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International Sports Sciences Association

The World Leader in Fitness Education and Certification — Since 1988

FITNESS: THE COMPLETE GUIDE

OFFICIAL TEXT FOR ISSA’S CERTIFIED FITNESS TRAINER PROGRAM

www.ISSAonline.edu Frederick C. Hatfield, PhD

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F i t n e s s : T h e C o m p l e t e G u i d e

CONTRIBUTORS
Frederick C. Hatfield, PhD, MSS
Sal Arria, DC, MSS
Karl Knopf, EdD
Michael Yessis, PhD
James A. Petersen, PhD
Daniel Gastelu, MS, MFS
Charles Staley, BS, MFS
Patrick S. Gamboa, BS, MSS

REVIEWERS
Thomas D. Fahey, EdD
Jane Frederick, MA, MFS
Doug Holt, BS, MFS, CSCS

EDITORS
Michelle Basta Boubion, BA, NSCA-CPT
Maura Weber, BA
Managing Editor, Muscle & Fitness Hers Magazine
Beth Saltz, MPH

GRAPHICS AND ILLUSTRATION

Sarah McDonough, Art Director
Karen Williams, Formatting and Photography (Strength)
Samantha Hird, Photography (Flexibility)
Alex Gundersen, Illustrator

Fitness: The Complete Guide (Edition 8.6.6) DISCLAIMER OF WARRANTY

10 9 8 7 6 5
Official Course Text for:
International Sports Sciences Association’s Certified Fitness
Trainer Program
Copyright © 2009 TXu1-157-866 International Sports Sciences
Association. All rights reserved. No part of this work may be repro-
duced or transmitted in any form or by any means, electronic or
mechanical, including photocopying and recording, or by any
information storage or retrieval system, except as may be expressly
permitted by 1976 Copyright Act or in writing by the Publisher.
Direct all correspondence, permissions requests, and inquiries to:
International Sports Sciences Association
1015 Mark Avenue • Carpinteria, CA 93013
1.805.745.8111 • www.ISSAonline.edu
This study guide is informational only. The data and information con-
tained herein are based upon information from various published as
well as unpublished sources and merely represents training, health and
nutrition literature and practice as summarized by the authors and edi-
tors. The publisher of this study guide makes no warranties, expressed or
implied, regarding the currency, completeness or scientific accuracy of
this information, nor does it warrant the fitness of the information for
any particular purpose. The information is not intended for use in con-
nection with the sale of any product. Any claims or presentations regard-
ing any specific products or brand names are strictly the responsibility of
the product owners or manufacturers. This summary of information
from unpublished sources, books, research journals and articles is not
intended to replace the advice or attention of health care professionals. It
is not intended to direct their behavior or replace their independent pro-
fessional judgement. If you have a problem with your health, or before
you embark on any health, fitness or sports training programs, seek
clearance from a qualified health care professional.
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I n t e r n a t i o n a l S p o r t s S c i e n c e s A s s o c i a t i o n
AUTHOR

ABOUT THE AUTHOR

Frederick C. Hatfield, MSS, PhD, is Co-founder and
President of the ISSA. Dr. Hatfield, (aka “Dr. Squat”) won
the World Championships three times in the sport of
powerlifting, and performed a competitive squat with
1014 pounds at a body weight of 255 pounds (more
weight than anyone in history had ever lifted in competi-
tion). Dr. Hatfield’s former positions include an assistant
professorship at the University of Wisconsin (Madison)
and Senior Vice President and Director of Research and
Development for Weider Health and Fitness,
Incorporated. Dr. Hatfield was honored by Southern
Connecticut State University when they presented him
with the 1991 Alumni Citation Award. He has written
over 60 books (including several best-sellers) and hundreds of articles in the general
areas of sports training, fitness, bodybuilding, and performance nutrition. He has been
coach and training consultant for several world-ranked and professional athletes, sports
governing bodies and professional teams worldwide. Dr. Hatfield qualified for the 1998
World Championships in Olympic Lifting and competed in the Masters Division.
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TABLE OF CONTENTS
Introduction, 1
Anatomy and Physiology,
Metabolism, 10
Basic Anatomy and Physiology, 30
Muscle Anatomy and Physiology, 72
Kinesiology and Biomechanics, 122
Kinesiology of Exercise, 126
Biomechanical Concepts of Exercise, 140
Musculoskeletal Deviations, 154
Muscle Mechanics, 166
Health and Physical Fitness, 184
Strength, 188
Cardiovascular Training Theory, 294
Flexibility, 320
Body Composition, 338
Program Development, 358
Program Development, 360
Basic Assessment of Fitness Participants, 370
Training Principles, 390
Periodization, 408
Determining Training Loads, 426
Page iv
Nutrition, 446
8 Weighing the Truth on Exercise and
Nutrition, 450
The Basics of Sound Nutrition, 462
Estimating Caloric Needs, 492
The ISSA Zig-Zag Approach to Muscle Gain
and Fat Loss, 518
Fad Diets and Nutrition, 528
Supplementation, 536
Injury and Disease, 576
Exercise and Older Adults, 580
Exercise and Adaptive Fitness, 588
Exercise and Our Youth, 594
Exercise and Hypertension, 598
Exercise and Diabetes, 604
Exercise and Arthritis, 610
Exercise and Coronary Heart Disease, 616
Exercise and Pregnancy, 622
Exercise and Asthma, 628
Exercise and Sports Medicine
in the Trenches, 634
Basic First Aid, 672
References, 683
Glossary, 701
Index, 721
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INTRODUCTION
Anatomy and Physiology
Kinesiology and Biomechanics
Health and Physical Fitness
Program Development
Nutrition
Injury and Disease

INTRODUCTION
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F i t n e s s : T h e C o m p l e t e G u i d e

INTRODUCTION

THE WHO, WHAT, WHY, AND HOW OF

PERSONAL TRAINING
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THE WHO, WHAT, WHY, AND HOW OF PERSONAL TRAINING

I n t e r n a t i o n a l S p o r t s S c i e n c e s A s s o c i a t i o n
INTRODUCTION 1

PERSONAL TRAINING
The fitness industry, as we know it today, is a multi-billion dollar industry.
Personal training is its ever-growing offspring. While the roots of personal train-
ing are difficult to pinpoint (its origin is credited to the 1950s) one could con-
tend that the roots of personal training date back to the beginning of recorded
history. While the profession or terminology associated with personal training
was not yet in existence, the concept of optimal health, which is the basis behind
the profession, was already being touted by ancient philosophers. Around 400
B.C., Hippocrates wrote:
“Eating alone will not keep a man well: he must also take exercise. For food and exercise,
while possessing opposite qualities, yet work together to produce health . . . and it is neces-
sary, as it appears, to discern the power of various exercises, both natural exercises and
artificial, to know which of them tends to increase flesh and which to lessen it; and not
only this, but also to proportion exercise to bulk of food, to the constitution of the patient,
to the age of the individual . . .”
Of all of our nation’s leaders, President Theodore Roosevelt was one of the
strongest — physically and mentally. However, he did not start that way. As a
child, Roosevelt was small for his age and quite sickly. He had debilitating asth-
ma, poor eyesight and was extremely thin. When he was twelve years old his
father told him,
“You have the mind, but you have not the body, and without the help of the body the
mind cannot go as far as it should. You must make the body.”
Theodore Roosevelt began spending every day building his body as well as his
mind. He worked out with weights, hiked, hunted, rowed, and boxed. History
can attest: Theodore Roosevelt’s strength in mind and body contributed to his
strength as the leader of our nation.
Another great leader of our nation was President John Fitzgerald Kennedy.
Kennedy, like Roosevelt, acknowledged the benefits of physical activity for
optimal health.
“Physical fitness is not only one of the most important keys to a healthy body, it is the
basis of dynamic and creative intellectual activity.”
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F i t n e s s : T h e C o m p l e t e G u i d e
2

WHO WANTS PERSONAL

TRAINING?
Since 1998, the number of Americans belonging to
health clubs has grown twenty-three percent or seven
million members according to the 2002 IHRSA/ASD
Health Club Trend Report. Health club membership
among children under eighteen years of age has
jumped by one-hundred-and-eight-seven percent
since 1987. The number of clients considering per-
sonal training services continues to grow. The
American Sports Data Inc., a company that special-
izes in sports and fitness research since 1983, project-
ed that 4,021,000 people in the United States alone
paid for personal training services in 1998. The survey
revealed the following:
• Three out of five clients are women.

• Clients report an average of 18 sessions

with a trainer.

• Clients pay an average fee of $34.00 per

session.

• Average household income of clients:

Under $25,000 18%
WHO IS A PERSONAL TRAINER? $25,000 - $49,999 20%
The profession of personal training is a relatively new
$50,000 - $74,999 20%
field, which continues to expand and redefine itself its
boundaries. Prior to the early 1980s, no minimal $75,000 and up 42%
requirements existed to qualify or identify one as a • Average sessions used in 12 months:
personal trainer. Those who engaged in training were
1–6 47%
still an esoteric group. Many learned about training
solely through personal experiences in the gym. 7 – 11 12%
Recognizing the need for standardization and credi- 12 – 24 11%
bility, Dr. Sal Arria and Dr. Fred Hatfield pioneered a 25 – 49 8%
personal fitness training program to merge gym expe-
50 + 11%
rience with practical and applied sciences.
Not Reported 11%
Today a personal fitness trainer can be defined as an
individual who educates and trains clients in the per- • Number of sessions clients used by age:
formance of safe and appropriate exercises to effec- 6 – 11 years old 22 sessions
tively lead their clients to optimal health. Personal 12 –17 26 sessions
trainers can be either self-employed or employed by
18 – 34 15 sessions
health clubs, physicians’ offices, physical therapy clin-
ics, wellness centers, hospitals, rehabilitation facilities 35 – 54 14 sessions
and private studios. 55 + 24 sessions
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THE WHO, WHAT, WHY, AND HOW OF PERSONAL TRAINING

I n t e r n a t i o n a l S p o r t s S c i e n c e s A s s o c i a t i o n
INTRODUCTION 3

These statistics support the growing trend and need

for personal training services. While those 4,021,000
individuals who purchased personal training services
are sold on the need for personal training, why is per-
sonal training a necessity?

WHY PERSONAL TRAINING IS

NECESSARY?
The Office of the Surgeon General released its Report
on Physical Activity and Health in 1996. The report
strongly supports the role of physical activity for good
health and prevention of major health problems. The
National Institutes of Health released a Consensus
Statement on the importance of physical activity for
cardiovascular health. The Healthy People 2000
objectives list physical activity and fitness as the first
of twenty-two priority areas. The American Heart
Association included physical inactivity and low fit-
ness levels as primary risk factors along with smoking
hypertension and high cholesterol. On the federal
side, two health club-related bills stand out for possi-
ble passage in 2004. The IMPACT Act (Improved
Nutrition and Physical Activity), approved by
Congress before its last break, provides $250 million ture of almost $3,000 for every individual in the
in grants for eligible organizations to help address the entire population. Regrettably, this financial commit-
obesity problem. Grants would be available to provide ment neither has shown signs of abating, nor has it
health services for improved nutrition, increased produced totally acceptable results with regard to
physical activity and obesity prevention. The Senate treating a wide variety of chronic health problems.
approved the bill (S. 1172) in December 2003 and the Attempts to identify the factors which have been
House will take up the bill (H.R. 716) in 2004. major contributions to this virtual epidemic of med-
Unfortunately even with the resounding benefits of ical problems have produced a litany of probable rea-
physical activity and fitness being touted and report- sons why such a large number of individuals are so
ed, America is currently undergoing an obesity epi- apparently unhealthy; poor eating habits, a sedentary
demic with twenty-five percent of Americans still lifestyle, stress, poor health habits (i.e., smoking), ad
remaining sedentary. This would equate to one out of infinitum. At the same time, a number of studies
four Americans still being sedentary. To make matters have been undertaken to identify what, if anything,
worse, the federal resources and funds for physical can be done to diminish either the number or the
activity have lagged far behind other aspects of health. severity of medical problems affecting the public.
Health and physical education in our schools are a These studies have provided considerable evidence
low priority and are often the first programs to be cut that exercise has substantial medicinal benefits for
in schools. individuals of all ages.
Consider the following as well. Americans spend Two of the most widely publicized efforts to investi-
more than $600 billion dollars annually for health gate the possible relationship between exercise and
care. This meteoric figure translates into an expendi- disease were longitudinal studies, each of which
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4
involved more than 10,000 subjects. Several years ago,
in a renowned study of 17,000 Harvard graduates,
Ralph Paffenbarger, MD, found that men who expend-
ed approximately 300 calories a day; the equivalent of
walking briskly for 45 minutes, reduced their death
rates from all causes by an extraordinary 28% and
lived an average of more than two years longer than
their sedentary classmates. A more recent study con-
ducted by Steven Blair, PED, of the Institute of
Aerobics Research in Dallas documented the fact that
a relatively modest amount of exercise has a significant
effect on the mortality rate of both men and women.
The higher the fitness level, the lower the death rate
(after the data was adjusted for age differences
between subjects in this eight-year investigation of
13,344 individuals). An analysis of the extensive data
yielded by both studies suggests one inescapable con-
clusion … exercise is medicine!
Accepting the premise that regular exercise can play a
key role in reducing your risk of medical problems
and in decreasing your ultimate costs for health care
is critical. Despite the vast number of individuals who
lead a sedentary lifestyle, the need for and the value of
exercising on a regular basis is an irrefutable fact of
life (and death). For example, Paffenbarger concluded
after a detailed review of the results of his long-term
investigation that not exercising had the equivalent
impact on your health as smoking one and one-half
packs of cigarettes a day. Fortunately, with few excep-
tions, most people are too sensible to ever consider
ravaging their health by smoking excessively.
Unfortunately, many of these same people fail to rec-
ognize the extraordinary benefits of exercise in the
prevention of medical problems.
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F i t n e s s : T h e C o m p l e t e G u i d e
Any listing of the medical problems and health-relat-
ed conditions that can be at least partially treated and
controlled by exercise would be extensive. Among the
most significant of these health concerns and the
manner in which exercise is thought to help alleviate
each condition are the following:
• Allergies. Exercise is one of the body’s most
efficient ways to control nasal congestion (and
the accompanying discomfort of restricted
nasal blood flow).
• Angina. Regular aerobic exercise dilates
vessels, increasing blood flow — thereby
improving the body’s ability to extract oxy-
gen from the bloodstream.
• Anxiety. Exercise triggers the release of
mood-altering chemicals in the brain.
• Arthritis. By forcing a skeletal joint to
move, exercise induces the manufacture of
synovial fluid, helps to distribute it over the
cartilage and forces it to circulate through-
out the joint space.
• Back Pain. Exercise helps to both strength-
en the abdominal muscles and the lower
back extensor muscles and stretch the ham-
string muscles.
• Bursitis and Tendonitis. Exercise can
strengthen the tendons — enabling them
to handle greater loads without being
injured.
• Cancer. Exercise helps maintain ideal
bodyweight and helps keep body fat to a
minimum.
• Carpal Tunnel Syndrome. Exercise helps
build up the muscles in the wrists and fore-
arms — thereby reducing the stress on
arms, elbows and hands.
• Cholesterol. Exercise helps to raise HDL
(the “good” cholesterol) levels in the blood
and lower LDL (the undesirable lipoprotein)
levels.
• Constipation. Exercise helps strengthen
the abdominal muscles, thereby making it
easier to pass a stool.
• Depression. Exercise helps speed metabo-
lism and deliver more oxygen to the brain;
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THE WHO, WHAT, WHY, AND HOW OF PERSONAL TRAINING

I n t e r n a t i o n a l S p o r t s S c i e n c e s A s s o c i a t i o n
INTRODUCTION 5

the improved level of circulation in the brain

tends to enhance your mood.
• Diabetes. Exercise helps lower excess blood
sugar levels, strengthen muscles and heart,
improve circulation, and reduce stress.
• Fatigue. Exercise can help alleviate the
fatigue-causing effects of stress, poor circu-
lation and blood oxygenation, bad posture,
and poor breathing habits.
• Glaucoma. Exercise helps relieve intraocular
hypertension — the pressure buildup on the
eyeball that heralds the onset of glaucoma.
• Headaches. Exercise helps force the brain
to secrete more of the body’s opiate-like,
pain-dampening chemicals (e.g., endor- • Memory Problems. Exercise helps to
phins and enkephalins). improve cognitive ability by increasing the
blood and oxygen flow to the brain.
• Heart Disease. Exercise helps promote
many changes that collectively lower the • Menstrual Problems and PMS. Exercise
risk of heart disease — a decrease in body helps to control the hormonal imbalances
fat, a decrease in LDL, an increase in the effi- often associated with PMS by increasing the
ciency of the heart and lungs, a decrease in release of beta-endorphins.
blood pressure and a lowered heart rate.
• Osteoporosis. Exercise promotes bone
• High Blood Pressure. Exercise reduces density — thereby lowering an individual’s
the level of stress-related chemicals in the risk of suffering a bone fracture.
bloodstream that constrict arteries and
• Overweight Problems. Exercise is an
veins, increases the release of endorphins,
appetite suppressant. It also increases meta-
raises the level of HDL in the bloodstream,
bolic rate, burns fat, increases lean muscle
lowers resting heart rate (over time),
mass and improves self-esteem.
improves the responsiveness of blood ves-
sels (over time), and helps reduce blood • Varicose Veins. Exercise can help control
pressure through bodyweight maintenance. the level of discomfort caused by existing
varicose veins and help prevent getting any
• Insomnia. Exercise helps reduce muscular additional varicose veins.
tension and stress.
Are the positive effects that result from exercising reg-
• Intermittent Claudication. Exercise ularly worth the required effort? Absolutely. Should
helps improve peripheral circulation and you make exercise an integral part of your daily regi-
increases pain tolerance.
men? Of course, you should. In countless ways, your
• Knee Problems. Exercise helps strengthen life may depend on it. The meteoric rise of health care
the structures attendant to the knee — and health problems makes your success as a person-
muscles, tendons and ligaments — thereby al trainer predictable.
facilitating the ability of the knee to with-
stand stress. Implications for Certified
• Lung Disease. Exercise helps strengthen
Fitness Trainer Professionals
the muscles associated with breathing and The need for personal training services continues to
helps boost the oxygen level in the blood. grow. As future ISSA fitness professionals it is imper-
00_PersonalTraining:00_PersonalTraining 6/3/09 12:40 PM
6
ative that we keep up with the ever-changing and
evolving recommendations for health and physical
fitness that have a direct application for fitness pro-
grams and exercise recommendations. With the
emergence of the latest technologies information
regarding health and fitness is easily accessible.
However, because of the nature of the media’s use of
vague and brief headlines in conjunction with radio
and TV sound bites that provide only limited, confus-
ing and often conflicting recommendations, it is
important that we can help our clients, friends and
family members put each new study or report in
proper perspective. Personal trainers today are com-
mitted to a long-term career in health and fitness and
are increasing their knowledge through additional
courses in post-rehabilitation, corporate wellness,
youth fitness, senior fitness, and pre and post-natal
specializations to better serve their clients in achiev-
ing and living the fitness lifestyle. As you can see, we
as personal trainers have an inherent responsibility to
positively shaping and influencing the health and fit-
ness attitudes of those around us and it is our hope
that individually and collectively we can bring health
and fitness to the masses and make the dream of opti-
mal health a reality for all.
WHAT SHOULD A PERSONAL
TRAINER KNOW?
As the industry continues to expand its boundaries
and the realm of scientific knowledge concerning the
human response and adaptation to exercise continues
to grow, it is essential that personal fitness trainers are
competent in:
• Exercise Programming
• Exercise Physiology
• Functional Anatomy and Biomechanics
• Assessments and Fitness Testing
• Nutrition and Weight Management
• Basic Emergency Procedures and Safety
• Program Administration
• Human Behavior/Motivation
Our ability as fitness professionals to educate and
effectively draw our clients into the fitness lifestyle
and optimal health comes from a plan that is based in
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F i t n e s s : T h e C o m p l e t e G u i d e
the aforementioned areas as well as the knowledge of
muscular, cardiopulmonary and metabolic adapta-
tions. These adaptations are known as the training
effect. The “training effect” is our body’s adaptation to
the learned and expected stress imposed by physical
activity. Our bodies begin to change at the cellular
level, allowing more energy to be released with less
oxygen. Your heart and capillaries become stronger
and more dispersed in order to allow a more efficient
flow of oxygen and nutrients. Your muscles, tendons
and bones involved with this activity also strengthen
to accommodate a better proficiency at performing
this activity. In time your body releases unnecessary
fat from its frame and your stride and gait become
more efficient. Your resting heat rate and blood pres-
sure drop. These adaptations can be achieved through
an educated trainer who can develop an appropriate
fitness and health plan.
The plan must include the basic principles of fitness
training: overload, specificity, individual differences,
reversibility, periodization, rest, over-training, and
stimulus variability. The plan requires a thorough
understanding of the major muscles of the body and
how they work and an understanding of metabolism;
how the body converts food energy into other forms
of energy the body can use at rest and during exercise.
Additionally, we must learn about the function and
regulation of the lungs, heart, blood vessels, hor-
mones, brain, and nerves, as well as the weight control
and temperature regulation systems at rest and dur-
ing exercise. Once we have the knowledge and sup-
port to develop a comprehensive, individualized and
periodized plans that effectively produce the training
effect, then we will be able to effectively draw our
friends, family members and future clients into the
fitness lifestyle and optimal health.
ISSA CODE OF ETHICS
AND STANDARDS
Principles and Purposes
Upon receipt of the ISSA Certificate, members
become, in effect, de facto representatives of the
leader in the fitness certification industry, and as
such are expected to conduct themselves according to
the highest standards of honor, ethics and profes-
sional behavior at all times. These principles are
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THE WHO, WHAT, WHY, AND HOW OF PERSONAL TRAINING
I n t e r n a t i o n a l S p o r t s S c i e n c e s
intended to aid ISSA members in their goal to pro-
vide the highest quality of service possible to their
clients and the community.
Academic Standards
Requirements for Graduation
1. Certification will not be issued to any stu-
dent/member who does not successfully
complete or meet all pertinent qualifications
or has not achieved passing scores on the
relevant ISSA examinations.
2. Certification will not be issued to any
client/member unless they have successfully
completed CPR training as evidenced by a
current and valid CPR card.
3. Certification will not be issued until all fees
are paid in full.
Professional Standards
ISSA members will:
1. Serve clients with integrity, competence,
objectivity and impartiality, always putting
the clients’ needs, interests and requests
ahead of his/her own. Members must
always strive for client satisfaction.
2. Recognize the value of continuing educa-
tion by upgrading and improving their
knowledge and skills on an annual or semi-
annual basis. Members must keep abreast of
relevant changes in all aspects of exercise
programming theory and techniques.
3. Not knowingly endanger his or her clients
or put his or her clients at risk. Unless they
have allied health care licenses, members
must stay within the realm of exercise train-
ing and lifestyle counseling with clients.
Clients with special medical conditions must
be referred to proper medical professionals.
4. Never attempt to diagnose an injury or any
other medical or health-related condition.
5. Never prescribe or dispense any kind of
medication whatsoever (including over-the-
counter medications) to anyone.
6. Never attempt to treat any health condition
or injury under any circumstance whatsoev-
er (except as standard first aid or CPR pro-
cedure may require).
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A s s o c i a t i o n
INTRODUCTION 7
7. Never recommend exercise for anyone with
a known medical problem without first
obtaining clearance to do so and/or instruc-
tions from the attending qualified medical
professional.
8. Ensure that CPR certification and knowl-
edge of first aid procedures is current.
9. Work towards the ultimate goal of helping
clients become more self-sufficient over
time, reducing the number of supervised
training sessions.
10. Respect client confidentiality. All client
information and records of client cases may
not be released without written release
from the client.
11. Charge fees that are reasonable, legitimate
and commensurate with services delivered
and the responsibility accepted. All addi-
tional fees and services must be disclosed to
clients in advance.
12. Adhere to the highest standards of accuracy
and truth in all dealings with clients, and
will not advertise their services in a decep-
tive manner.
13. Not get intimately involved with their
clients. Minimize problems by always main-
taining a professional demeanor, not
becoming overly friendly with clients, par-
ticularly of the opposite sex, and docu-
menting training sessions, evaluations, and
training programs. We cannot overempha-
size this point: Be a professional and do
not get involved with clients!
Dr. Sal Arria and Dr. Fred Hatfield had a vision to pio-
neer a personal fitness trainer program that would
merge in-gym experience with practical and applied
sciences more than fifteen years ago to share the ben-
efits of the fitness lifestyle with the masses. As the pro-
fession continues to grow and expand it boundaries,
for the ISSA trainer of today and the ISSA trainer of
tomorrow education and support is vital. It is the
hope and vision of the ISSA that through this course
text and the support provided by the entire ISSA staff,
our trainers will be well rounded and more educated
than in the past and will be knowledgeable on exercise
and how it relates to optimal health and fitness.
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Section One
ANATOMYand
PHYSIOLOGY