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 c。ntents
UNIT ONE THE CELL, 1
1 Cellular Biology, 1
2 Altered Cellular and Tissue Biology, 6
3 The Cellular Environment: Fluids and Electrolytes,
Acids and Bases, 12
UNIT T明TO GENES AND GENE-ENVIRONMENT
INTERACTION, 19
4 Genes and Genetic Diseases, 19
5 Genes, Environment-Lifestyle, and Common
Diseases, 24
6 Epigenetics and Disease, 27
UNIT THREE MECHANIS岛1SOF
SELF-DEFENSE, 30
7 Innate Immunity: Inflammation and Wound Healing, 30
8 Adaptive Immunity, 36
9 Alterations in Immunity and Inflammation, 40
10 Infection, 45
11 Stress and Disease, 51
UNIT FOUR CELLULAR PROLIFERATION:
CANCER,55
12 Cancer Biology, 55
13 Cancer Epidemiology, 61
14 Cancer in Children, 64
UNIT FIVE THE NEUROLOGIC SYSTEM, 67
15 Structure and Function of the Neurologic
System, 67
16 Pain, Temperature Regulation, Sleep, and Sensory
Function, 74
17 Alterations in Cognitive Systems, Cerebral
Hemodynamics, and Motor Function, 81
18 Disorders of the Central and Peripheral Nervous
Systems and the Neuromuscular Junction, 87
19 Neurobiology of Schizophrenia, Mood Disorders,
and Anxiety Disorders, 93
20 Alterations of Neurologic Function in
Children, 98
UNIT SIX THE ENDOCRINE SYSTEM, 101
21 Mechanisms of Hormonal Regulation, 101
22 Alterations of Hormonal Regulation, 107
23 Obesity and Disorders of Nutrition, 114
UNIT SEVEN THE REPRODUCTIVE
SYSTEMS, 118
24 Structure and Function of the Reproductive
Systems, 118
25 Alterations of the Female Reproductive System, 122
26 Alterations of the Male Reproductive System, 129
27 Sexually Transmitted Infections, 132
UNIT EIGHT THE HEMATOLOGIC
SYSTEM, 137
28 Structure and Function of the Hematologic
System, 137
29 Alterations of Erythrocyte, Platelet, and Hemostatic
Function, 144
30 Alterations of Leukocyte and Lymphoid
Function, 152
31 Alterations of Hematologic Function in
Children, 156
UNIT NINE THE CARDIOVASCULAR AND
LYMPHATIC SYSTEMS, 162
32 Structure and Function of the Cardiovascular and
Lymphatic Systems, 162
33 Alterations of Cardiovascular Function, 169
34 Alterations of Cardiovascular Function in
Children, 179
UNIT TEN THE PUL岛10NARY SYSTEM, 184
35 Structure and Function of the Pulmonary
System, 184
36 Alterations of Pulmonary Function, 191
37 Alterations of Pulmonary Function in Children, 200
UNIT ELEVEN THE RENAL AND UROLOGIC
SYSTEMS, 206
38 Structure and Function of the Renal and Urologic
Systems, 206
39 Alterations of Renal and Urinary Tract Function, 212
40 Alterations of Renal and Urinary Tract Function in
Children, 218
UNIT T矶TELVE THE DIGESTIVE SYSTEM, 223
41 Structure and Function of the Digestive
System, 223
42 Alterations of Digestive Function, 231
43 Alterations of Digestive Function in Children, 238
UNIT THIRTEEN THE MUSCULOSKELETAL UNIT FIFTEEN MULTIPLE INTERACTING
SYSTEM, 243 SYSTEMS, 276
44 Structure and Function of the Musculoskeletal 49 Shock, Multiple Organ Dysfunction Syndrome, and
System, 243 Bums in Adults, 276
45 Alterations of 孔1usculoskeletal Function, 249 50 Shock, Multiple Organ Dysfunction Syndrome, and
46 Alterations of Musculoskeletal Function in Bums in Children, 281
Children, 258 Answer Key, 286

UNIT FOURTEEN THE INTEGUMENTARY

SYSTEM, 263
47 Structure, Function, and Disorders of the
Integument, 263
48 Alterations of the Integument in Children, 270
 UNIT ONE THE CELL

Cellular Biol 。

IDENTIFY CELLULAR STRUCTURES AND THEIR FUNCTIONS

Identify the structures αnd mαtch their cellular functions with their Zoeαtion in the picture.

I) G、A

' I)

--

＠勤

飞几t
＠‘苦.； ...

.
·· ‘
‘·

、，..
”
, ,
d
.j
,

, • J
,
,

1. This structure generates ATP by oxidative phosphorylation; it is a .

2. This structure synthesizes proteins; it is a .

3. This structure processes and packages proteins for delivery; it is the .

4. This structure serves as a repository of genetic information; it is the .

Copyright© 2019, Elsevier Inc. All rights rese「ved. Chapter 1 Cellular Biology
 5. This structure synthesizes steroid hormones and folds proteins; it is the .

6. This structure synthesizes ribosomes; it is the .

7. This structure delivers proteins that are secreted to their destinations; it is a secretory .

8. This structure contains digestive enzymes; it is a .

DESCRIBE THE DIFFERENCES

Describe the difference between eαch pair of terms.

9. What is the difference between a eukaryote and a prokaryote?

10. What is the difference between the nucleolus and the nucleus?

11. What is the difference between microtubules and microfilaments?

12. What is the difference between hydrophilic and hydrophobic?

13. What is the difference between a lysosome and a peroxisome?

COMPLETE THE SENTENCES

Write one word in each blαnk to complete these sentences.

14. Proteins in the nucleus that bind DNA and help regulate its activity are called .

15. Cells such as neutrophils that use hydrogen peroxide as a defensive weapon synthesize it in their .

16. A section of a membrane that is rich in cholesterol and helps organize membrane proteins is called a lipid
.

17. The cells that secrete the extracellular matrix are called .

18. The mechanical force of water pushing against cellular membranes is called pressure.

19. An solution has the same osmolality as normal body fluids.

2
Chapter 1 Cellular Biology Copyright© 2019, Elsevier Inc. All rights reserved.
20. In a simple epithelium, the epithelial cells 盯e in contact with a membrane that provides support.

21. tissue is characterized by only a few cells surrounded by a lot of extracellular matrix.

22. A myocyte is a cell.

ORDER THE STEPS

Sequence the eνents that occur during each o.f these processes.

23. Write the letters here in the correct order of the events that occur during a neuronal action potential:

A. Sodium ions move into the cell.

B. Potassium ions leave the cell.
C. Sodium pe口neability increases.
D. Resting membrane potential is reestablished.
E. Potassium permeability increases.

24. Write the letters here in the co盯ect order of the phases of the normal cell cycle, beginning with the phase 由at

precedes DNA synthesis:

A. M phase
B. S phase
C. G1 phase
D. G2 phase

CIRCLE THE CORRECT WORDS

Circle the correct word 卢vm the choices proνided to complete these sentences.

25. The main di旺erence between cells that divide rapidly and those that divide slowly is the amount of time they spend
in the (S, G1) phase of the cell cycle.

26. Cells develop specialized functions through the process of (di旺erentiation, intermediary metabolism).

27. A p盯ticle that is dissolved is called a (substrate, solute).

28. Mitochondria need a lot of (glucose, oxygen) to function normally.

29. During osmosis, (particles, water molecules) move across the plasma membrane.

30. (Autocrine, Paracrine) signals act on ne盯by cells by (diffusion, active transport) through interstitial fluid.

31. A cell that has an insufficient oxygen supply will not be able to perform 由e chemistry of (the Krebs cycle, glycolysis).

32. (Active transport, Facilitated diffusion) can move substances against their concentration gradients.

33. Receptors are (proteins, lipids) that bind speci白c small molecules.

34. ER stress occurs when unfolded or misfolded (lipids, proteins) accumulate in the endoplasmic reticulum.

Copyright© 2019, Elsevier Inc. All rights reseived. Chapter 1 Cellula『 Biology
WRITE YOUR DEFINITIONS

Test your understanding by dφiing each term using your own words.

35. Ligand

36. Caveolae

37. Mechanotransduction

38. Amphipathic molecule

39. Endocytosis

CH。。SE THE DIRECTION

For each situation, choose the direction in which the items will move. Choose A or B 卢om the figure.

A. From ECF into the cell

B. From the cell to ECF

40. If the ECF becomes hypotonic, in which direction will water move?

41. If the concentration of substance X in the ECF is higher than its concentration inside the cell, in which
direction will active transport move substance X?

42. If the glucose concentration in the ECF is higher than its concentration inside the cell, in which direction will
facilitated diffusion move glucose?

43. In which direction does Na1, K1-ATPase move sodium ions?

44. In which direction does Na+, K+-ATPase move potassium ions?

Chapter 1 Cellular Biology Copyright© 2019, Elsevier Inc. All rights reserved.
PROVIDE THE EXPLANATION

Use appropriαte technical terms to explain these eνents.

45. A mutation a旺ecting what function would cause a lysosomal storage disease?

46. How does the presence of gap junctions in cardiac muscle facilitate cardiac function?

47. Explain why intracellular receptors do not use second messengers, but many cell surface receptors do.

48. What happens during the interphase portion of the cell cycle? Why 缸e those events important?

5
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 1 Cellular Biology
 Altered Cellular and Tissue Bi 。l。

MATCH THE DEFINITIONS

Mα：tch the word on the right with its definition on the left.

1. Stiffening of skeletal muscles after death A. Apoptosis

2. Unintentional decrease of core body temperature below 35°C (95°F) B. Free radical

3. A type of cellular housekeeping in which a cell digests some of its own C. Livor mortis
components
D. Accidental hypothermia
4. Area of cell death in which dead cells disintegrate, but the debris is not
digested completely by enzymes E. Rigor mortis

5. Area of cell death in which denatured proteins appear firm and opaque F. Coagulative necrosis

6. An atom or group of atoms having an unpaired electron G. Autophagy

7. Purple discoloration of dependent tissues after death H. Caseous necrosis

8. Cell death that involves orderly dismantling of cell components and

packaging the remainders in vesicles

CATEGORIZE THE CLINICAL EXAMPLES

Write the type of cellular αdaptation beside its clinical example. Choices: atroph只 hypertroph只 hyperplαsia, metaplasia.

9. Lining of uterus thickens after ovulation because of increased amounts of estrogen.

10. Man who lifts weights regularly develops larger biceps.

11. Thymus gland decreases in size during childhood.

12. Columnar epithelium in bronchi of cigarette smoker is replaced by stratified squamous

epithelium.

13. Captain of roller derby team has greater thigh diameter on left than right from skating clockwise.

14. Left calf is smaller than right calf when cast is removed from it.

15. Liver regenerates after surgical removal of damaged portion.

6
Chapter 2 Altered Cellular and Tissue Biology Copyright© 2019, Elsevier Inc. All rights reserved.
CIRCLE THE CORRECT WORDS

Circle the correct word斤。m the choices provided to complete these sentences.

16. Cell death by (necrosis, apoptosis) causes inflammation, but cell death by (necrosis, apoptosis) does not.

17. Dysplasia also is called (normal, atypical) hyperplasia.

18. Release of (potassium, calcium) ions from intracellular stores into the cytoplasm during ischemia damages the cell.

19. Compared with normal aerobic metabolism, cells that use anaerobic metabolism produce (more, less) ATP and
(more, less) lactic acid.

20. The most important way to prevent medication-related poisoning deaths in children is safe (storage, prescribing) of
medications.

21 . Reactive oxygen species, such as (superoxide radicals, superoxide dismutas时， damage cells by attacking their
(potassium, membranes).

22. Postmortem changes (involve, do not involve) the inflammatory response.

23. Liquefactive necrosis occurs most commonly in the (brain, heart) because the cells there are rich in (lipases,
hydrolases).

24. Gangrene occurs when cells die of (hypoxia, trauma) and (poisoning, bacterial invasion).

DESCRIBE THE DIFFERENCES

Describe the difference between eαch pair of terms.

25 . 矶＇hat is the difference between hypertrophy and hyperplasia?

26. What is the difference between suffocation and strangulation?

27 . 矶＇hat is the difference between an abrasion and a laceration?

28. What is the difference between dystrophic calci且cation and metastatic calcification?

29 . 矶＇hat is the difference between a penetrating gunshot wound and a perforating gunshot wound?

7
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 2 Altered Cellular and Tissue Biology
ORDER THE STEPS
Beginning with the αcute obstruction ofα coronaηαrteη， sequence the eνents that occur during necrosis of a myocardial cell.

30. Write the letters here in the co盯ect order of the steps:
A. ATP supply decreases within the cell.
B. Acute obstruction of coronary arterγcuts off arterial blood supply to myocardium.
C. Cell runs on anaerobic metabolism because of lack of oxygen.
D. Cell bursts and spills its contents into the interstitial fluid.
E. Active transport of ions across the cell membrane slows.
F. Lysosomal enzymes destroy components of their own cell.
G. Osmosis causes cell swelling, and calcium accumulates in the cell.
H. Organelles, including lysosomes, swell and rupture.

COMPLETE THE SENTENCES

Write one word in each blank to complete these sentences.

31. Active enzymes that dismantle the cellular components during apoptosis are called .

32. Acute cellular swelling during ischemia is reversible if is supplied quickly.

33. Active tuberculosis disease is characterized by necrosis, whereas death of brain cells is characterized
by necrosis.

34. During apoptosis, cell contents are contained in vesicles called , which are
removed by .

35. Liver enzymes metabolize most blood ethanol to , which damages tissues.

36. When excessive reactive oxygen species overwhelm the endogenous antioxidant systems,
occurs.

37. Death of the entire person is called death.

38. Melanin is synthesized by epidermal cells called and accumulates in epidermal cells called
.

RESPOND TO CLINICAL SITUATIONS

Place yourself in these situations αnd write your resp onses in the sp aces provided.

39. Mr. Turino had severe crushing in uries of both lower extremities when his house collapsed on him during an
earthquake. Among other abnormal values, his laboratory tests show elevated creatine kinase in his blood. Why is
his blood creatine kinase high?

40. Mrs. Montoya died peacefully in her sleep at home while lying prone. When her relatives discovered her body and
rolled her over, they saw purple discoloration of half of her face and of her abdomen. They 缸e very concerned that
she might have been beaten the night before she died. What factual information do they need to relieve their concern?

Chapter 2 Altered Cellular and Tissue Biology Copyright© 2019, Elsevier Inc. All rights reserved.
41 . The entire Berg family was in the hospital room when Mrs. Berg died quietly from terminal cancer. As the family is
preparing to leave, Kevin Berg, age 10, says to his mother,“I think grandma is not really dead. She is just sleeping.
Dead people are sti旺 as boards. I saw that on TV. Grandma ’ s hands are cold, but her arms 缸e not sti任” His mother
looks at the nurse for help. In addition to addressing the emotional issues, what factual information should be
provided?

42. Two of your colleagues are discussing the effects of reactive oxygen species (ROS) on cells. “ Too many ROS cause
necrosis ,” says one. “ But I read that too many ROS cause apoptosis ,'’ says the other. What information should be
explained to them to clarify that both are correct?

DRAW YOUR ANSWERS

Read the questions and dr1αw your answers.

These are normal cells that 町e capable of cell division and normally receive basal levels of hormonal stimulation.

Normal
(From Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment an.d mαnαgement
of clinical problems, ed 6, St Louis, 2004, Mosby.)

43. Draw what these cells would look like after their hormonal stimulation has been reduced substantially for several
weeks.

44. Draw what these cells would look like after receiving excessive hormonal stimulation for several weeks.

IDENTIFY THE CHARACTERISTICS

Choose the chαyαcteristics of αpoptosis. You mαy select more thα：none αnswe瓦 Choose α：ll thαtαrpply.

45. Write the letters of your choice(s) here:

A. Cell is damaged by its own lysosomal enzymes.
B. Cell shrinks when its cytoskeleton is dismantled.
C. The cell i时ury is reversible if nutrients are restored in time.
D. Process causes inflammation.
E. Sections of the cell bud off into vesicles.
F. Cell swells when osmosis occurs.
G. Process occurs when caspases are inactivated.

9
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 2 Altered Cellular and Tissue Biology
TEACH PEOPLE ABOUT PATHOPHYSIOLOGY

Write your response to each situation in the spαce provided.

46. Kenesha Francis, age 9, broke her arm 6 weeks ago, and the cast will be removed today. Before the cast is removed,
teach her about the expected appearance of her arm in words appropriate to her age.

47. “τbe doctor said my heart enlarged because my blood pressure is high,” says Mr. Hendricks. “ Please explain that !”

48. Mr. Bax has diabetes and will have amputation of toes shown in the photograph.

(From Damjanov I: Pathology for the health professio时， ed 4, Philadelphia, 2012, Saunders.)

He asks,“Why did my toes get black and hard rather than swollen and mushy like my dad ’ s toes did before surgery ?”

10
Chapter 2 Altered Cellular and Tissue Biology Copyright© 2019, Elsevier Inc. All rights reserved.
PUZZLE OUT THESE TECHNICAL TERMS

Use the clues to complete the puzzle, demonstr1αting your knowledge of important technical tenηs.

6 「｜

7 8 - - -

- - - -

11
L」
｜」
i

Across Down
1. Adaptive increase in the number of cells 1. Adaptive increase in cell size
7. Shrunken nucleus appearing as a small, 2. Adaptive decrease in cell size
dense mass 3. Loss of skeletal muscle mass and strength
10. Adaptive replacement of one mature cell 4. Lack of oxygen to tissues caused by insufficient blood supply
type by another normal cell type 5. Goes with mortis to denote postmortem reduction of body
11 . Yellow-brown age pigment temperature
6. Abnormal change in size, shape, and organization of mature
tissue cells
8. Nuclear dissolution and lysis of chromatin
9. Partial deprivation of oxygen

11
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 2 Altered Cellular and Tissue Biology
 The Cellular Environment: Fluids
and Electrolvtes . Acids and Bases

MATCH THE DEFINITIONS

Mαtch eαch word on the right with its dφnition on the lφ．

1. Excessive carbon dioxide in the blood A. Edema

2. Elevated sodium concentration in the blood B. Ascites

3. Fluid accumulation in interstitial spaces C. Acidosis

4. Fluid accumulation in the peritoneal cavity D. H ypercapnia

5. Decreased pH of the blood E. Hyperkalemia

F. H ypematremia
6. Elevated potassium concentration in the blood

CIRCLE THE CORRECT WORDS

Circle the correct word卢om the choices provided to complete these sentences.

7. The osmolality of the intracellular fluid normally is (higher than, the same as, lower than) the extracellular fluid
because water crosses cell membranes (with difficulty, freely) through aquaporins.

8. (Sodium, Albumin) is primarily responsible for the plasma oncotic pressure.

9. Thirst prompts fluid intake through action of (baroreceptors, osmoreceptors) located in the (hypothalamus, posterior
pituitary).

10. Isotonic fluid excess causes (hypematremia, hypervolemia).

11. Renal compensation for an acid-base balance is (fast, slow); pulmonary compensation for an acid-base balance is
(fast, slow).

12. Fluid moves out of capillaries by (osmosis，自ltration) and into or out of cells by (osmosis, filtration).

13. Hypercapnia means an excess of (metabolic acid, carbon dioxide) in the blood.

14. The most dangerous effect of hyperkalemia is its action on the (kidneys, heart).

CATEGORIZE THE CAUSES OF EDEMA

Write the major cαuse of the edema beside each clinical situation. Choices: increαsed cαpillaη hydrostatic pressure,
decreαsed plasma oncotic pressure, increased capillary permeability, lymphatic obstruction.

15. Tumor grows in lymph node

16. Right heart failure

12
Chapter 3 The Cellular Environment: Fluids and Electrolytes, Acids and Bases Copyright© 2019, Elsevier Inc. All rights reserved.
 17. Infected wound

18. Clot in a vein

19. Protein malnutrition

20. Bee sting

21. End-stage kidney disease

SELECT THE GREATER

Consider the pairs and select the one that is greateχ

22. Who has a greater percentage of body weight as water: a lean woman or an obese woman?

23. Who has a greater percentage of body weight as water: an infant or an adolescent?

24. Who has a greater percentage of body weight as water if both people weigh the same: a woman or a man?

25. Who has a greater percentage of body weight as water if both people weigh the same: a 56-year-old man or a
78-year-old man?

26. Where is the potassium ion concentration greater: extracellular fluid or intracellular fluid?

27. Where is the sodium ion concentration greater: extracellular fluid or intracellular fluid?

28. Which is greater: the pH of an acid solution or the pH of an alkaline solution?

29. Which is greater: the respiratory rate during metabolic acidosis or the resp让atory rate during metabolic alkalosis?

EXPLAIN THE PICTURES

Examine the pictures and answer the questions αbout them.

Na+ Na+
H20, ) \_ Na+
H20, ‘

／飞了。
1

Na+ \ /H20 "~ +

Na+
。） \ 气 Na+ ,,,,,『 ./ ~ Na+ 7、 ,'!,_ Na+
Na+ '
\
｜、、＼
、、 / 、

H20
H20 Na+ Na+

Neur。n Neur。n Neur。n

A 8 c

30. Compare the sodium concentration in panels A, B, and C. Panel B shows isotonic fluid, so the fluid in A is
, and the fluid in C is .

13
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 3 The Cellular Environment: Fluids and Electrolytes, Acids and Bases
31. Why did the ne旧on in panel A swell?

32. What cerebral clinical manifestations occur when neurons swell as in panel A?

33. Why are the cerebral clinical manifestations of the situation in panel C 归11ilar to those in panel A?

CHARACTERIZE THE HORMONES

Write one letter and one number by each hormone in the lφ column to indicαte the stimuli that increase its secretion
αnd its physiologic 写ffects when secreted.

Choose the Stimuli that Increase Choose the Physiologic Effects

Hormone Secretion of the Hormone of the Hormone

34. Aldosterone A. High plasma calcium 1. Increases renal sodium and water
excretion
35. Parathyroid hormone B. Increased plasma osmolality,
substantially decreased arterial 2. Increases renal sodium and water
36. Atrial natriuretic peptide blood pressure reabsorption; increases renal
excretion of potassium and
37. Calcitonin C. Low plasma calcium hydrogen ions

38. Antidiuretic hormone
D. Increased volume in the cardiac 3. Increases reso叩tion of bone;
atria stimulates renal reabsorption
of calcium; inhibits renal
E. Angiotensin II, increased plasma reabsorption of phosphate
potassium
4. Increases renal water
reabsorption, vasoconstriction

5. Inhibits osteoclasts in bone

DESCRIBE THE DIFFERENCES

Describe the difference between eαch pα ir of terms.

39. What is the di旺erence between interstitial fluid and extracellular fluid?

40. What is the di旺erence between a volatile acid and a nonvolatile acid?

14
Chapter 3 The Cellular Environment Fluids and Electrolytes, Acids and Bases Copyright 。 20 1 9, Elsevier Inc. All rights reserved.
41 . 矶＇hat is the difference between acidemia and acidosis?

42. With regard to an acid-base imbalance, what is the difference between correction and compensation?

COMPLETE THE SENTENCES

Write one word in each blank to complete these sentences.

43. One-third of body water is in the fluid, and two-thirds is in the fluid.

44. A standard 70-kg man has liters of total body water.

45. Excessive fluid within the interstitial space is called .

46. An fluid has the same concentration of solute as the plasma.

47. A person who has a lung disease may develop a primary acid-base imbalance, but a person who
has a kidney disease may develop a primary acid-base imbalance.

48. When the blood pH is 7 .40, the bicarbonate-to-carbonic acid ratio is .

49. A buffer pair is a weak and its .

50. Calculating the anion gap may help to distinguish between different causes of metabolic .

51 . Overuse of phosphate-containing, over-the-counter enemas can cause , which in tum will

the plasma calcium concentration.

15
Copyright© 2019, Elsevier Inc. All rights rese「ved . Chapter 3 The Cellular Environment: Fluids and Electrolytes, Acids and Bases
ASSESS THESE PATIENTS

Write one letter αnd one number by each p atient situαtion in the l ift column to indicate the imbαlance(s） 户r which that
patient has high risk αnd the assessment findings for the imbalance(s).

Choose the Assessment Findings

Patient
52. 孔1rs .Singh takes
glucocorticoids for
a chronic disease.
53. Mr. Wiggins has been
sobbing and breathing
deeply and rapidly for an
hour since his wife died.
54. Mr. Jenkins is comatose
from a heroin overdose.
Choose the Imbalance(s) for
Which the Patient Has High Risk
A. Isotonic fluid deficit, hypokalernia,
metabolic alkalosis
B. Isotonic fluid excess and
hypokalemia
C. Hypercalcernia
D. Respiratory acidosis
E. Respiratory alkalosis
that Indicate the High-Risk
Imbalance(s)
1. Paresthesias of fingers,
lightheadedness, confusion
2. Slow, shallow respirations; blood
pH less than 7 .35 ; blood Paco2
increased
3. Dependent edema, weight gain,
distended neck veins when up-
right, skeletal muscle weakness,
constipation, abdominal distention

55. Baby Thompson has 4. Fatigue, weakness, anorexia,

repeated vomiting 仕om constipation, lethargy
pyloric stenosis.
5. Tachycardia; rapid weight loss;
56. Mrs. Smythe has decreased urine output; skeletal
hyperparathyroidism. muscle weakness; slow, shallow
respirations; lethargy

CHOOSE THE DIRECTION

Fo γeαch situαtion, choose the direction thαt the items will move. Choose A or B from the figure.

A. From ECF into the cell

B. From the cell to ECF

57. In which direction does insulin move potassium ions?

58. In which direction does epinephrine move potassium ions?

59. In which direction does alkalosis move potassium ions?

60. In which direction does hypematremia move water?

16
Chapter 3 The Cellular Environment: Fluids and Electrolytes, Acids and Bases Copyright© 2019, Elsevier Inc. All rights reserved.
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of The coat without
a seam, and other poems
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: The coat without a seam, and other poems

Author: Helen Gray Cone

Release date: August 28, 2023 [eBook #71508]

Language: English

Original publication: New York: E. P. Dutton & Company, 1919

Credits: The Online Distributed Proofreading Team at

https://www.pgdp.net (This file was produced from
images generously made available by The Internet
Archive)

*** START OF THE PROJECT GUTENBERG EBOOK THE COAT

WITHOUT A SEAM, AND OTHER POEMS ***
 THE
COAT WITHOUT A SEAM And
Other Poems
 BY THE
SAME
AUTHOR

A CHANT OF LOVE FOR

ENGLAND AND OTHER POEMS

A volume of miscellaneous
poems containing as its title poem
a reply to the German “Hymn of
Hate.”
“Firmly and finely fashioned,
and unaffectedly sincere.”—The
New York Times.
“Miss Cone’s verse shows a
delicacy of imagination which is
deserving of high praise.”—The
Outlook.
$1.50 net

NEW YORK
E. P.
DUTTON &
COMPANY
681 Fifth
Avenue
 THE
COAT WITHOUT A SEAM
And Other Poems

BY
HELEN GRAY CONE
Author of “A Chant of Love for England,
and Other Poems”

NEW YORK
E. P. DUTTON & COMPANY
681 Fifth Avenue
 Copyright 1919, by
E. P. DUTTON & COMPANY

All Rights Reserved

Printed in the United States of America

Grateful acknowledgment is made, for permission to reprint some

of the poems in this book, to Scribner’s Magazine, The Outlook, The
Sonnet, The New York Evening Post, The New York Times, The
Boston Evening Transcript, and The Association Monthly.
 CONTENTS
PAGE
The Coat Without a Seam 1
Sonnets of the Great Peace 9
Moods of War:
The Sword 21
Aligned 23
Earth-brown Armies 26
The Imperative 27
War-Sacrifice 29
The Youth and War 31
Mothers of Soldiers 33
A Reprisal 35
On the Death of an Untried Soldier 39
The Airman 41
To Francis Ledwidge 42
The Way of the White Souls 44
Respite 47
Happy Country 49
To France 51
To Belgium 53
The Creed of an American 55
The Ultimate Victory 58
Roosevelt, 1919 60
The Quiet Days:
Old Burying Hill 65
Heartbreak Road 66
Romance 67
Faith 69
Intimations 70
On the Singing of “Gaudeamus Igitur” 72
The Countersign 74
Failure Triumphant 75
The Spark 77
Foxgloves 79
The Christmas Bagpipes 80
When Roses Go Down to the Sea 82
Ritual for Summer Dead 85
Red October 87
The Singer Chooses the Songs of the 89
Wind
The Gleam Travels 91
The Gray Victory 93
Flags and the Sky 96
THE COAT WITHOUT A
SEAM

THE COAT WITHOUT A SEAM

There was a web, ere Time began,

Woven on the loom of God,
Woven for the need of Man.
Through the web two colors ran,
Blue that is the sky of God,
Red that is the blood of Man.
The web was woven, the web was one:
The stars sang when the work was done.

God had willed it to be worn—

Fit garment for the heavenly feast—
By Man, that was to be His son.
Only God could dream that dream!
When Time began, and Man was born,
He clothed himself in the skin of the beast,
And under it beat the heart of the beast.
Not till Man be born God’s son
Shall he wear the Coat without a Seam!

(Ah, the dream, the wondrous dream

Of a World without a Seam,
Man being one, as God is one,
Brother’s brother and Father’s son,
All earth, all Heaven, without a seam!)
The Roman strode through field and flood,
Blind as Fate with battle-blood;
Victory glittered in his hand;
And when he laid him down at night
Under the stars of some strange land,
Weary of the march or fight,
He wrapped his heart in the vast dream
Of a World without a Seam;
Yet the dream was not divine;
The fierce heart beat like marching feet:
“The World is one—the World is mine!”
That was the dream of states foregone,
Of Babylon, of Macedon;
Sleeked by whatsoever art,
It is the dream of the beast’s heart.
Massive-treading Rome paced on
(As Macedon, as Babylon,)
Into the dusk of states foregone:
She left her mantle still astream
Along the wind, her purple dream—
Not the Coat without a Seam!
The eyes of emperors see it float,
They hail it for the sacred Coat:
Men follow on through field and flood,
Blind as Fate with battle-blood.
See the sworded sceptred train,
Out of the dusk they all advance:
Iron-crownéd Charlemagne,
Barbarossa flaming past,
Sombre majesties of Spain,
Pomps of old monarchic France—
Supreme Napoleon last,
Sweeping his ermine-bordered robe
And gripping fast the globe.
(Nay, who is this that follows him,
A vision helmeted and grim,
A countenance pallid and aghast?)
—Into the dusk they all are gone,
As Babylon, as Macedon.
Not till Man shall dream God’s dream
Shall he wear the Coat without a Seam!

(Ah, the dream, the wondrous dream

Of a World without a Seam!
Man being one, as God is one,
Brother’s brother and Father’s son,
All earth, all Heaven without a seam!)

“What shall we do, we simple folk

Who walk as cattle in the yoke?
Surely the vision of this Coat—
Fit garment for the heavenly feast—
Is for prophet and for priest,
Not for men of little note!
Surely the quest to find this Coat—
Woven of empyrean thread
Heaven-blue and heart-red—
This is for Kings and Chancellors,
Parliaments and Emperors,
Not for men of little note!”
—Nay, this do ye every one:
All your days to dream God’s dream,
That Man, who is to be His son,
Shall wear the Coat without a Seam!
SONNETS OF THE GREAT PEACE

“Incertainties now crown themselves assured

And peace proclaims olives of endless age.”

—Shakespeare’s Sonnet CVII.

What boon is this, this fresh and crystal thing,

Perfect as snow, dropped from the deep of the sky—
This healing, shed as from the soft swift wing
Of some great mystical bird low-sweeping by?
This music suddenly thrilling through the mind
Angelic unimagined ecstasy,
As when warm fingers of the Spring unbind
Young brooks that laugh and leap, at last being free?
By what white magic, what unfathomed art,
Was this best gift secretly perfected,
This amulet, that laid against the heart
Melts all the icy weight that held it dead?
This is that Peace we had and did not know;
This is that Peace we lost—how long ago!

II

Shall we not now work wonders with this charm,

To the vext heart of the world benignly laid,
Fending all future golden lads from harm,
 And all gray mothers, and every starry maid?
Yea, all kind beasts that ask with patient eyes
Our wisdom to forestall bewildering pain:
Yea, all kind fields, trees rippling to the skies,
Brown earth sweet-breathing under natural rain.
Shall we not now, being freed, being healed of Peace,
Retrieve all days to be from blot and blight,
Give to the chained goodwill of Man release,
And a new deed of manumission write
On a new page, made by this marvellous boon
Pure as unfooted snow under the moon?

III

How did we cast away our careless days

In that old time before we knew their worth,
Wandering with chance, even as a child that strays,
Spilling their unprized splendors on the earth!
But now we have eaten War as daily bread,
Borne it upon our souls a weary weight,
Made it the pillow to a restless head,
Breathed it as air, sick with the reek of hate:
And Peace is come a stranger, and grave-eyed,
Like a young maid turned woman; on our knees
We do her reverence as a spirit enskyed;
How should we spend such shining days as these?
They have cost great pain: needs must we hold them dear,
Counting our jewels with a heavenly fear.

IV

Ghosts of great flags that billowed in the sun

With glorious colors above the crowded street,
 Lifting our hearts to know the rent world one,
Teaching the march of Man to hurrying feet,
Shall ye not haunt those skyward spaces still
With memory of your sun-illumined streaming,
Bright brother-angels heralding goodwill,
Beckoners of sordid spirits to noble dreaming?
Or shall your many beauteous blazonries
Fade out from the dulled sense and be forgot,
And intimations so august as these
Lapse into silence even as they were not,
Comrades turn rivals, and heart-fast allies
Weavers of schemes, peering with insect eyes?

What shame were this to those who lie asleep

Under the scarlet poppies, having bought
A clean new world with blood! Shall we not keep
Faith with our dead, and give them what they sought?
Is not a world the measure of our debt
To those whose young lives sadly we inherit,
Living them out, making them fruitful yet?
What lesser meed fits their transcendent merit?
The future was their sacrificial gift,
And joy unborn, and beauty uncreate,
And little children that should racing lift
Their torch of life, laughing at death and fate:
Shall we not make, mindful of all they gave,
A star of this old earth which is their grave?
MOODS OF WAR
 THE SWORD

One of the seventy had a sword

The day that Christ was crucified:
He followed where they led his Lord,
The man that could not stand aside.

When that first hammer-stroke rang loud,

And left and right the rabble swayed,
He flashed from out the staring crowd,
He died upon the Roman blade.

His fruitless deed, his noteless name,

By careless Rome were never told.
Now shall we give him praise or blame?
Account him base, acclaim him bold?

Was he the traitor to his Lord,

Deeper than Peter that denied,
The loving soul that took the sword,
The man that would not stand aside?

Or did the glorious company

Of Michael’s sworded seraphim
With chivalrous high courtesy
Rise up to make a place for him?
 ALIGNED

Why do you leap in the wind so wild,

O Star-Flag, O Sky-Flag?
And why do you ripple as if you smiled,
Flag of my heart’s delight?
“I laugh because I am loosed at last,
Free of the cords that bound me fast
Mute as a mummy, furled on the mast,
Far from the beckoning fight!

“I joy because I am aligned—

The Star-Flag, the Sky-Flag—
With these the noblest of my kind,
Flags of the soul’s desire!
And where the blended Crosses blaze,
And where the Tricolor lifts and sways
To the marching pulse of the Marseillaise,
I may be tried in the fire!”

Yea, not for gold and not for ease,

My Star-Flag, my Sky-Flag,
The Fathers launched you on the breeze,
Flag of man’s best emprise!
Yea, not for power and not for greed,
But to fly forever, follow or lead,
For the world’s hope and the world’s need,
Flower of all seas and all skies!
And better you were a riddled rag,
My Star-Flag, my Sky-Flag,
The faded ghost of a fighting-flag,
Shredded, and scorched with flame,
Than that you should now be satisfied
Over splendid cities and waters wide
To flutter and float in an idle pride,
To flaunt in a silken shame!

Then well may you leap in the wind so wild,

O Star-Flag, O Sky-Flag!
And well may you ripple as if you smiled,
Flag of our hearts’ delight!
We joy because you are aligned
With these the noblest of your kind:
We are yours and theirs with a single mind—
Let us on to the beckoning fight!