gonads 336
Prostaglandins 337
A Quick Trip Through the Diseases 
of the Endocrine System 338
Pharmacology Corner 339
Summary 340
Case Study 341
Review Questions 342
Career Connections 344
Anatomy, Physiology, and Disease 
in Action 344
Case Study 372
Review Questions 372
Career Connections 374
Anatomy, Physiology, and Disease 
in Action 375
Chapter 12 The Cardiovascular System:
Chapter 11 The Senses: The Sights 
and Sounds 345
The Senses 346
Sense of Sight 347
Te External Structures of the Eye 347
Te Internal Structures of the Eye 348
Pathology Connection: Injuries 
and Disorders of the Eyes 350
The Sense of Hearing 356
Structures of the Ear 356
Pathology Connection: Diseases 
of the Ear 360
Other Senses 362
Taste 362
Smell 363
Touch 364
A Quick Trip Through Some Diseases
of the Eye 368
A Quick Trip Through Some Diseases
of the Ears 369
Pharmacology Corner 370
Summary 371
Transport and Supply 377
System Overview 378
Incredible Pumps: The Heart 380
General Structure and Function 380
Cardiac Cycle 382
Pathology Connection: Problems 
with Cardiac Muscle and Cardiac 
Vasculature 387
Pathology Connection: Electrical 
Disturbances 397
Hematology 399
Blood Composition 399
Red Blood Cells 401
White Blood Cells 401
Infammation 402
Trombocytes 403
Blood Types and Transfusions 403
Pathology Connection: Assorted Blood 
Conditions 406
Blood Vessels: The Vascular
System 407
Structure and Function 407
Capillaries and Veins 408
Blood Clotting 411
Pathology Connection: Clotting 413
Pathology Connection: Problems 
Associated with Systemic Blood 
Vessels 415
A Quick Trip Through Some Diseases
of the Cardiovascular System 415
Pharmacology Corner 423
Summary 424
Case Study 425
Review Questions 425
Career Connections 428
Anatomy, Physiology, and Disease 
in Action 429
viii • CONTENTS
Chapter 13 The Respiratory System: It’s 
a Gas 431
System Overview 432
Ventilation versus Respiration 434
The Respiratory System 436
Te Airways and Te Lungs 436
Te Upper Airway of the Respiratory 
Tract 436
Pathology Connection: The Nose 439
Te Sinuses 441
Te Pharynx 442
Te Larynx 443
Pathology Connection: The Upper 
Airway 444
The Lower Respiratory Tract 447
Te Alveolar Capillary Membrane: Where 
the Action Is 450
Pulmonary Function Testing 452
Pathology Connection: The Lower 
Airways 454
Te Housing of the Lungs and Related 
Structures 462
Pathology Connection: Pleural Space 
Problems 463
Te Lungs 464
Te Protective Bony Torax 464
How We Breathe 465
A Quick Trip Through the Diseases 
of the Respiratory System 469
Pharmacology Corner 472
Summary 473
Case Study 474
Review Questions 474
Career Connections 476
Anatomy, Physiology, and Disease 
in Action 477
Pathology Connection: Cancer Stages 
and the Lymphatic System 486
The Immune System 488
Antigens and Antibodies 488
Innate versus Adaptive Immunity 488
Components of the Immune System 489
Pathology Connection: Leukemia 491
Pathology Connection: Inflammation, 
a Two-Edged Sword 493
How the Immune System Works 495
Innate Immunity 495
Adaptive Immunity 496
Pathology Connection: Autoimmune 
Disorders 497
Pathology Connection: HIV and 
AIDS 502
B and T Cell Action 503
The Big Picture 507
Pathology Connection: Hypersensitivity 
Reactions 508
A Quick Trip Through Some Diseases 
of the Immune System 510
Pharmacology Corner 511
Summary 512
Case Study 515
Review Questions 516
Career Connections 518
Anatomy, Physiology, and Disease 
in Action 518
Chapter 15 The Gastrointestinal System: Fuel 
Chapter 14 The Lymphatic and Immune
Systems: Your Defense Systems 479
The Defense Zone 480
The Lymphatic System 480
Pathology Connection: Tonsillitis 483
Lymph Organs 485
Pathology Connection: Lymphatic 
Disorders 486
for the Trip 519
System Overview 520
The Mouth and Oral Cavity 522
Oral Cavity 522
Tongue 522
Salivary Glands 522
Teeth 524
Pathology Connection: Oral 
Disorders 527
Pharynx 527
Esophagus 528
The Walls of the Alimentary 
Canal 529
Contents • ix
Stomach 531
Pathology Connection: Stomach Acid 
Disorders 535
Small Intestine 537
Large Intestine 541
Pathology Connection: Disorders of the 
Lower Gastrointestinal Tract 543
Accessory Organs 544
Liver 544
Gallbladder 545
Pancreas 546
Pathology Connection: Cholecystitis, 
Pancreatitis, and Hepatitis 547
Common Symptoms of Digestive 
System Disorders 548
A Quick Trip Through Some Diseases
of the Gastrointestinal System 549
Pharmacology Corner 556
Summary 556
Case Study 558
Review Questions 558
Career Connections 562
Anatomy, Physiology, and Disease 
in Action 563
Pathology Connection: Dialysis 
or Kidney Transplant Therapy 589
Te Urinary Bladder and Urination 
Refex 590
Pathology Connection: Incontinence 
and Urinary Tract Infection (UTI) 592
A Quick Trip Through Disorders of the 
Urinary System 593
Pharmacology Corner 595
Summary 596
Case Study 597
Review Questions 598
Career Connections 600
Anatomy, Physiology, and Disease 
in Action 600
Chapter 17 The Reproductive System: 
Chapter 16 The Urinary System: Filtration and 
Fluid Balance 565
System Overview 566
The Anatomy of the Kidney 567
External Anatomy 567
Internal Anatomy 568
Microscopic Anatomy of the Kidney: 
Te Nephron 570
Pathology Connection: Kidney 
Stones and Polycystic Kidney Disease 
(PKD) 572
Urine Formation 576
Control of Filtration 576
Pathology Connection: 
Nephropathy 580
Control of Tubular Reabsorption 
and Secretion 582
Pathology Connection: Uremia 
and Renal Failure 585
Replacement and Repair 601
Tissue Growth and Replacement 602
Mitosis 602
Sexual Reproduction 603
Reduction Division: Meiosis 603
The Human Life Cycle 605
The Human Reproductive System 607
Female Anatomy 607
Pathology Connection: 
Endometriosis 610
Reproductive Physiology: Female 613
Te Menstrual Cycle 613
Pathology Connection: Menstrual 
Disorders 618
Male Anatomy 621
Pathology Connection: Male 
Reproductive Diseases 623
Reproductive Physiology: Male 625
Spermatogenesis 625
Pathology Connection: Erectile 
Dysfunction (ED) 627
Pregnancy 628
Pathology Connection: Infertility 629
Pathology Connection: Breast 
Health 632
x • CONTENTS
A Quick Trip Through Some Diseases 
of the Reproductive System 634
Pharmacology Corner 636
Summary 637
Case Study 639
Review Questions 639
Career Connections 642
Anatomy, Physiology, and Disease 
in Action 643
Career Connections 676
Anatomy, Physiology, and Disease 
in Action 676
Chapter 19 Anatomy and Physiology and the 
Chapter 18 Basic Diagnostic Tests: What Do 
the Tests Tell Us? 645
Overview of Diagnostic Testing 646
Blood Testing 647
Blood Basics 647
General Blood Disorders 649
Specifc Blood Tests 649
Blood Chemistry 655
Urine Testing 658
Dipsticks 659
Specifc Urine Tests 660
Fecal Testing 665
Amount, Consistency, Form,
and Shape 665
Stool pH 665
Stool Color 665
Blood in Stool 666
Mucus in Stool 666
Cerebral Spinal Fluid (CSF) Testing 667
CSF Color 667
CSF Cell Counts 668
Culture and Sensitivity (C&S) 
Testing 668
Cardiac Diagnostics 669
Electrocardiogram (ECG/EKG) 669
Holter Monitor 669
Stress Testing 670
“Scopes” 670
Pulmonary Function Testing (PFT) 671
Polysomnography 672
Summary 673
Case Study 674
Review Questions 674
Scientific Method 677
Overview of the Scientific Method 678
Patterns of Knowing 678
Te Scientifc Method 679
Formulating Questions 680
Hypotheses and Teories 680
Testing Hypotheses 682
Making Measurement 685
Presenting and Data 689
Drawing Inferences 692
Limitations of the Scientifc Method 695
Summary 696
Review Questions 696
Anatomy, Physiology, and Disease in 
Action 698
Chapter 20 The Journey’s End: Now What? 699
Forensic Science 700
Disease Detection 701
Primitive Surgery 701
Remains Identifcation 702
Murder Most Foul! 702
Fingerprints 703
DNA Fingerprinting 704
Geriatrics 705
General Body Changes 706
Gustatory Changes 707
Te Brain and Nervous System 707
Te Cardiovascular System 707
Genitourinary System 708
Integumentary System 708
Polypharmacy 708
 Wellness 709
Nervous System 710
Skeletal System 710
Muscular System 711
Integumentary System 712
Cardiovascular System 712
Respiratory System 713
Contents • xi
Chapter 21 Health Care: Careers and Career 
Appendix A Medical Terminology, Words Parts, 
Planning 731
Interests 732
Values 732
Abilities 732
Heath Care Education 733
Resources For Occupational Research 733
Jobs and Professions 734
Professional and Personal 
Characteristics 749
Ethical Roles and Responsibilities of a 
Health Care Worker 752
Meetings in the Workplace 753
Safety in the Workplace 753
Job-Seeking Skills 754
Your Career Plan 755
Volunteering 757
Suggested Activities 758 
and Singular and Plural Endings 779
Appendix B Clinical Abbreviations and 
“Do Not Use” List 790
Appendix C Infectious Diseases and Teir 
Pathogens 800
Appendix D Laboratory Reference Values 803
Appendix E Multisystem Efects of Various 
Diseases and Conditions 807
Appendix F Vitamins and Minerals: Sources, 
The Study Success Companion: The Key to Your 
Functions, and Efects of Defciency 
and Toxicity 818
Successful Journey 759
Study Skills 760
1. Select a Good Time and Place to Study 760
2. Use Good Study Habits 761
3. Take Care of Yourself 763
Stress Management 763
Stress Misconceptions 763
What Causes Physical and Emotional 
Stress? 764
A Stress Management System 766
Efective Coping Strategies 766
Efective Physical Strategies 767
The Mathematical Language of 
Medicine 769
Why Learn the Metric System? 769
Exponential Powers of 10 769
Systems of Measurement 770
Conversion of Units 774
Using the Factor Label Method for Conversion 
Between Systems 777
Appendix G Standard and Transmission-Based 
Precautions 821
Glossary 826
Index 874