Human Anatomy & Physiology 12th

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 Equipping You with 21st-Century Skills
to Succeed in A&P and Beyond…

The 12th Edition of Elaine Marieb and Katja Hoehn’s best-selling A&P text and media program
motivates and supports both novice learners and expert students, more than ever before. Each
carefully-paced chapter guides you in advancing from mastering terminology to applying knowledge
in clinical scenarios, to practicing the critical thinking and problem-solving skills that are required for
entry to nursing, allied health, and exercise science programs.

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A01_MARI1803_12_GE_FM.indd 1 05/08/2022 19:31

 Identify “Big Picture” Concepts
Before Exploring Details

Before you look up details and information within a chapter, read the Chapter-
Opening Roadmap, which visually groups and organizes “big picture” concepts
and shows how they are related. To focus your studying, review the numbered
Key Concept Headings, Learning Outcomes, and summaries.

8 Joints
UNIQUE! Chapter Roadmaps
provide a visual overview of the key
concepts in the chapter and show
how they relate to each other. Each
key concept “brick” in the roadmap
corresponds to a numbered section
In this chapter, you will learn that
within the chapter.
Joints determine how bones move relative to each other

by first asking then asking

8.1 How are joints classified? 8.6 What happens

when things go wrong?
then exploring
Each numbered section within the and finally, exploring
chapter begins with a Key Concept
Developmental Aspects
Heading that helps you quickly grasp 8.2 Fibrous joints 8.3 Cartilaginous 8.4 Synovial joints
of Joints
joints
the “big idea” of the discussion that
follows. looking closer at focusing on

Movement of 8.5 Selected

synovial joints synovial joints

The graceful movements of ballet dancers and the rough-

and-tumble grapplings of football players demonstrate the 8.1 Joints are classified into
great variety of motion allowed by joints, or articulations— three structural and three functional
the sites where two or more bones meet. Our joints have two
fundamental functions: They give our skeleton mobility, and
categories
they hold it together, sometimes playing a protective role in Learning Outcomes
the process. ✔ Define joint or articulation.
✔ Classify joints by structure and by function.
Joints are classified by structure and by function. The structural
CAREER CONNECTION classification focuses on the material binding the bones together
and whether or not a joint cavity is present. Structurally, there
are fibrous, cartilaginous, and synovial joints (Table 8.1 on
p. 285). Only synovial joints have a joint cavity.
The functional classification is based on the amount of move-
ment allowed at the joint. On this basis, there are synarthroses
(sin0ar-thro9sēz; syn 5 together, arthro 5 joint), which are immov-
able joints; amphiarthroses (am0fe-ar-thro9sēz; amphi 5 on both
Career Connection Videos sides), slightly movable joints; and diarthroses (di0ar-thro9sēz;
dia 5 through, apart), or freely movable joints. Freely movable joints
feature a health care professional Watch a video to learn how
the chapter content is used predominate in the appendicular skeleton (limbs). Immovable and
who describes how the chapter in a real health care setting. slightly movable joints are largely restricted to the axial skeleton.
Go to Mastering A&P® > Study Area > This localization of functional joint types makes sense because
content relates to their everyday Animations and Videos or use quick the less movable the joint, the more stable it is likely to be.
access URL https://bit.ly/3P8hiZa In general, fibrous joints are immovable, and synovial joints
work. You can access all of the are freely movable. However, cartilaginous joints have both rigid
Career Connections videos through 281
an open access web page at https://
bit.ly/3P8hiZa. Learning Outcomes are presented at
See p. 281
M08_MARI1803_12_GE_C08.indd 281 22/07/22 13:42

the beginning of each chapter section

to give you a preview of essential
information to study.

A01_MARI1803_12_GE_FM.indd 2 05/08/2022 19:31

 Pace Yourself:
Learn & Review the Basics

Summary Tables present key information and serve as “one-stop shopping” study tools.
192 UNIT 2 Covering, Support, and Movement of the Body

Table 5.1 Summary of Cutaneous Glands

ECCRINE SWEAT GLANDS APOCRINE SWEAT GLANDS SEBACEOUS GLANDS

5
Functions ●● Temperature control May act as sexual scent glands ●● Lubricate skin and hair
Some antibacterial properties Help prevent water loss
Chapter 5 The Integumentary System 193
●● ●●

●● Antibacterial properties

Type of Hypotonic filtrate of blood plasma Filtrate of blood plasma with added Sebum (an oily secretion)
external ear canal. Their secretion mixesproteins
Secretion with sebum
and fatty produced
substances
by of
Method nearby Merocrine
sebaceous glands to form a sticky,
(exocytosis) Merocrine bitter substance
(exocytosis)
Check Your Understanding
Holocrine
called cerumen, or earwax, that is thought to deter insects and
Secretion 17. Which cutaneous glands are associated with hair follicles?
block
Secretion
Exits Duct At
entry of
Skin foreign
surface material. Usually upper part of hair follicle;
rarely, skin surface
18. When
Usually Anthony
upper part returned home from a run in 30°C weather,
of hair follicle;
sometimes, skin surface
●● Mammary glands. Mammary glands, another type of spe-
his face was dripping with sweat. Why?
Body Location Everywhere, but especially palms, Mostly axillary and anogenital regions Everywhere except palms and soles
cialized sweat gland, secrete milk. Although they are prop-
soles, forehead 19. What is the difference between heat-induced sweating
and a “cold sweat,” and which variety of sweat gland is
erly part of the integumentary system, we will consider the
involved?
See p. pores
so-called
192 of aglands
mammary in Chapterwhich
person’s complexion, 27 are
with female reproductive
openings eccrine glands, they lie deeper
20. inAPPLY
the dermis or even in glands
Sebaceous the sub- are not found in thick skin. Why is
organs.
of hair follicles.) cutaneous tissue, and their ducts empty into hair follicles.
their absence in those body regions desirable?
Eccrine gland secretion, commonly called sweat, is a hypo- Apocrine secretion contains the same basic components as
tonic filtrate of the blood that passes through the secretory cells true sweat, plus fatty substances and proteins. Consequently, For it answers, see Answers Appendix.
Sebaceous Glands
of the sweat glands and is released by exocytosis. It is 99% water, is viscous and sometimes has a milky or yellowish color. The
with some salts (mostly sodium chloride), traces of metabolic secretion is odorless, but when bacteria on the skin decom-
The sebaceous
(urea, uric acid,glands (se-ba9shus; “greasy”), orpose oilitsglands
wastes
(Figure
peptide 5.9a),
called dermcidin.
and ammonia),
are simple branched
Normally,
and a microbe-killing
alveolar
sweat is acidic with glands
a pH that are found
unpleasant
First and foremost, the skin is a
5.8
organic molecules, it takes on a musky and generally
odor, the basis of body odor.
between
all over 4 and
the6.body except in the thick skin of the palms Apocrine
Sweating’s major role is to prevent the body from overheat-
and soles. barrier
glands begin functioning at puberty under the
influence of the male sex hormones (androgens) and play little
They are small on the body trunk andandlimbs, but quite
role inlarge on a constant body temperature. Their precise
ing. Heat-induced sweating begins on the forehead spreads maintaining Learning Outcome
the face,
inferiorly neck,
over and upper
the remainder of thechest. These glands
body. Emotionally secretefunction
induced an oilyis sub-
not yet known. Three lines of evidence suggest that
sweating—the
stance called so-called
sebum “cold(se9bum).
sweat” broughtTheoncentral
by fright cells
or ofthey
themay be the human✔
alveoli Describe
equivalent howanimals’
of other the skin accomplishes at least five different
sexual
nervousness—begins on the palms, soles, and axillae (armpits) scent glands: (1) SexualText Recall
foreplay icons
increases
functions. guide (2)
their activity; you to review
accumulate
and then spreads oily lipids
to other until they become so engorged
body areas. that they
they enlarge specific
and recede with pages
the phases where menstrual
of a woman’s a concept was first
burst, so functionally these glands are holocrine glands ( and
cycle; p. 156 ).
(3) behavioralLike
studiesthe
show
introduced. skin of asecretions
that their grape, mayour skin keeps its contents juicy and 5
The accumulated
Apocrine Sweat lipids
Glands and cell fragments constituteactsebum. as pheromones (chemical messengers released by one indi-
whole. The skin and its appendages perform a variety of functions,
vidual that trigger a response in other members of the same
Most, but not
The approximately 2000 all, sebaceous
apocrine glands
sweat glands develop
(ap9o-krin) are asspecies).
outgrowths including protection, body temperature regulation, cutaneous sen-
See
largelyp.confined
of hair 193 to theand
follicles axillary and anogenital
secrete areas.aInhair
sebum into spite follicle, Twoorimportant
occa- types of sation, metabolic
modified functions,
apocrine glands are: blood reservoir, and excretion.
of their name, they are merocrine glands, which release their
sionally to a pore on the skin surface. Arrector
product by exocytosis like the eccrine sweat glands. Larger than pili contractions
●● Ceruminous glands. Ceruminous glands (sĕ-roo9mĭ-nus; cera

Building Vocabulary Coaching Activities in Mastering

force sebum out of the hair follicles to the skin surface. Protection
5 wax) are modified
A&Papocrine
®
areglands
a fun found
wayin the
tolining
learn of the
word roots and
A&P terminology
Sebum while
softens and buildingthe
lubricates and practicing
hair and skin,important language skills.
prevents hair Given its superficial location, the skin is our most vulnerable
from becoming brittle, and slows water loss from the skin. Per- organ system, exposed to microorganisms, abrasion, tempera-
haps even more important is its bactericidal (bacterium-killing) ture extremes, harmful chemicals, and UV radiation. The skin
action. Sebaceous glands increase their activity during puberty constitutes at least three types of barriers: chemical, physical,
under the influence of male sex hormones.
M05_MARI1803_12_GE_C05.indd 192 and biological. 23/06/2022 20:49

HOMEOSTATIC Chemical Barriers

CLINICAL
IMBALANCE 5.7
Chemical barriers include skin secretions and melanin.
Acne is an active inflammation of the sebaceous glands Although the skin’s surface teems with bacteria, the low pH of
accompanied by “pimples” (pustules or cysts), whiteheads, skin secretions—the acid mantle—retards their multiplication.
or blackheads on the skin. If In addition, dermcidin in sweat and bactericidal substances05/08/2022
A01_MARI1803_12_GE_FM.indd 3 19:31
 Study the Figures
as You Read the Text

Anatomy and Physiology is a visual science. To succeed, you need to practice and develop visual
literacy skills for understanding and interpreting information. To help you achieve this goal, the text
and associated figures are tightly integrated so that you do not have to flip pages back and forth to
connect visuals with words.

26 Focus Figures walk you through

complex processes using exceptionally
clear, easy-to-follow illustrations with
integrated text explanations.

FOCUS FIGURE 21.1 An Example of a Primary Immune Response

The immune system has three lines of defense
against foreign invaders. Third Line of Defense: Adaptive Defenses
Lymph node
1 Dendritic cells (APCs) engulf
viruses and dead virus-infected cells.

Let’s look at how the body defends against 2 Dendritic cells migrate to
its first exposure to influenza virus. a lymph node where they
activate T lymphocytes.
3 Dendritic cell activates CD4 cell, which forms
a clone of helper T (TH) cells and memory cells.

CD4 cell

First Line of Defense: Surface Barriers Dendritic cell Memory CD4 T cell
The mucous membrane lining the airways helps
prevent the virus from entering the body.
TH cell
TH cells
Mucus traps viruses.

Cilia sweep contaminated mucus toward the

pharynx, where it is swallowed and digested. B cell
TH cell

See pp. Mucus

Cilia CD8 cell

840–841 Virus

Bronchiole
4a Dendritic cell and TH cell
together activate CD8 cell, which
forms a clone of cytotoxic T (TC)
4b TH cell activates a B
cell, which forms a clone
of plasma cells and
cells and memory cells. memory B cells.

Memory B cell
Memory CD8 T cell
Second Line of Defense: Innate Internal Defenses
Virus-infected cells release interferon to
warn nearby uninfected cells.
Cellular immunity
(via TC cells) targets TC cells
Inflammatory intracellular viruses by
Phagocytes (e.g., resident macrophages) killing infected cells.
chemicals engulf viruses and “sound the alarm” by Plasma
releasing inflammatory chemicals. cells

5a TC cells migrate
Inflammation brings more immune cells and to site of infection.
plasma proteins to the area by dilating They attack and kill

Focus Figure arterioles and increasing capillary permeability. the infected cells.
Antibodies
Perforins
5b Plasma cells release

“Mini-Animation”
Complement activation enhances inflammation
and causes opsonization of virus particles. Humoral immunity antibodies, which travel (via
Capillary targets extracellular blood) to site of infection.
permeability (free) viruses.

Coaching Activities
NK cells recognize and kill
virus-infected cells.
C3b
Arteriole Virus

bring some of the

dilates

Focus Figures to life Antibodies neutralize viruses by covering Agglutination and complement
the proteins that allow the virus to bind to activation enhance phagocytosis by

using short video Perforins and enter our cells. No entry = no infection. neutrophils and macrophages.

840 841
segments.

Blue text represents the voice of an A&P

instructor, highlighting important points to
remember.

y, Activation and Differentiation of B Cells

An immunocompetent but naive B
at target lymphocyte is activated when match-
Antigen
31 unique In-Line Figures are
ing antigens bind to its surface recep- Cross-linked strategically placed within the text to
receptors
tors and cross-link adjacent receptors visually reinforce the text discussion.
together. Antigen binding is quickly
followed by receptor-mediated endo-
of a B cell and cytosis of the cross-linked antigen-receptor complexes. As we
emory cells in See p. 828
described previously, this is called clonal selection and is fol-
lowed by proliferation and differentiation into effector cells
e humoral
(Figure 21.11). (As we will see shortly, interactions with T cells
are usually required to help B cells achieve full activation.)
antibodies and
Most cells of the clone differentiate into plasma cells, the
antibody-secreting effector cells of the humoral response.
eps in lymphocyte Plasma cells develop the elaborate internal machinery (largely
w this basic pattern rough endoplasmic reticulum) needed to secrete antibodies
counters its antigen, at the unbelievable rate of about 2000 molecules per second.
response, in which Each plasma cell functions at this breakneck pace for 4 to 5
A01_MARI1803_12_GE_FM.indd 4 05/08/2022 19:32
e.
 Apply Your Knowledge to a Range &
Variety of Questions

As you build your knowledge and confidence in A&P, 858practiceUNIT 4 Maintenance

responding to the of the Body
more challenging
questions—you are a membrane attack complex
likely to encounter (MAC)].onSpecifically,
similar questions in complement-mediated
a test or licensing exam. Your extra effort
celltime!
will pay off at exam lysis, MAC complexes causeTablea target
22.1cell (usually
The a bacterium)
Upper Respiratory to become
System
ystem is always ready to leaky. This allows water to enter STRUCTURE
and cytoplasmic contentsGENERAL
DESCRIPTION, to exitAND Chapter
the DISTINCTIVE
cell, 11 Fundamentals of the Nervous
kill- FEATURES System
FUNCTION
me to mount the adaptive ing the cell. In contrast, cytotoxicNose T cells and NK
(external Juttingcells kill portion
external their targetsis supported (usually
by bone and cartilage.
Some Internal
Definitions: Produces
Voltage,muR
e barriers and internal virus-infected cells) by releasing cavity) Checknose Your
and nasalUnderstanding
nasal cavity is divided by midline nasal septum and lined with mucosa.
perforins and granzymes onto the identified
incoming air
Voltage, the measure of potentia
moral and cellular immu- target cell. Perforins form a pore Paranasal
5. How does a nucleus
in the target
Roof
cell
of nasal
within
membrane,
thecavity
braincontains
differ from
and
olfactory
granzymes
a nucleusepithelium. Receptors fo
electrical charges, is measured
within a neuron? Mucosa-lined, air-filled cavities in cranial bones surrounding nasal cavity Lighten skull
barriers (the skin and A greater variety
enter and range
through of pore, activating
this enzymes
6. sinuses
How is a myelinthat ( trigger
sheath formed
p. 245). apoptosis
in the CNS, (cell suicide).
and what is its
(1 mV = 0.001 V). Voltage
incoming air
is a
self-assessment questions points and is called the poten
e. 3. Opsonization is the 23.theThe cellYour
have
being activated is7.a CD4 function?
Pharynx cell and so could
Passageway become
connectingeither nasal cavitya helper
to larynx Toropharynx,
and oral cavity to between the
potential Passageway
points.
been added to Check What is the structural classification of the neuron shown
gocytosis by decorating Understanding cell or a regulatory T cell. 24. HIV is particularly
esophagus.
hard
Three subdivisions:
for theclassification?
immune system
nasopharynx,
charge
and
between two points, the h
sections within below? What is itslaryngopharynx.
usual functional Name to
. Antibodies and comple-each chapterdefeat and include Apply, the parts labeled a–d. The flow of electrical charge
Predict, What If?, Draw because, and(1) it destroys helper
Make T cells, which Housesare key
tonsils playerstissue
(lymphoid in adaptive
masses involved in protection against
current, and it can beFacilitates
used to ex do
psonins. 4. Our own cellsConnections immunity
. Dozens ofand new(2) visual
8. APPLY Which structural
it has a high mutation rate and
pathogens).
so
and functional type of neuron
it can avoid detection by the a flashlight. The
antigens
amount of char
is involved in sensing the smell of your perfume? Which
by viruses or when they questions ask you to label structures
immune system by changing its surface antigens.
type is needed 25. the
to transfer Binding
impulsesoftoan theallergen
brain for onto points depends on two factors:
nd pain are the cardinal or interpret visual information. integration? tance is the hindrance to charg
specific IgE antibodies attached to mast cells triggers the mast cells to release through which the current mu
h caused by vasodilation of histamine.
directly posterior to the larynx, c whereCentralthe respiratory and diges- ●● The conducting zone co
electrical resistance are insulat
tive pathways diverge, b and extends to
process the inferior edge of the sageways from the nose to
d by the body core) to the cricoid cartilage. The laryngopharynx is continuous with the
tance are conductors.
provide fairly rigid condu
ase of histamine and other Review Questions 1. d; 2. b; 3. d; 4. d; 5. a; 6. a; 7. c; 8. d; 9. d; 10. (1)b, g; Ohm’s law gives the relation
esophagus posteriorly. sites. The conducting zo
(2)d, i; (3)a, e; (4)a, e, f, h; (5)e, h; (6)c, f, g; 11. d; 12. The antibody classes and and resistance:
capillary permeability. The esophagus a
conducts food and fluids to
d the stomach; air and warm incoming air.
to the interstitial fluid (IF), their likely locations in the body are: IgM—attached to B cell plasma membrane
enters the larynx anteriorly. During swallowing, food has the has fewer irritants (dust,
Current (I ) =
9. “right
MAKEofCONNECTIONS
way,” and air Which
passagepart temporarily
of the neuronstops. is its fiber? the body, and it is warm a
fluid out of blood vessels as a monomer and in plasma as a pentamer; IgA—dimers found
How do nerve fibers differ from the fibers of connective in secretions
such as saliva, tears, intestinal juice,
tissueand
Check
(seemilk;
Chapter IgD—attached
4) and the fibers intomuscle B cell (seeplasma Ohm’s law tells us three thing
in is due to two things: Chapter Your 9)? Understanding The Larynx
nd prostaglandins) on membrane as a monomer; IgG—in 1. plasma;
Air movingIgE—attached
from theFor answers,
nose to theto see
mast
larynx cellsAppendix.
Answers
passes inaskin,
by number
●● Current (I) is directly proporti
Basic Anatomy
mucosae of the gastrointestinal and respiratory
of structures. List tracts, and
(in order) astonsils.
many of these structures as voltage (potential difference),
ess free nerve endings. The larynx (lar9ingks), o
See p. 431you can. ●● There is no net current flow
5 cm from the level of the t
uld make Julian particu- 2. Name the two types of mucous membrane found in the same potential.
11.4 nasal The resting membrane Superiorly it attaches to th
s of adaptive immunity Chapter 22 cavity. ●● Current is inversely
laryngopharynx. related
Inferiorly
“Draw” questions ask you to create
, it is systemic, and itvisuals
has that reinforce potential
3. DRAW depends Create a summary on differences
table to help you study in theion resistance,
(Figure the smaller the cu
22.5b).
Check Your concepts
Understanding 1. Thepharynx by comparing
structures that airand contrasting
passes by are its three
the nasalparts. For
city and reactivity, whereas
important
drawing a structure, annotating a figure, or
by
concentration each part, and
identify what permeability
it conducts (air, food, or both), the The
In the larynx
body, has three
electrical func
current
cavity (nares, nasal vestibule, nasal conchae), nasopharynx, oropharynx, and cellular Provide a patent (open)the
membranes. (Unlike
f-antigens, particularly creating a summary table. Learningtype of epithelium found there, and the associated tonsils.
Outcomes house
●●
wiring, there are no free
ai
laryngopharynx. 2. The nasal✔ cavity contains both respiratory mucosa and
For answers, see Answers Appendix. olfactory
Describe the relationship between current, voltage, and a livingAct as a switching mecha
●●
of immunocompetence of system.) Recall that the
mucosa. 3. ❯ 4. The epiglottis resistance. numbers proper
of channels
positive and negative
ace of specific and unique seals the larynx when we 22✔ Identify 22.2different The Conducts
lower
types of membrane Epithelium
respiratory ion channels. Tonsils
system Voice
lar plasma
●● production
membranes (a [becau
charge
eceptor is a membrane- ✔ Define resting
Nasopharynx membrane Air potential and describe
Pseudostratified Pharyngeal its cords)]
tial across those membranes. T
swallow. 5. The incomplete, electrochemical consists ofbasis. conducting ciliated and respiratory Tubal the resistance to currentof flow.
ell receptor.) 11. Dendritic C-shaped cartilage rings of Likezone
The framework the la
Dendritic cells are most
All of the End-of-Chapter Review
questions are now organized into 3 levels
structures columnar
all cells, neurons have a resting membrane potential. of nine cartilages connect
Role of Membrane Ion Chan
of difficulty basedtheontrachea
Bloom’sallow it to expandHowever,
Taxonomy
Oropharynx
Learning unlike most other
Outcomes
Air and cells, Stratified
neurons can rapidly Palatine
change (Figure 22.6). Except for
the antigen does thecategories: and contract and yet keep it their membrane potential. This ability underlies the function of
food squamous Lingual Recall
lagesthat
areplasma
hyalinemembranes
cartilages.
✔
neurons Distinguish between conducting and respiratory zone
throughout the nervous system. In order to understand membrane proteins that act as
of B or T cells that has Level 1: Remember/Understand
from collapsing. 6. The manyhow neurons
Laryngopharynx
structures. Air and Stratified (none)
of these
The large,
channels
shield-shaped
is selective a
Level 2: Apply/Analyze work, let’s first explore
food squamoussome basic priciples of fusion of two cartilage plat
he T cell that would sur- tiny alveoli together have a electricity
✔ Describe the structure, function, and location of the
and revisit the resting membrane potential. allows to pass. For example,
upright open book, with the a
Level 3: Evaluate/Synthesize larynx, trachea, and bronchi.
gen. 14. The secondary large surface area. This and theSee thinness
✔ p. 858 and
Describe ofthe
their
Answers
makeup respiratory
Appendix
of membranes
the respiratory make and
membrane,
onlyrior
potassium
midlineions to pass.
of the neck. Th
Membrane
prominence channels are largw
(lah-rin9je-al),
onse because the immune them ideal for gas exchange.Basic Principles of Electricity
relate structure to function.
7. ✔The peanut was most likely
Identify the organs forming the respiratory
in the right main subunits. Some channels,
Adam’s apple (Figure 22.6a leaka
ells that are specific for bronchus because it is wider ofand
The human
more
body is electrically neutral—it has the same number
vertical in
passageway(s) than the left.order
descending 8. The untiltwoyoucircula-
reach the
always
larger in males than in fema
open. Other channels
positive and negative charges. However, there are regions forms a molecular “gate”during
that chp
at right. (You can tell tions of the lungs are the pulmonary alveoli. stimulate its growth
where onecirculation,
type of charge which deliversmaking
predominates, deoxygenatedthose regions the channel in response to specif
s a pentamer.) IgG antibody tilage is the ring-shaped cri
Anatomically,
positively or the
negatively lower
blood to the lungs for oxygenation and returns oxygenated blood to the heart, respiratory
charged. Becausesystem consists
opposite of the
charges lar- types of gated channels:
atop and anchored to the trac
rimary immune response. ynx,energy
attract, trachea, bronchi,
must be used and(work
lungs.must Functionally,
be done) to theseparate
respiratory
and the bronchial circulation,them. which Chemically
Three pairs gated channels
of small cart
Onprovides wholesystemic theof(oxygenated) togetherblood to ●●
system as aother
the consists
hand, two zones:
coming of opposite
n bring about destruction
A01_MARI1803_12_GE_FM.indd 5 lung tissue. 9. Angiotensin converting charges liberates enzyme energy is found
that caninbethe used plasma
to do work. membrane For this
channels,
cuneiform open when
05/08/2022 19:32
the
(ku-ne9ĭ-form), app a
●●
 we use areolar connective tissue (ah-re9o-lar) as our prototype,
or model (Figure 4.9 and Figure 4.11a). All other subclasses
are simply variants of this plan.
Ground Substance
Ground substance is the unstructured material that fills the
collagen, elastic, and reticular fibers. Of these, collagen fibers
are by far the strongest and most abundant.
Collagen Fibers These fibers are constructed primarily of the
fibrous protein collagen. Collagen molecules are secreted into
the extracellular space, where they assemble spontaneously into
cross-linked fibrils, which in turn are bundled together into the

Prepare for Your Future Career &

space between the cells and contains the fibers. It has three thick collagen fibers seen with a microscope. Because their fibrils
components: cross-link, collagen fibers are extremely tough and provide high
Interstitial fluid. The ground substance consists of large tensile strength (the ability to resist being pulled apart) to the

Practice Solving Real-World Problems

●●
4 amounts of fluid and functions as a molecular sieve through matrix. Indeed, stress tests show that collagen fibers are stronger
which nutrients and other dissolved substances can dif- than steel fibers of the same size!
fuse between the blood capillaries and the cells. The fibers Long, thin, elastic fibers form branching networks
Elastic Fibers
embedded in the ground substance make it less pliable and in the extracellular matrix. These fibers contain a rubberlike pro-
hinder diffusion somewhat. tein, elastin, that allows them to stretch and recoil like rubber
●● Cell adhesion proteins. These proteins serve mainly as a con- bands. Connective tissue can stretch only so much before its thick,
The authors
nective of that
tissue glue thisallows
text,connective
Elaine Marieb and
tissue cells to Katja ropelike
attach Hoehn, collagen
share fibersfrom
insights become taut. own
their Then, clinical
when the experience
tension lets to
help
to the you prepare
extracellular for your future career in health care.
matrix. up,All
elastic fibersexamples
clinical snap the connective tissue backare
and applications to itssignaled
normal with
length and shape. Elastic fibers are found where greater elasticity
●● an easy-to-find
Proteoglycans. The“Clinical”
proteoglycanslabel.
consist of a protein core is needed, for example, in the skin, lungs, and blood vessel walls.
to which large polysaccharides called glycosaminoglycans
(GAGs) (gli0kos-ah-me0no-gli9kanz) are attached. The strand-
HOMEOSTATIC
Homeostatic
like Imbalancesulfate
GAGs [e.g., chondroitin discussions alert youacid
and hyaluronic to CLINICAL
IMBALANCE 4.2
the consequences
(hi0ah-lu-ron9ik)] stick of
outbody
from systems not
the protein functioning
core like the fibers
ofoptimally. Relevant
a bottle brush. photos have
The proteoglycans been
tend added
to form hugetoaggre- Marfan syndrome is an inherited disorder that causes a change
selected
gates discussions
in which the GAGsfor visual reinforcement.
intertwine and trap water, forming a in the types of proteins that comprise elastic fibers. As a result
substance that varies from a fluid to a viscous gel. The higher of this change, the elasticity in tissues is reduced, leading to
NEW! Discussions have been added on Marfan the overgrowth (aortic enlargement and long arms, legs, and
the GAG content, the more viscous the ground substance.
syndrome, brittle bone disease, tetanus, and fingers) and instability (lung collapse and eye problems) of tis-
anxiety disorders.
Connective Tissue Fibers sues. Although people suffering from Marfan syndrome are
born with the condition, not all of them show symptoms at birth
The fibers of connective tissue are proteins that provide sup- or during childhood; some only develop symptoms as adults.
port. Three types of fibers are found in connective tissue matrix:

See p. 158 Chapter 16 The Endocrine System 673

Connective tissue is composed of (1) fibers, (2) ground substance, and (3) cells.

Extracellular
well, complains matrix
of repeated “colds,” and is extremely “puffy”
Clinical CaseExplain
(edematous). Studies are provided
the reason for these at the end
symptoms. CLINICAL CASE STUDY
of Chapters 5–29 and challenge you to apply your
Fibers Ground substance
Level 3 Evaluate/Synthesize
knowledge to realistic clinical scenarios. One-Year-Old
Capillary Girl with Cells
Retarded Growth
• Collagen fiber
20. Which type of hormone receptor—plasma membrane bound or Miriam gave birth to a twin boy and girl a year ago. She
• Elastic fiber • Fat cell
intracellular—would be expected to provide the most long-lived is concerned about
response
• Reticular fiber to hormone binding and why? Theresa, her daughter,
21. Name two endocrine glands (or regions) that are important in since her growth and
the stress response, and explain why they are important. development is much
22. How are the hyperglycemia and lipidemia of insulin deficiency slower than that of her • Mast cell
linked? brother. Miriam visits
23. List some problems that elderly people might have as a result a pediatric outpatient
of decreasing hormone production. clinic, where she
• Neutrophil
24. Mary 830 Morgan has just4been
UNIT brought into
Maintenance of thethe emergency room
Body informs the physician (a type of white blood cell)
of City General Hospital. She is perspiring profusely and is that, apart from having retarded growth, Theresa has a poor
breathing
almostrapidly and irregularly.
six million deaths per year. HerWhile
breath smells like programs
immunization acetone appetite,
botulism, suffers
rabies, andfrom
tetanusconstipation, and is lethargic.
(antitoxin) because The phy-
these rapidly
(sweettoand prevent theand
fruity), outbreak
her bloodof life-threatening
glucose tests infectious
out at 650 diseases fatalsician
diseases would
orders kill atests
blood person before
to check active immunity
Theresa’s
• Fibroblast growthcould
hormone
mg/100 tendmltooffocus
blood.on children,
She is inthese vaccines
acidosis. Whichcan hormone
also be effective
drug in be established. The donated antibodies
(GH), thyroid-stimulating hormone provide
(TSH), immediate pro-
and thyroxine
shouldadults. However, access
be administered, and to vaccines remains regrettably unequal
why? tection,
See but their effect is short-lived
4) levels.
(Tp. 673 (two to three weeks).
• Macrophage
25. Kyle, both for children
a 5-year-old boy,and
has adults
beenglobally.
growing by leaps and bounds; 1. ✚ NCLEX-STYLE Theresa’s retarded growth could be due to:
his height Conventional
is 100% above vaccines
normalhaveforshortcomings.
his age. HeThe hasbiggest
been short- • Lymphocyte
coming of is that they areandnot always as effectiveA orCTlong-lasting as a. The positive feedback of(aGH
typeonof the hypothalamus
white blood cell)
complaining headaches vision problems. scan Susumu Tonegawa (b. 1939)
NEW! Boxeslike.
we would onInscientists feature
some individuals, details about
contaminating the (for
proteins b. A pituitary tumor that is causing hypersecretion of GH
reveals a large pituitary tumor. (a)scientists.
Which hormone is being is a Japanese scientist who won
livesexample,
and works of eminent
egg albumin) cause allergic responsesThese to will show
the vaccine. c. Hypersecretion of growth hormone–releasing hormone
secreted in excess? (b) What condition will Kyle exhibit if the Nobel Prize in Physiology or
you the human
Passive side
humoral of science.
immunity differs from active immunity, Medicine (GHRH) by the hypothalamus
Figurecorrective
4.9 Areolar connective
measures are not tissue:
taken? A(c)
prototype
What is the (model)
probableconnective tissue. This in 1987 for elucidating
tissue underlies both in the antibody
epithelia and sourcecapillaries.
surrounds and in the degree
(See of protection
Figure 4.11a it pro-
for a t h
micrograph.) e d.
g e Hyposecretion
n e t i c m e c h a ofn i sGH
m s by the anterior pituitary
cause vides
of his(Figure
headaches and
21.13). visual
Instead of problems?
being made by your plasma cells, underlying adaptive
Theresa’s bloodimmunity.
tests indicate that her GH levels are
26. Aaron,ready-made
a 42-year-old singleare
antibodies father, goes to
introduced intohis physician
your body. As a result, A normal,
problem butin adaptive
her TSH immunity
levels are elevated, and her T4 levels
complaining of nausea and chronic fatigue. He
your B cells are not challenged by antigens, immunologicalreports having
wasarethat,
low.although the presence
The physician tells Miriam that since Theresa’s GH
felt fatigued
memoryand doeslistless for about
not occur, and thehalf a year,provided
protection but he had by the “bor- oflevels
millions of different anti- growth is not due to pituitary
attributed this to stress. He has lost considerable weight and, are normal, her retarded
rowed” antibodies ends when they naturally degrade in the body. body proteins was known, there
M04_MARI1803_12_GE_C04.indd 158
strangely,Passive
his skin looks tanned,
immunity even naturally
is conferred though heonspendsa fetuslong
or infant dwarfism. 27/07/2022 17:11
weren’t enough genes in the 16
hours when
at workthe and rarelyantibodies
mother’s ventures cross
outside. His doctor
the placenta finds
or are ingested 2. ✚ genome
human NCLEX-STYLE Given the
to account for levels of TSH and T4 in Theresa’s
very low
withblood pressure
the mother’s andFor
milk. a rapid,
several weak pulse.
months afterBlood
birth,tests
the baby these.blood,
So howwhich of the
were all following
these is most likely the cause of her
show is protected
that Aaron doesfrom not
all the antigens
have anemia, to which
but histhe mother
plasma has been
glucose, signs
different and symptoms?
antibodies produced? By comparing the DNA of
and Na+ are low, and his plasma K+ is high. His doctor
exposed.
cortisol, maturea. and
Sheimmature
has a pituitary tumor,
B cells, which discovered
Tonegawa is causing hypersecre-
that
orders anPassive
ACTH immunity
stimulationcan test,also be conferred
in which Aaron’sartificially
secretion by tion
the regions ofof TSH.
DNA that produce antibodies become greatly
administering
of cortisol is measured exogenous
after heantibodies
is given a (from outside
synthetic formyour
of own b. Herasthyroid
rearranged the B gland
cell matures,
is poorlywhich is how a small
developed.
ACTH. body) as gamma
(a) What wouldglobulin,
account harvested
for Aaron’sfrom
lowthe plasma
plasma Naof
+ an numberc. of
Sheantibody-producing
has Graves’ disease.genes generate the huge
immune donor.+ Exogenous antibodies are used to prevent hepa- variety
and high plasma K ? (b) What is the reason for doing an ACTH d.ofHer
antibodies seen. glands are defective.
parathyroid
titis A (antiserum) and treat poisonous snake bites (antivenom),
stimulation test? (c) Which gland is primarily affected if ACTH
does not cause a normal elevation of cortisol secretion? What is See3.p.Miriam
830 does not completely understand what Theresa’s
blood tests indicate. She asks the physician if she needs to
this abnormality called? (d) Which gland is primarily affected if put Theresa on a high-calorie diet to speed up her growth.
ACTH does cause an elevation
Adaptive defensesof cortisol
Humoralsecretion?
immunity What would be the physician’s answer?
4. The physician diagnoses Theresa with congenital hypo-
Antigen-binding thyroidism, and starts a treatment involving synthetic T4.
H
ea

A01_MARI1803_12_GE_FM.indd 6 site 05/08/2022 19:32

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Human Anatomy & Physiology

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ION purchased this book within the United States or Canada, you should be aware
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EDITION
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Human Anatomy & Physiology Laboratory Manual facilitates and enriches
erience of students and teachers specializing in nursing, physical therapy,

Human Anatomy
Human Anatomy & Physiology

piratory therapy, and exercise science as well as those in biology and

ms. This text emphasizes the background discussions and terminology
rm all experiments and eliminates the need for students to bring a textbook

& Physiology
by Elaine Marieb & Lori Smith
Laboratory Manual

on continues to serve as a self-contained learning aid that helps students

xercises such as examining skeletal muscle cell anatomy, palpating skull
ning the ventral body cavity. Each laboratory exercise is preceded by a Pre-
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Manual Main 12/e ISBN 9781292442259
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mbalance discussions direct students’ attention to conditions representing

Cat 13/e ISBN 9781292442099

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TWELFTH EDITION
nge activities enhance collaborative group learning by challenging students
identify relationships between anatomical structures and physiological
hieve a deeper understanding of anatomy and physiology concepts.
ation questions, newly added to each chapter’s Exercise Review Sheet,

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.1 exercises, located at the back of the laboratory manual, offer

b activities that can be used to supplement wet labs.
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y for purchase is Mastering A&P for Human Anatomy & Physiology Laboratory
ng and learning platform that empowers instructors to personalize learning
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Eight new Pre-Lab Video Coaching Activities focus on key concepts in
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 Human
Anatomy
& Physiology
TWELFTH GLOBAL EDITION

Elaine N. Marieb, R.N., Ph.D.

Holyoke Community College

Katja Hoehn, M.D., Ph.D.

Mount Royal University

A01_MARI1803_12_GE_FM.indd 11 05/08/2022 19:32

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 About the Authors
We dedicate this work to our students both
present and past, who always inspire us to
“push the envelope.”
Elaine N. Marieb
After receiving her Ph.D. in zoology from the University of
Massachusetts at Amherst, Elaine N. Marieb joined the faculty
of the Biological Science Division of Holyoke Community Col-
lege. While teaching at Holyoke Community College, where
many of her students were pursuing nursing degrees, she devel-
oped a desire to better understand the relationship between the
scientific study of the human body and the clinical aspects of the
nursing practice. To that end, while continuing to teach full time,
Dr. Marieb pursued her nursing education, which culminated in
a Master of Science degree with a clinical specialization in ger-
ontology from the University of Massachusetts. It is this experi-
ence that informed the development of the unique perspective
and accessibility for which her publications are known.
Dr. Marieb gave generously to provide opportunities for
students to further their education. She funded the E.N. Marieb
Katja Hoehn
Dr. Katja Hoehn is a professor in the Department of Biology at
Mount Royal University in Calgary, Canada. Dr. Hoehn’s first
love is teaching. Her teaching excellence has been recognized by
several awards during her 24 years at Mount Royal University.
These include a PanCanadian Educational Technology Faculty
Award (1999), a Teaching Excellence Award from the Students’
Association of Mount Royal (2001), and the Mount Royal Dis-
tinguished Faculty Teaching Award (2004).
Dr. Hoehn received her M.D. (with Distinction) from the
University of Saskatchewan, and her Ph.D. in Pharmacology
from Dalhousie University. In 1991, the Dalhousie Medical
Research Foundation presented her with the Max Forman (Jr.)
Prize for excellence in medical research. During her Ph.D. and
postdoctoral studies, she also pursued her passion for teaching
by presenting guest lectures to first- and second-year medical
students at Dalhousie University and at the University of Calgary.
Dr. Hoehn has been a contributor to several books, written
numerous research papers in Neuroscience and Pharmacology,
A01_MARI1803_12_GE_FM.indd 13
Science Research Awards at Mount Holyoke College, which
promotes research by undergraduate science majors, and under-
wrote renovation of the biology labs in Clapp Laboratory at
that college. Dr. Marieb also contributed to the University of
Massachusetts at Amherst, where she provided funding for
­
reconstruction and instrumentation of a cutting-edge cytology
research laboratory. Recognizing the severe national shortage
of nursing faculty, she underwrote the Nursing Scholars of the
Future Grant Program at the university.
In 2012 and 2017, Dr. Marieb gave generous philanthropic
support to Florida Gulf Coast University as a long-term invest-
ment in education, research, and training for healthcare and
human services professionals in the local community. In honor
of her contributions, the university is now home to the Elaine
Nicpon Marieb College of Health and Human Services.
and has co-authored some
of the previous editions
of this textbook. For
many years, she has also
reviewed and authored
electronic media that
accompanies Pearson
anatomy and physiology
books.
Following Dr. Marieb’s example, Dr. Hoehn provides finan-
cial support for students in the form of a scholarship that she estab-
lished in 2006 for nursing students at Mount Royal University.
Dr. Hoehn is also actively involved in the Human Anatomy
and Physiology Society (HAPS) and is a member of the
American Association of Anatomists. When not teaching, she
likes to spend time outdoors with her husband and two sons.
She also enjoys competing in long-course triathlons, and play-
ing Irish flute down at the local pub.
13
05/08/2022 19:32
 Preface
T
oday’s students have access to an enormous amount of
information about anatomy and physiology. As educators,
our biggest challenge is to help students focus on mastering
the basic concepts of this field. Providing this firm foundation
will help students to become lifelong learners who can criti-
cally evaluate new information, connect that information to the
Unifying Themes
Three unifying themes that have helped to organize and set the
tone of this textbook continue to be valid and are retained in
this edition. These themes are:
Interrelationships of body organ systems. This theme empha-
sizes the fact that nearly all regulatory mechanisms have inter-
actions with several organ systems. The respiratory system,
for example, cannot carry out its role of gas exchange in the
body if there are problems with the cardiovascular system that
prevent the normal delivery of blood throughout the body. The
System Connections feature and Make Connections questions
throughout the book help students connect new information
to old information and think of the body as a community of
dynamic parts instead of a number of independent units.
Homeostasis. Homeostasis is the normal and most desirable
condition of the body. Its loss is always associated with past
or present pathology. This theme is not included to emphasize
pathological conditions, but rather to illustrate what happens
in the body “when things go wrong” and homeostasis is lost.
Whenever students see a red balance beam symbol accompa-
nied by an associated clinical topic, their understanding of how
the body works to stay in balance is reinforced.
Complementarity of structure and function. This theme
encourages students to understand the structure of some body
part (ranging from a molecule to an organ) in order to under-
stand the function of that structure. For example, muscle cells
can produce movement because they are contractile cells.
14
A01_MARI1803_12_GE_FM.indd 14
foundation they have already established, and apply it in a clini-
cal setting. How can we help students build a strong foundation
in anatomy and physiology? We believe that this new edition of
our textbook will help learners by building on the strengths of
previous editions while using new and innovative ways to help
students visualize connections between various concepts.
Key Features of the Twelfth Edition
The following are the key features of the Twelfth Edition:
NEW! Boxes on scientists feature details about the lives and
works of eminent scientists. These will show students the
human side of science. Please refer to p. 16 for a list of these
boxes.
NEW! Homeostatic Imbalance discussions have been added on
Marfan syndrome, brittle bone disease, tetanus, and anxiety
disorders.
NEW! We have added tables on the following topics:
• Functions of neurons and neuroglia
• Focal versus diffuse brain injuries
• Antihypertensive medications and renin-angiotensin-­
aldosterone system
NEW! We have updated the content with information on recent
developments on topics such as sperm centrioles, using fibro-
blasts as stem cells, 3D bioprinting used for skin grafts, how
COVID-19 causes loss of smell, and juxtacrines.
NEW! We have added an A Closer Look feature on COVID-19.
To help students make connections between new and pre-
viously learned material. In order for students to master new
concepts, they must link these new concepts with concepts they
already understand. In this edition, we help them do this by adding:
• Text recall icons ( ). These icons direct the student back to
the specific pages where a concept was first introduced.
05/08/2022 20:44

• Make Connections questions. We’ve added more of this
type of question to the Check Your Understanding review
questions that follow each module within a chapter. To
answer these questions, the student must employ concepts
learned previously (most often in previous chapters).
• New kinds of higher-level questions. Each chapter has
at least five higher-level questions that require students to
think more deeply, pulling together strands from multiple
concepts. These questions are clearly identified as APPLY ,
DRAW , PREDICT , MAKE CONNECTIONS , and WHAT IF? questions.
To enhance students’ visual literacy. Anatomy is and has
always been taught principally through images. Increasingly,
however, physiological data is also represented as images,
whether it be molecular interactions or graphical descriptions of
processes. Throughout their future health care careers, students
will need to be able to understand and interpret information pre-
sented visually. In this edition, we help them do this through:
• Focus figures. Focus figures are illustrations that use a
“big picture” layout and dramatic art to guide the student
through difficult physiological processes in a step-by-step
way. Our Focus figures have been a hit with both students
and instructors.
• DRAW questions in each chapter. Students often think that
they understand an illustration simply by looking at it, but
to truly comprehend an illustration and cement its concepts
requires a more active learning approach. For this reason
we include at least one higher-level review question within
each chapter that requires a student either to draw an illus-
tration or to add to an existing diagram.
• Questions about illustrations. To help students practice
their visual literacy skills, we have added Check Your
Understanding questions that include an illustration as part
of the question. Some of these are as simple as labeling
exercises, but many require more advanced interpretation.
• Updated art. Today’s students are accustomed to seeing
sophisticated photorealistically rendered images. However,
many students are not adept at extracting, and thinking
A01_MARI1803_12_GE_FM.indd 15
Preface 15
c­ ritically about, the relevant information contained in such
illustrations. With this in mind we continue to refine and
update our illustrations as students’ needs change, improv-
ing their ability to teach important concepts.
• In-line figures. These are small (less than a half-column
wide) illustrations or photos strategically located within the
text that discuss the concept they illustrate. This edition has
31 such in-line figures.
To help students clinically apply what they have learned
• Updated Homeostatic Imbalance features. Many of the
Homeostatic Imbalance features have been updated. All
have been reviewed for accuracy and relevancy. In addition,
the updated book design makes these features stand out more
clearly.
• Clinical Case Studies in Chapters 5-29 with ✚ NCLEX-STYLE
questions. The end-of-chapter review questions, which are
now organized into three levels of difficulty based on Bloom’s
Taxonomy categories, culminate in a clinical case study that
allows students to apply some of the concepts they have
learned to a clinical scenario. Each case study has two ques-
tions that are similar in style to those in the NCLEX exam.
• Clinically relevant photos. We have a number of photos that
have clinical relevance (procedures, conditions, etc.) that
will help students apply what they are reading to real-life
situations and to their future careers.
As in the previous edition, we have taken painstak-
ing care to ensure that almost all the text and the associated
art are covered on the same two-page spread. Although this
sounds like a simple goal, it actually takes a great deal of
work and has not usually been achieved by other textbooks.
We make this effort because it is invaluable to student learn-
ing to not have to flip pages back and forth between art and
text. Finally, you will notice the appearance of icons referenc-
ing ­Mastering A&P® interspersed within the text. This guides
students to go to the relevant on-line activities to supplement
their learning.
05/08/2022 19:32
 Notable Scientists

CHAPTER 1 Marie Curie 47 CHAPTER 16 Dora Jacobsohn 642

CHAPTER 3 Reiji and Tsuneko Okazaki 127 CHAPTER 17 Karl Landsteiner 695
CHAPTER 4 Ernst Ruska 147 CHAPTER 18 Willem Einthoven 722
CHAPTER 6 Andreas Vesalius 206 CHAPTER 19 Nikolai Korotkoff 749
Rhian Touyz 756
CHAPTER 7 Kristopher Kilian 277
CHAPTER 21 Susumu Tonegawa 830
CHAPTER 8 Hugh Herr 304
CHAPTER 22 John Scott Haldane 881
CHAPTER 9 Claude Bernard 320
CHAPTER 23 John C. Brown 939
CHAPTER 10 Archimedes 358
CHAPTER 24 Gerty Cori 978
CHAPTER 11 Santiago Ramón y Cajal 426
CHAPTER 25 Eduardo Braun-Menéndez 1023
CHAPTER 12 Roger Sperry 476
CHAPTER 26 Peter Agre 1052
CHAPTER 13 Filippo Pacini 525
CHAPTER 27 Neena B. Schwartz 1110
CHAPTER 14 Hermona Soreq 575
CHAPTER 28 Robert G. Edwards 1153
CHAPTER 15 Alcmaeon of Croton 586
Robert Bárány 622 CHAPTER 29 Emanuelle Charpentier 1169

16

A01_MARI1803_12_GE_FM.indd 16 05/08/2022 19:32

 Acknowledgments
P
roducing a new edition of this book is an enormous
­undertaking. Let us take you through the steps and intro-
duce you to the people behind the scenes that have helped
make this book what it is. Every new edition begins with a revi-
sion plan. We’d like to thank all of the students and instruc-
tors who have provided the feedback (gathered by our editorial
team) that forms the basis of this plan. Once this plan was in
place, Barbara Price (our text Development Editor) scoured
each chapter. This was Barbara’s first exposure to the book and
her fresh eyes on the text found opportunities to further clarify
the presentation. In addition, she noted places where additional
chunking of the text (such as bulleted lists) would help the stu-
dents. Her excellent work has made this text better. We incor-
porated her ideas, and reviewer feedback, together with our
own updates and ideas for reorganization of the text and art.
Thanks to Patricia Bowne for contributing to the Clinical Case
Studies and Wendy Mercier for reviewing all of the Case Stud-
ies. We also very much appreciate the help of Karen Dougherty,
who used her expertise as a physician and educator to review all
of the Homeostatic Imbalance features and help us revise and
update them.
We then laid out each chapter to maintain text-art correlation
before passing the manuscript off to Michele Mangelli. Michele
wore many different hats during this revision. She was both the
Program Manager for the editorial side of things as well as the
Goddess of Production. She reviewed the revised manuscript
before she sent it to ace copyeditor Anita Hueftle. Anita saved
us on many occasions from public embarrassment by finding our
spelling and grammar errors, our logical lapses, and various other
inconsistencies. We can’t thank Anita enough for her meticulous
and outstanding work! (Any remaining errors are our fault.)
At the same time the text was in revision, the art program was
going through a similar process. This book would not be what it
is without the help of Laura Southworth, our superb Art Develop-
ment Editor. Laura’s creativity, attention to detail, and her sense of
what will teach well and what won’t have helped us immensely.
She has worked tirelessly to make our Focus figures and other art
even better. Finding good, usable photos is never easy, and we are
grateful for the hard work of Kristin Piljay (Photo Researcher). It
was also a pleasure to work with Jean Lake again, who expertly
juggled the administrative aspects of the art program and kept us all
on track. This team ensured that the artists at Imagineering had all
the information they needed to produce beautiful final art products.
As the manuscript made the transition from Editorial to
Production, Michelle Mangelli (wearing a different hat—this
A01_MARI1803_12_GE_FM.indd 17
one as the Production and Design Manager) took over again.
As head honcho and skilled handler of all aspects of produc-
tion, everyone answered to her from this point on. Kudos to our
excellent production coordinator, Karen Gulliver, who did much
of the hands-on handling, routing, and scheduling of the man-
uscript. We’d also like to thank Martha Ghent (Proofreader),
Betsy Dietrich (Art Proofreader), Sallie Steele (Indexer), Alicia
Elliot (Project Manager at Imagineering), and Cenveo (Com-
positor). Izak Paul meticulously read every chapter for scientific
accuracy, and we are very grateful for his careful work. Thanks
also to Gary Hespenheide for his stunning design work on the
cover, chapter opening pages, and the text.
It was a pleasure to work with Lauren Harp, our Acquisi-
tions Editor. Her extensive knowledge of the needs of both fac-
ulty and students in anatomy and physiology has helped inform
this revision. Her enthusiasm for this book is infectious, her
choice for the cover is inspired, and we are delighted to have her
on board! Before Lauren became part of the team, Serina Beau-
parlant, our Editor-in-Chief, stepped up to helm the planning
phase of this revision. Fiercely dedicated to making this book
and its associated media resources the best teaching tools that
they can be, Serina has been invaluable in shaping this revision.
We deeply appreciate all she has done for us and this book. Lauren
and Serina were competently aided by Editorial Assistant
Dapinder Dosanjh (and before her, Nicky Montalvo).
Other members of our team with whom we have less con-
tact but who are nonetheless vital are: Barbara Yien, Director
of Content Development, Stacey Weinberger (our Senior Manu-
facturing Buyer), and Derek Perrigo (our top-notch Marketing
Manager). We appreciate the hard work of our media produc-
tion team headed by Lauren Chen, Lauren Hill, Laura Tommasi,
Sarah Young Dualan, and Cheryl Chi, and also wish to thank
Eric Leaver for his astute observations on certain figures.
Kudos to our entire team. We feel we have once again pre-
pared a superb textbook. We hope you agree.
Many people reviewed parts of this text—both professors
and students, either individually or in focus groups—and we
would like to thank them. Input from the following reviewers
has contributed to the continued excellence and accuracy of
this text and its accompanying Mastering A&P® assignment
options, including Interactive Physiology 2.0:
Matthew Abbott, Des Moines Area Community College
Emily Allen, Rowan College at Gloucester County
Lynne Anderson, Meridian Community College
17
05/08/2022 19:32
 18 Acknowledgments
David C. Ansardi, Calhoun Community College
Martin W. Asobayire, Essex Community College
David Babb, West Hills College Lemoore
Yvonne Baptiste-Szymanski, Niagara County Community
College
Claudia Barreto, University of New Mexico–Valencia
Jerry Barton, Tarrant County College
Shawn Bearden, Idaho State University
Charles Benton, Madison Area Technical College
J. Gordon Betts, Tyler Junior College
Diana Bourke, Community College of Allegheny County
Sherry Bowen, Indian River State College
Michael Brady, Columbia Basin College
Betsy Brantley, Valencia College
Beth Braun, Truman College
Carol A. Britson, University of Mississippi
C. Steven Cahill, West Kentucky Community and Technical
College
Christie Campbell, Ozarks Technical Community College
Maria C. Carles, Northern Essex Community College
Tamyra Carmona, Cosumnes River College
Marien Cendon, Miami Dade College
Brendon Chastain, West Kentucky Community Technical College
Sam Chen, Moraine Valley Community College
Alexander G. Cheroske, Mesa Community College–Red
Mountain
Brandi Childress, Georgia Perimeter College
William M. Clark, Lone Star College–Kingwood
Joseph Comber, Villanova University
Teresa Cowan, Baker College–Auburn Hills
Donna Crapanzano, Stony Brook University
Maurice M. Culver, Florida State College at Jacksonville
Jason Dechant, University of Pittsburgh
Smruti A. Desai, Lone Star College–CyFair
Karen H. Dougherty, Hopkinsville Community College
Sondra Dubowsky, McLennan Community College
Karen Dunbar Kareiva, Ivy Tech Community College
Kathryn Durham, Lorain County Community College
Karen Eastman, Chattanooga State Community College
Sharon S. Ellerton, Queensborough Community College–CUNY
Paul Emerick, Monroe Community College
Elyce Ervin, University of Toledo
Martha Eshleman, Pulaski Technical College
Colin Everhart, St. Petersburg Community College
Brian D. Feige, Mott Community College
Michele Finn, Monroe Community College
John E. Fishback, Ozarks Technical Community College
Maria Florez, Lone Star College–CyFair
Reza Forough, Bellevue College
Juanita A. Forrester, Chattahoochee Technical College
Aaron Fried, Mohawk Valley Community College
A01_MARI1803_12_GE_FM.indd 18
Dean Furbish, Wake Technical Community College
Marie Gabbard, College of Western Idaho
Sophia Garcia, Tarrant County College
Jane E. Gavin, University of South Dakota
Peter Germroth, Hillsborough Community College
Emily K. Getty, Ivy Tech Community College
Amy Giesecke, Chattahoochee Technical College
Anna Gilletly, Central New Mexico Community College
Gary Glaser, Genesee Community College
Richard Gonzalez-Diaz, Seminole State College of Florida
Abigail Goosie, Walters State Community College
Pattie S. Green, Tacoma Community College
Edwin Griff, University of Cincinnati
George G. Hanak, Pasco-Hernando State College
Mary Beth Hanlin, Des Moines Area Community College–Boone
Heidi Hawkins, College of Southern Idaho
Martie Heath-Sinclair, Hawkeye Community College
Nora Hebert, Red Rocks Community College
Nadia Hedhli, Hudson County Community College
D.J. Hennager, Kirkwood Community College
Jennifer Hill, Montgomery College–Takoma Park-Silver Spring
Shannon K. Hill, Temple College
Mark Hollier, Georgia Perimeter College
H. Rodney Holmes, Waubonsee Community College
Mark J. Hubley, Prince George’s Community College
Carolyn Huffman, Wichita Area Technical College
Julie Huggins, Arkansas State University
Jason Hunt, Brigham Young University–Idaho
Alexander Ibe, Weatherford College
Alexander Imholtz, Prince George’s Community College
Virginia Irintcheva, Black Hawk College
Brian E. Jordan, C.S. Mott Community College
Thomas Jordan, Pima Community College
Christopher Jung, University of Alaska Anchorage
William M. Karkow, University of Dubuque
Suzanne Keller, Indian Hills Community College
Michael Kielb, Eastern Michigan University
Marta Klesath, North Carolina State University
Nelson H. Kraus, University of Indianapolis
Paul M. Lea IV, Northern Virginia Community College
Steven Lewis, Metropolitan Community College–Penn Valley
Juanita Limas, Kirkwood Community College
Jerri K. Lindsey, Tarrant County College–Northeast
Chelsea Loafman, Central Texas College
Paul Luyster, Tarrant County College
Ken Malachowsky, Florence-Darlington Technical College
Theresa Martin, College of San Mateo
Nicole Mashburn, Calhoun Community College
Abdallah M. Matari, Hudson County Community College
Bhavya Mathur, Chattahoochee Technical College
05/08/2022 19:32

Tiffany Beth McFalls-Smith, Elizabethtown Community and
Technical College
Jennifer Menon, Johnson County Community College
Jaime Mergliano, John Tyler Community College
Sharon Miles, Itawamba Community College
Todd Miller, Hunter College of CUNY
Louise Millis, North Hennepin Community College
Justin Moore, American River College
Christine Morin, Prince George’s Community College
Qian F. Moss, Des Moines Area Community College
Regina Munro, Chandler-Gilbert Community College
Necia Nicholas, Calhoun Community College
Maria Oehler, Florida State College–Jacksonville
Betsy Ott, Tyler Junior College
Ellen Ott-Reeves, Blinn College–Bryan
Stephen Page, Community College of Baltimore County &
Townson University
Vikash Patel, Nevada State College
Dennis Pearson, Morton College
Diane Pelletier, Green River Community College
Jessica Petersen, Pensacola State College
Jason Pienaar, University of Alabama
Becky Pierce, Delta College
Gilbert Pitts, Austin Peay State University
Renee Prenitzer, Greenville Technical College
Fernando Prince, Laredo Community College
Sarah A. Pugh, Shelton State Community College
Suzanne Pundt, University of Texas at Tyler
Rolando J. Ramirez, The University of Akron
Wendy Rappazzo, Harford Community College
Terrence J. Ravine, University of South Alabama
Christine S. Rigsby, Middle Georgia State University
Laura H. Ritt, Burlington County College
Cynthia Robison, Wallace Community College
Susan Rohde, Triton College
Brian Sailer, Central New Mexico Community College
Sharon Schapel, Mott Community College
Mark Schmidt, Clark State Community College
Michael W. Sipala, Bristol Community College
Amy Skibiel, Auburn University
Lori Smith, American River College–Los Rios
Kerry Smith, Oakland Community College–Auburn Hills
Tom Sobat, Ivy Tech Community College
Kay Sourbeer, Tidewater Community College
Ashley Spring-Beerensson, Eastern Florida State College
Justin R. St. Juliana, Ivy Tech Community College
Cindy Stanfield, University of South Alabama
Laura Steele, Ivy Tech Community College–Northeast
George A. Steer, Jefferson College of Health Sciences
Michelle Stettner, Meridian Community College
Sherry Stewart, Navarro College
A01_MARI1803_12_GE_FM.indd 19
Acknowledgments 19
Susan E. Tappen, Central New Mexico Community College
Dean Thornton, South Georgia State College
Rita A. Thrasher, Pensacola State College
Brenda Tondi, George Mason University
Sheela Vemu, Waubonsee Community College
Khursheed Wankadiya, Central Piedmont Community College
Chad Wayne, University of Houston
Kira L. Wennstrom, Shoreline Community College
Shirley A. Whitescarver, Bluegrass Community and Technical
College–KCTCS
John Whitlock, Hillsborough Community College
Patricia Wilhelm, Johnson and Wales University
Luann Wilkinson, Marion Technical College
Selwyn A. Williams, Miami Dade College
Darrellyn Williams, Pulaski Technical College
Peggie Williamson, Central Texas College
Heather Wilson-Ashworth, Utah Valley University
MaryJo A. Witz, Monroe Community College
Jackie Wright, South Plains College
James Robert Yount, Brevard Community College
We would like to acknowledge the following group who
reviewed various iterations of the new Focus figures: Matthew
Abbott, David Ansardi, Jake Dechant, Karen Dougherty, Peter
Germroth, Gary Glaser, Suzanne Keller, Gilbert Pitts, Terry
Ravine, Michelle Stettner, and Rita Thrasher.
We would also like to acknowledge the support of Katja’s
colleagues at Mount Royal University (Trevor Day, Sarah Hewitt,
Tracy O’Connor, Sarah Orton, Izak Paul, Lorraine Royal, Karen
Sheedy, Kartika Tjandra, and Margot Williams); Department Chairs
(Ruth Pickett-Seltner and Melanie Rathburn); and Deans (Jeffrey
Goldberg and Jonathan Withey). Thanks also to Katja’s husband,
Dr. Lawrence Haynes, a fellow physiologist who has worked
together with Katja and has been involved in all aspects of this
revision. We would like to thank Katja and Larry’s sons, Eric and
Stefan Haynes, for putting up with their parents through many revi-
sions of this book and for continuing to be an inspiration and a joy.
We really would appreciate hearing from you concerning
your opinion—suggestions and constructive criticisms—of this
text. It is this type of feedback that will help us in the next revi-
sion and underlies the continued improvement of this text.
Elaine Marieb
Katja Hoehn
05/08/2022 19:32
 Global Edition Acknowledgments

Pearson would like to thank the following for contributing to the Global Edition:
Richard Brooksbank, University of the Witwatersrand
Snezana Kusljic, The University of Melbourne
Liana Maree, University of the Western Cape
Christiane Van den Branden, Vrije Universiteit Brussel

Pearson would also like to thank the following for reviewing the Global Edition:
Sarah Allsop, University of Bristol
Richard Brooksbank, University of the Witwatersrand
Snezana Kusljic, The University of Melbourne
Peace Mabeta, University of Pretoria
Hemant Mehta, Australian Catholic University
Shahed Nalla, University of Johannesburg
Puspha Sinnayah, Victoria University
Carine Smith, Stellenbosch University
Eva Strandell, Halmstad University

20

A01_MARI1803_12_GE_FM.indd 20 05/08/2022 19:32

 Brief Contents

UNIT 1 Organization of the Body UNIT 4 Maintenance of the Body

1 The Human Body: An Orientation 31 17 Blood 674

2 Chemistry Comes Alive 53 18 The Cardiovascular System: The Heart 702
3 Cells: The Living Units 90 19 The Cardiovascular System: Blood Vessels 738
4 Tissue: The Living Fabric 145 20 The Lymphatic System and Lymphoid Organs
and Tissues 798

UNIT 2 Covering, Support, and Movement of the Body 21 The Immune System: Innate and Adaptive Body
Defenses 813
5 The Integumentary System 180 22 The Respiratory System 852
6 Bones and Skeletal Tissues 203 23 The Digestive System 902
7 The Skeleton 229 24 Nutrition, Metabolism, and Energy Balance 960
8 Joints 281 25 The Urinary System 1008
9 Muscles and Muscle Tissue 309 26 Fluid, Electrolyte, and Acid-Base Balance 1046
10 The Muscular System 353
UNIT 5 Continuity
UNIT 3 Regulation and Integration of the Body
27 The Reproductive System 1075
11 Fundamentals of the Nervous System and Nervous 28 Pregnancy and Human Development 1125
Tissue 420
29 Heredity 1158
12 The Central Nervous System 466
13 The Peripheral Nervous System and Reflex
Activity 521
14 The Autonomic Nervous System 563
15 The Special Senses 585
16 The Endocrine System 633

21

A01_MARI1803_12_GE_FM.indd 21 05/08/2022 19:32

 Contents

2.8 Carbohydrates provide an easily used energy source for

UNIT 1 Organization of the Body the body 73

1 The Human Body: An Orientation 31

2.9 Lipids insulate body organs, build cell membranes, and
provide stored energy 75
2.10 Proteins are the body’s basic structural material and have
1.1 Form (anatomy) determines function (physiology) 32
many vital functions 78
1.2 The body’s organization ranges from atoms to the entire
2.11 DNA and RNA store, transmit, and help express genetic
organism 34
information 83
1.3 What are the requirements for life? 35
2.12 ATP transfers energy to other compounds 85
1.4 Homeostasis is maintained by negative feedback 39
1.5 Anatomical terms describe body directions, regions, and
planes 42
3 Cells: The Living Units 90
A CLOSER LOOK Medical Imaging: Illuminating the Body 46 3.1 Cells are the smallest unit of life 91
1.6 Many internal organs lie in membrane-lined body PART 1 PLASMA MEMBRANE 93
cavities 48
3.2 The plasma membrane is a double layer of phospholipids

2 Chemistry Comes Alive 53

with embedded proteins 93
FOCUS FIGURE 3.1 The Plasma Membrane 94
PART 1 BASIC CHEMISTRY 54 3.3 Passive membrane transport is diffusion of molecules
down their concentration gradient 98
2.1 Matter is the stuff of the universe and energy moves
matter 54 3.4 Active membrane transport directly or indirectly uses
ATP 103
2.2 The properties of an element depend on the structure of
its atoms 55 FOCUS FIGURE 3.2 Primary Active Transport: The Na+-K+
Pump 104
2.3 Atoms bound together form molecules; different
molecules can make mixtures 58 3.5 Selective diffusion establishes the membrane
potential 109
2.4 Three types of chemical bonds are ionic, covalent, and
hydrogen 61 3.6 Cell adhesion molecules and membrane receptors allow
the cell to interact with its environment 111
2.5 Chemical reactions occur when electrons are shared,
gained, or lost 65 FOCUS FIGURE 3.3 G Proteins 112

PART 2 BIOCHEMISTRY 68 PART 2 THE CYTOPLASM 113

2.6 Inorganic compounds include water, salts, and many acids 3.7 Cytoplasmic organelles each perform a specialized
and bases 68 task 113
2.7 Organic compounds are made by dehydration synthesis 3.8 Cilia and microvilli are two main types of cellular
and broken down by hydrolysis 71 extensions 120

22

A01_MARI1803_12_GE_FM.indd 22 05/08/2022 19:32

 Contents 23
PART 3 NUCLEUS 121 5.6 Nails are scale-like modifications of the epidermis 190
3.9 The nucleus includes the nuclear envelope, the nucleolus, 5.7 Sweat glands help control body temperature, and
and chromatin 121 sebaceous glands secrete sebum 191
3.10 The cell cycle consists of interphase and a mitotic phase 126 5.8 First and foremost, the skin is a barrier 193
3.11 Messenger RNA carries instructions from DNA for 5.9 Skin cancer and burns are major challenges to the
building proteins 128 body 195
FOCUS FIGURE 3.4 Mitosis 130 DEVELOPMENTAL ASPECTS of the Integumentary System 197
FOCUS FIGURE 3.5 Translation 136 SYSTEM CONNECTIONS 198
3.12 Autophagy and proteasomes dispose of unneeded
organelles and proteins; apoptosis disposes of unneeded
cells 138
6 Bones and Skeletal Tissues 203
DEVELOPMENTAL ASPECTS of Cells 139 6.1 Hyaline, elastic, and fibrocartilage help form the
skeleton 204

4 Tissue: The Living Fabric 145 6.2 Bones perform several important functions 205
6.3 Bones are classified by their location and shape 206
4.1 Tissue samples are fixed, sliced, and stained for
microscopy 147 6.4 The gross structure of all bones consists of compact bone
sandwiching spongy bone 206
4.2 Epithelial tissue covers body surfaces, lines cavities, and
forms glands 147 6.5 Bones develop either by intramembranous or
endochondral ossification 214
4.3 Connective tissue is the most abundant and widely
distributed tissue in the body 156 6.6 Bone remodeling involves bone deposition and
removal 218
4.4 Muscle tissue is responsible for body movement 168
6.7 Bone repair involves hematoma and callus formation, and
4.5 Nervous tissue is a specialized tissue of the nervous remodeling 220
system 170
6.8 Bone disorders result from abnormal bone deposition and
4.6 The cutaneous membrane is dry; mucous and serous resorption 223
membranes are wet 171
DEVELOPMENTAL ASPECTS of Bones 224
4.7 Tissue repair involves inflammation, organization, and
regeneration 172 SYSTEM CONNECTIONS 226

7 The Skeleton
A CLOSER LOOK Cancer—The Intimate Enemy 174
DEVELOPMENTAL ASPECTS of Tissues 176
229
PART 1 THE AXIAL SKELETON 229
UNIT 2 Covering, Support, and Movement of the Body 7.1 The skull consists of 8 cranial bones and 14 facial
bones 231
5 The Integumentary System 180 7.2 The vertebral column is a flexible, curved support
structure 248
5.1 The skin consists of two layers: the epidermis and
7.3 The thoracic cage is the bony structure of the chest 254
dermis 180
5.2 The epidermis is a keratinized stratified squamous PART 2 THE APPENDICULAR SKELETON 257
epithelium 182 7.4 Each pectoral girdle consists of a clavicle and a scapula 257
5.3 The dermis consists of papillary dermis and reticular 7.5 The upper limb consists of the arm, forearm, and hand 260
dermis 184
7.6 The hip bones attach to the sacrum, forming the pelvic
5.4 Melanin, carotene, and hemoglobin determine skin girdle 266
color 186
7.7 The lower limb consists of the thigh, leg, and foot 270
5.5 Hair consists of dead, keratinized cells 187
DEVELOPMENTAL ASPECTS of the Skeleton 276

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 24 Contents

8 Joints 281 10 The Muscular System 353

8.1 Joints are classified into three structural and three 10.1 For any movement, muscles can act in one of three
functional categories 281 ways 354
8.2 In fibrous joints, the bones are connected by fibrous 10.2 How are skeletal muscles named? 354
tissue 282
FOCUS FIGURE 10.1 Muscle Action 355
8.3 In cartilaginous joints, the bones are connected by
10.3 Fascicle arrangements help determine muscle shape and
cartilage 283
force 356
8.4 Synovial joints have a fluid-filled joint cavity 284
10.4 Muscles acting with bones form lever systems 357
FOCUS FIGURE 8.1 Synovial Joints 292
10.5 A muscle’s origin and insertion determine its action 362
8.5 Five examples illustrate the diversity of synovial joints 294
Table 10.1 Muscles of the Head, Part I: Facial Expression 363
8.6 Joints are easily damaged by injury, inflammation, and
Table 10.2 Muscles of the Head, Part II: Mastication and
degeneration 302
Tongue Movement 366
A CLOSER LOOK Joints: From Medieval Armor to Bionic
Table 10.3 Muscles of the Anterior Neck and Throat:
Humans 304
Swallowing 368
DEVELOPMENTAL ASPECTS of Joints 305
Table 10.4 Muscles of the Neck and Vertebral Column: Head
Movements and Trunk Extension 370
9 Muscles and Muscle Tissue 309 Table 10.5 Deep Muscles of the Thorax: Breathing 374
Table 10.6 Muscles of the Abdominal Wall: Trunk Movements
9.1 There are three types of muscle tissue 310
and Compression of Abdominal Viscera 376
9.2 A skeletal muscle is made up of muscle fibers, nerves,
Table 10.7 Muscles of the Pelvic Floor and Perineum: Support
blood vessels, and connective tissues 311
of Abdominopelvic Organs 378
9.3 Skeletal muscle fibers contain calcium-regulated molecular
Table 10.8 Superficial Muscles of the Anterior and Posterior
motors 314
Thorax: Movements of the Scapula and Arm 380
9.4 Motor neurons stimulate skeletal muscle fibers to
Table 10.9 Muscles Crossing the Shoulder Joint: Movements of
contract 320
the Arm (Humerus) 384
FOCUS FIGURE 9.1 Events at the Neuromuscular Junction 322
Table 10.10 Muscles Crossing the Elbow Joint: Flexion and
FOCUS FIGURE 9.2 Excitation-Contraction Coupling 324 Extension of the Forearm 387
FOCUS FIGURE 9.3 Cross Bridge Cycle 327 Table 10.11 Muscles of the Forearm: Movements of the Wrist,
Hand, and Fingers 388
9.5 Temporal summation and motor unit recruitment allow
smooth, graded skeletal muscle contractions 328 Table 10.12 Summary: Actions of Muscles Acting on the Arm,
Forearm, and Hand 392
9.6 ATP for muscle contraction is produced aerobically or
anaerobically 333 Table 10.13 Intrinsic Muscles of the Hand: Fine Movements of
the Fingers 394
9.7 The force, velocity, and duration of skeletal muscle
contractions are determined by a variety of factors 336 Table 10.14 Muscles Crossing the Hip and Knee Joints:
Movements of the Thigh and Leg 397
9.8 How does skeletal muscle respond to exercise? 339
Table 10.15 Muscles of the Leg: Movements of the Ankle and
9.9 Smooth muscle is nonstriated involuntary muscle 340
Toes 404
DEVELOPMENTAL ASPECTS of Muscles 346
Table 10.16 Intrinsic Muscles of the Foot: Toe Movement and
A CLOSER LOOK Athletes Looking Good and Doing Better with Arch Support 410
Anabolic Steroids? 347
Table 10.17 Summary: Actions of Muscles Acting on the Thigh,
SYSTEM CONNECTIONS 348 Leg, and Foot 414

A01_MARI1803_12_GE_FM.indd 24 05/08/2022 19:32

 Contents 25
12.7 The interconnected structures of the brain allow higher
UNIT 3 Regulation and Integration of the Body mental functions 490

11 Fundamentals of the Nervous 12.8 The brain is protected by bone, meninges, cerebrospinal
fluid, and the blood brain barrier 496
System and Nervous Tissue 420 12.9 Brain injuries and disorders have devastating
consequences 500
11.1 The nervous system receives, integrates, and responds to
12.10 The spinal cord is a reflex center and conduction
information 421
pathway 502
11.2 Neuroglia support and maintain neurons 422
12.11 Neuronal pathways carry sensory and motor information
11.3 Neurons are the structural units of the nervous system 424 to and from the brain 508
11.4 The resting membrane potential depends on differences DEVELOPMENTAL ASPECTS of the Central Nervous System 514
in ion concentration and permeability 431
FOCUS FIGURE 11.1 Resting Membrane Potential 433 13 The Peripheral Nervous System and
11.5 Graded potentials are brief, short-distance signals within Reflex Activity 521
a neuron 435
11.6 Action potentials are brief, long-distance signals within a PART 1 SENSORY RECEPTORS AND SENSATION 522
neuron 436
13.1 Sensory receptors are activated by changes in the internal
FOCUS FIGURE 11.2 Action Potential 438 or external environment 522
11.7 Synapses transmit signals between neurons 443 13.2 Receptors, ascending pathways, and cerebral cortex
process sensory information 525
FOCUS FIGURE 11.3 Chemical Synapse 446
11.8 Postsynaptic potentials excite or inhibit the receiving
PART 2 TRANSMISSION LINES: NERVES AND
neuron 447 THEIR STRUCTURE AND REPAIR 528

11.9 The effect of a neurotransmitter depends on its 13.3 Nerves are cordlike bundles of axons that conduct
receptor 449 sensory and motor impulses 528

FOCUS FIGURE 11.4 Postsynaptic Potentials and Their 13.4 There are 12 pairs of cranial nerves 530
Summation 450 13.5 31 pairs of spinal nerves innervate the body 539
11.10 Neurons act together, making complex behaviors
PART 3 MOTOR ENDINGS AND MOTOR ACTIVITY 549
possible 457
13.6 Peripheral motor endings connect nerves to their
DEVELOPMENTAL ASPECTS of Neurons 458
effectors 549
A CLOSER LOOK Pleasure and Addiction 460
13.7 There are three levels of motor control 549

12 The Central Nervous System 466 PART 4 REFLEX ACTIVITY 551

13.8 The reflex arc enables rapid and predictable responses 551
12.1 Folding during development determines the complex
13.9 Spinal reflexes are somatic reflexes mediated by the
structure of the adult brain 467
spinal cord 552
12.2 The cerebral hemispheres consist of cortex, white matter,
FOCUS FIGURE 13.1 Stretch Reflex 554
and the basal nuclei 471
DEVELOPMENTAL ASPECTS of the Peripheral Nervous
12.3 The diencephalon includes the thalamus, hypothalamus,
System 558
and epithalamus 479
12.4 The brain stem consists of the midbrain, pons, and
medulla oblongata 482 14 The Autonomic Nervous
12.5 The cerebellum adjusts motor output, ensuring System 563
coordination and balance 486
14.1 The ANS differs from the somatic nervous system in that
12.6 Functional brain systems span multiple brain it can stimulate or inhibit its effectors 564
structures 488

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 26 Contents

14.2 The ANS consists of the parasympathetic and

sympathetic divisions 566 16 The Endocrine System 633
14.3 Long preganglionic parasympathetic fibers originate in
16.1 The endocrine system is one of the body’s two major
the craniosacral CNS 568 control systems 634
14.4 Short preganglionic sympathetic fibers originate in the
16.2 The chemical structure of a hormone determines how
thoracolumbar CNS 570 it acts 635
14.5 Visceral reflex arcs have the same five components as 16.3 Hormones act through second messengers or by
somatic reflex arcs 574 activating specific genes 635
14.6 Acetylcholine and norepinephrine are the major ANS 16.4 Three types of stimuli cause hormone release 639
neurotransmitters 575
16.5 Cells respond to a hormone if they have a receptor for
14.7 The parasympathetic and sympathetic divisions usually that hormone 640
produce opposite effects 577
16.6 The hypothalamus controls release of hormones from the
14.8 The hypothalamus oversees ANS activity 579 pituitary gland in two different ways 641
14.9 Most ANS disorders involve abnormalities in smooth FOCUS FIGURE 16.1 Hypothalamus and Pituitary
muscle control 580 Interactions 642
DEVELOPMENTAL ASPECTS of the ANS 580 16.7 The thyroid gland controls metabolism 649
SYSTEM CONNECTIONS 582 16.8 The parathyroid glands are primary regulators of blood
calcium levels 653
15 The Special Senses 585 16.9 The adrenal glands produce hormones involved in
electrolyte balance and the stress response 654
PART 1 THE EYE AND VISION 586 16.10 The pineal gland secretes melatonin 659
15.1 The eye has three layers, a lens, and humors, and is FOCUS FIGURE 16.2 Stress and the Adrenal Gland 660
surrounded by accessory structures 586
16.11 The pancreas, gonads, and most other organs secrete
15.2 The cornea and lens focus light on the retina 595 hormones 662
15.3 Phototransduction begins when light activates visual A CLOSER LOOK Sweet Revenge: Taming the Diabetes
pigments in retinal photoreceptors 599 Monster? 665
15.4 Visual information from the retina passes through relay DEVELOPMENTAL ASPECTS of the Endocrine System 668
nuclei to the visual cortex 605
SYSTEM CONNECTIONS 669
PART 2 THE CHEMICAL SENSES: SMELL AND TASTE 607
15.5 Airborne chemicals are detected by olfactory receptors in UNIT 4 Maintenance of the Body
the nose 607
15.6 Dissolved chemicals are detected by receptor cells in taste
buds 610 17 Blood 674
PART 3 THE EAR: HEARING AND BALANCE 612 17.1 The functions of blood are transport, regulation, and
protection 675
15.7 The ear has three major areas 612
17.2 Blood consists of plasma and formed elements 675
15.8 Sound is a pressure wave that stimulates
mechanosensitive cochlear hair cells 617 17.3 Erythrocytes play a crucial role in oxygen and carbon
dioxide transport 677
15.9 Sound information is processed and relayed through brain
stem and thalamic nuclei to the auditory cortex 621 17.4 Leukocytes defend the body 683

15.10 Hair cells in the maculae and cristae ampullares monitor 17.5 Platelets are cell fragments that help stop bleeding 689
head position and movement 622 17.6 Hemostasis prevents blood loss 689
15.11 Ear abnormalities can affect hearing, equilibrium, or 17.7 Transfusion can replace lost blood 695
both 626
17.8 Blood tests give insights into a patient’s health 698
DEVELOPMENTAL ASPECTS of the Special Senses 627
DEVELOPMENTAL ASPECTS of Blood 698

A01_MARI1803_12_GE_FM.indd 26 05/08/2022 19:32

 Contents 27

18 The Cardiovascular System: CIRCULATORY PATHWAYS: BLOOD VESSELS OF THE

PART 3
BODY 766
The Heart 702 19.11 The vessels of the systemic circulation transport blood to
all body tissues 767
18.1 The heart has four chambers and pumps blood through
Table 19.3 Pulmonary and Systemic Circulations 768
the pulmonary and systemic circuits 703
Table 19.4 The Aorta and Major Arteries of the Systemic
18.2 Heart valves make blood flow in one direction 711
Circulation 770
18.3 Blood flows from atrium to ventricle, and then to either
Table 19.5 Arteries of the Head and Neck 772
the lungs or the rest of the body 712
FOCUS FIGURE 18.1 Blood Flow through the Heart 713 Table 19.6 Arteries of the Upper Limbs and Thorax 774

18.4 Intercalated discs connect cardiac muscle fibers into a Table 19.7 Arteries of the Abdomen 776
functional syncytium 715 Table 19.8 Arteries of the Pelvis and Lower Limbs 780
18.5 Pacemaker cells trigger action potentials throughout Table 19.9 The Venae Cavae and the Major Veins of the
the heart 718 Systemic Circulation 782
18.6 The cardiac cycle describes the mechanical events Table 19.10 Veins of the Head and Neck 784
associated with blood flow through the heart 724
Table 19.11 Veins of the Upper Limbs and Thorax 786
FOCUS FIGURE 18.2 The Cardiac Cycle 726
Table 19.12 Veins of the Abdomen 788
18.7 Stroke volume and heart rate are regulated to alter
cardiac output 728 Table 19.13 Veins of the Pelvis and Lower Limbs 790

DEVELOPMENTAL ASPECTS of the Heart 732 DEVELOPMENTAL ASPECTS of Blood Vessels 791
Atherosclerosis? Get Out the Cardiovascular
19 The Cardiovascular System:
A CLOSER LOOK
Drain Cleaner 792

Blood Vessels 738 SYSTEM CONNECTIONS 793

PART 1 BLOOD VESSEL STRUCTURE AND FUNCTION 739 20 The Lymphatic System and
19.1 Most blood vessel walls have three layers 741 Lymphoid Organs and Tissues 798
19.2 Arteries are pressure reservoirs, distributing vessels, or
20.1 The lymphatic system includes lymphatic vessels, lymph,
resistance vessels 742
and lymph nodes 799
19.3 Capillaries are exchange vessels 742
20.2 Lymphoid cells and tissues are found in lymphoid organs
19.4 Veins are blood reservoirs that return blood toward the and in connective tissue of other organs 802
heart 744
20.3 Lymph nodes cleanse lymph and house lymphocytes 803
19.5 Anastomoses are special interconnections between blood
vessels 746 20.4 The spleen removes bloodborne pathogens and aged red
blood cells 805
PART 2 PHYSIOLOGY OF CIRCULATION 746
20.5 MALT guards the body’s entryways against pathogens 806
19.6 Blood flows from high to low pressure against
20.6 T lymphocytes mature in the thymus 808
resistance 746
DEVELOPMENTAL ASPECTS of the Lymphatic System and
19.7 Blood pressure decreases as blood flows from arteries
Lymphoid Organs and Tissues 808
through capillaries and into veins 748
SYSTEM CONNECTIONS 810
19.8 Blood pressure is regulated by short- and long-term
controls 750
19.9 Intrinsic and extrinsic controls determine blood flow 21 The Immune System: Innate and
through tissues 757 Adaptive Body Defenses 813
19.10 Slow blood flow through capillaries promotes diffusion
of nutrients and gases, and bulk flow of fluids 762 PART 1 INNATE DEFENSES 814
FOCUS FIGURE 19.1 Bulk Flow across Capillary Walls 764 21.1 S
 urface barriers act as the first line of defense to keep
invaders out of the body 814

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 28 Contents

21.2 Innate internal defenses are cells and chemicals that act
as the second line of defense 815 23 The Digestive System 902
PART 2 ADAPTIVE DEFENSES 822 PART 1 OVERVIEW OF THE DIGESTIVE SYSTEM 903
21.3 Antigens are substances that trigger the body’s adaptive
23.1 What major processes occur during digestive system
defenses 823
activity? 904
21.4 B and T lymphocytes and antigen-presenting cells are
23.2 The GI tract has four layers and is usually surrounded by
cells of the adaptive immune response 824
peritoneum 905
21.5 In humoral immunity, antibodies are produced that
23.3 The GI tract has its own nervous system called the enteric
target extracellular antigens 828
nervous system 908
21.6 Cellular immunity consists of T lymphocytes that direct
adaptive immunity or attack cellular targets 833 PART 2FUNCTIONAL ANATOMY OF THE DIGESTIVE
SYSTEM 909
FOCUS FIGURE 21.1 An Example of a Primary Immune
Response 840 23.4 Ingestion occurs only at the mouth 910

A CLOSER LOOK COVID-19 843 23.5 The pharynx and esophagus move food from the mouth
to the stomach 915
21.7 Insufficient or overactive immune responses create
problems 844 23.6 The stomach temporarily stores food and begins protein
digestion 918
DEVELOPMENTAL ASPECTS of the Immune System 847
23.7 The liver secretes bile; the pancreas secretes digestive

22 The Respiratory System 852

enzymes 927
23.8 The small intestine is the major site for digestion and
absorption 934
PART 1 FUNCTIONAL ANATOMY 854
23.9 The large intestine absorbs water and eliminates
22.1 The upper respiratory system warms, humidifies, and feces 940
filters air 854
PART 3 PHYSIOLOGY OF DIGESTION AND
22.2 The lower respiratory system consists of conducting and
ABSORPTION 946
respiratory zone structures 858
23.10 Digestion hydrolyzes food into nutrients that are
22.3 Each multilobed lung occupies its own pleural cavity 867
absorbed across the gut epithelium 946
PART 2 RESPIRATORY PHYSIOLOGY 868 23.11 How is each type of nutrient processed? 946
22.4 Volume changes cause pressure changes, which cause air DEVELOPMENTAL ASPECTS of the Digestive System 952
to move 868
SYSTEM CONNECTIONS 954
22.5 Measuring respiratory volumes, capacities, and flow rates
helps us assess ventilation 874
22.6 Gases exchange by diffusion between the blood, lungs,
24 Nutrition, Metabolism, and Energy
and tissues 876 Balance 960
22.7 Oxygen is transported by hemoglobin, and carbon
dioxide is transported in three different ways 881 PART 1 NUTRIENTS 961

FOCUS FIGURE 22.1 The Oxygen-Hemoglobin Dissociation 24.1 Carbohydrates, lipids, and proteins supply energy and are
Curve 882 used as building blocks 961

22.8 Respiratory centers in the brain stem control breathing with 24.2 Most vitamins act as coenzymes; minerals have many
input from chemoreceptors and higher brain centers 887 roles in the body 965

22.9 Exercise and high altitude bring about respiratory PART 2 METABOLISM 967
adjustments 891
24.3 Metabolism is the sum of all biochemical reactions in the
22.10 Respiratory diseases are major causes of disability and body 968
death 892
24.4 Carbohydrate metabolism is the central player in ATP
DEVELOPMENTAL ASPECTS of the Respiratory System 894 production 970
SYSTEM CONNECTIONS 896 FOCUS FIGURE 24.1 Oxidative Phosphorylation 975

A01_MARI1803_12_GE_FM.indd 28 05/08/2022 19:32

 Contents 29
24.5 Lipid metabolism is key for long-term energy storage and 26.4 Chemical buffers and respiratory regulation rapidly
release 980 minimize pH changes 1060
24.6 Amino acids are used to build proteins or for energy 982 26.5 Renal regulation is a long-term mechanism for controlling
acid-base balance 1063
24.7 Energy is stored in the absorptive state and released in
the postabsorptive state 983 26.6 Abnormalities of acid-base balance are classified as
metabolic or respiratory 1067
24.8 The liver metabolizes, stores, and detoxifies 989
A CLOSER LOOK Sleuthing: Using Blood Values to Determine
A CLOSER LOOK Obesity: Magical Solution Wanted 992
the Cause of Acidosis or Alkalosis 1068
PART 3 ENERGY BALANCE 994 DEVELOPMENTAL ASPECTS of Fluid, Electrolyte, and Acid-Base
24.9 Neural and hormonal factors regulate food intake 994 Balance 1069

24.10 Thyroxine is the major hormone that controls basal SYSTEM CONNECTIONS 1070
metabolic rate 996
24.11 The hypothalamus acts as the body’s thermostat 997 UNIT 5 Continuity
DEVELOPMENTAL ASPECTS of Nutrition and Metabolism 1002

27 The Reproductive System 1075

25 The Urinary System 1008
27.1 The male and female reproductive systems share
25.1 The kidneys have three distinct regions and a rich blood common features 1076
supply 1009 PART 1 ANATOMY OF THE MALE REPRODUCTIVE
25.2 Nephrons are the functional units of the kidney 1012 SYSTEM 1081
25.3 Overview: Filtration, absorption, and secretion are the 27.2 The testes are enclosed and protected by the
key processes of urine formation 1017 scrotum 1082
25.4 Urine formation, step 1: The glomeruli make filtrate 1018 27.3 Sperm travel from the testes to the body exterior through
a system of ducts 1084
25.5 Urine formation, step 2: Most of the filtrate is reabsorbed
into the blood 1023 27.4 The penis is the copulatory organ of the male 1084
25.6 Urine formation, step 3: Certain substances are secreted 27.5 The male accessory glands produce the bulk of
into the filtrate 1028 semen 1086
25.7 The kidneys create and use an osmotic gradient to PART 2PHYSIOLOGY OF THE MALE REPRODUCTIVE
regulate urine concentration and volume 1029 SYSTEM 1087
FOCUS FIGURE 25.1 Medullary Osmotic Gradient 1030 27.6 The male sexual response includes erection and
25.8 Renal function is evaluated by analyzing blood and ejaculation 1087
urine 1034 27.7 Spermatogenesis is the sequence of events that leads to
25.9 The ureters, bladder, and urethra transport, store, and formation of sperm 1088
eliminate urine 1036 27.8 Male reproductive function is regulated by hypothalamic,
DEVELOPMENTAL ASPECTS of the Urinary System 1040 anterior pituitary, and testicular hormones 1093

PART 3 ANATOMY OF THE FEMALE REPRODUCTIVE

26 Fluid, Electrolyte, and Acid-Base SYSTEM 1094

27.9 Immature eggs develop in follicles in the ovaries 1095
Balance 1046
27.10 The female duct system includes the uterine tubes,
26.1 Body fluids consist of water and solutes in three main uterus, and vagina 1096
compartments 1047
27.11 The external genitalia of the female include those
26.2 Both intake and output of water are regulated 1050 structures that lie external to the vagina 1101
26.3 Sodium, potassium, calcium, and phosphate levels are 27.12 The mammary glands produce milk 1102
tightly regulated 1053

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 30 Contents

PART 4PHYSIOLOGY OF THE FEMALE REPRODUCTIVE 28.8 Lactation is milk secretion by the mammary glands in
SYSTEM 1103 response to prolactin 1150
27.13 Oogenesis is the sequence of events that leads to the A CLOSER LOOK Contraception 1152
formation of ova 1103
28.9 Assisted reproductive technology may help an infertile
27.14 The ovarian cycle consists of the follicular phase and the couple have offspring 1153
luteal phase 1107
27.15 Female reproductive function is regulated by hypothalamic,
anterior pituitary, and ovarian hormones 1108
29 Heredity 1158
27.16 The female sexual response is more diverse and complex 29.1 Genes are the vocabulary of genetics 1159
than that of males 1112 29.2 Genetic variation results from independent assortment,
crossing over, and random fertilization 1160
PART 5 SEXUALLY TRANSMITTED INFECTIONS 1114
29.3 Several patterns of inheritance have long been
27.17 Sexually transmitted infections cause reproductive and
known 1162
other disorders 1114
29.4 Environmental factors may influence or override gene
DEVELOPMENTAL ASPECTS of the Reproductive System 1115
expression 1165
SYSTEM CONNECTIONS 1119
29.5 Factors other than nuclear DNA sequence can determine
inheritance 1165
28 Pregnancy and Human 29.6 Genetic screening is used to detect genetic disorders 1167
Development 1125
28.1 Fertilization combines the sperm and egg chromosomes, Appendices
forming a zygote 1126 Answers Appendix 1173
FOCUS FIGURE 28.1 Sperm Penetration and the Blocks to A The Metric System 1190
Polyspermy 1128 B Functional Groups in Organic Molecules 1192
28.2 Embryonic development begins as the zygote undergoes C The Amino Acids 1193
cleavage and forms a blastocyst en route to the D Two Important Metabolic Pathways 1194
uterus 1131 E Periodic Table of the Elements 1197
28.3 Implantation occurs when the embryo burrows into the F Reference Values for Selected Blood and Urine
uterine wall, triggering placenta formation 1132 Studies 1198
28.4 Embryonic events include gastrula formation and tissue Glossary 1203
differentiation, which are followed by rapid growth of
the fetus 1136 Photo and Illustration Credits 1225
FOCUS FIGURE 28.2 Fetal and Newborn Circulation 1142 Index 1227
28.5 During pregnancy, the mother undergoes anatomical,
physiological, and metabolic changes 1146
28.6 The three stages of labor are the dilation, expulsion, and
placental stages 1148
28.7 An infant’s extrauterine adjustments include taking the
first breath and closure of vascular shunts 1150

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 1 The Human Body:
An Orientation
In this chapter, you will learn that
Anatomy and physiology provide a framework that helps us understand the human body
1.1 What are anatomy
and physiology, and
how are they related?
1.2 How is the body
organized structurally?
1.3 What are the
requirements for life?
CAREER CONNECTION
Watch a video to learn how
the chapter content is used
in a real health care setting.
Go to Mastering A&P® > Study Area >
Animations and Videos or use quick
access URL https://bit.ly/3P8hiZa
M01_MARI1803_12_GE_C01.indd 31
by asking
1.4 How does the body 1.5 What terms do we need
keep its internal to describe anatomy?
environment in balance?
and exploring
1.6 Body cavities and
membranes
Welcome to the study of one of the most fascinating
subjects possible—your own body. Such a study is not only
highly personal, but timely as well. We get news of some medi­
cal advance almost daily. To appreciate emerging discoveries in
molecular genetics, to understand new techniques for detecting
and treating disease, and to make use of published facts on how
to stay healthy, you’ll find it helps to learn about the workings
of your body. If you are preparing for a career in the health sci­
ences, the study of anatomy and physiology has added rewards
because it provides the essential foundation for your clinical
experiences.
In this chapter we define and contrast anatomy and physio­
logy and discuss how the human body is organized. Then we
review needs and processes common to all living organisms.
Three essential concepts—the complementarity of structure
and function, the hierarchy of structural organization, and
homeostasis—will unify and form the bedrock for your study
of the human body. And finally you’ll learn the language of
anatomy—terminology that anatomists use to describe the body
and its parts.
31
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 32 UNIT 1 Organization of the Body
1.1 Form (anatomy) determines
function (physiology)
Learning Outcomes
✔✔Define anatomy and physiology and describe their
subdivisions.
✔✔Explain the principle of complementarity.
Two complementary branches of science—anatomy and
1 physiology—provide the concepts that help us to understand the
human body. Anatomy studies the structure of body parts and
their relationships to one another. Anatomy has a certain appeal
because it is concrete. Body structures can be seen, felt, and
examined closely. You don’t need to imagine what they look like.
Physiology concerns the function of the body, in other
words, how the body parts work and carry out their life-
sustaining activities. When all is said and done, physiology is
explainable only in terms of the underlying anatomy.
For simplicity, when we refer to body structures and physi­
ological values (body temperature, heart rate, and the like), we
will assume that we are talking about a healthy young reference
man weighing about 70 kilograms (kg) or a healthy young ref-
erence woman weighing about 57 kg.
Although we use the reference values and common direc­
tional and regional terms to refer to all human bodies, you know
from observing the faces and body shapes of people around
you that we humans differ in our external anatomy. The same
kind of variability holds for internal organs as well. In one per­
son, for example, a nerve or blood vessel may be somewhat out
of place, or a small muscle may be missing. Nonetheless, well
over 90% of all structures present in any human body match the
textbook descriptions. We seldom see extreme anatomical vari­
ations because they are incompatible with life.
Topics of Anatomy
Anatomy is a broad field with many subdivisions, each providing
enough information to be a course in itself. Gross, or macro-
scopic, anatomy is the study of large body structures visible
to the naked eye, such as the heart, lungs, and kidneys. Indeed,
the term anatomy (from Greek, meaning “to cut apart”) relates
most closely to gross anatomy because in such studies preserved
animals or their organs are dissected (cut up) to be examined.
Gross anatomy can be approached in different ways.
●● In regional anatomy, all the structures (muscles, bones, blood
vessels, nerves, etc.) in a particular region of the body, such as
the abdomen or leg, are examined at the same time.
●● In systemic anatomy (sis-tem9ik),* body structure is studied
system by system. For example, when studying the cardio­
vascular system, you would examine the heart and the blood
vessels of the entire body.
●● Another subdivision of gross anatomy is surface anatomy,
the study of internal structures as they relate to the overlying
skin surface. You use surface anatomy when you identify the
* For the pronunciation guide rules, see the first page of the glossary in the back
of the book.
M01_MARI1803_12_GE_C01.indd 32
bulging muscles beneath a bodybuilder’s skin, and clinicians
use it to locate appropriate blood vessels in which to feel
pulses and draw blood.
Microscopic anatomy deals with structures too small to be
seen with the naked eye. For most such studies, exceedingly thin
slices of body tissues are stained and mounted on glass slides to
be examined under the microscope. Subdivisions of microscopic
anatomy include cytology (si-tol9o-je), which considers the cells
of the body, and histology (his-tol9o-je), the study of tissues.
Developmental anatomy traces structural changes that
occur throughout the life span. Embryology (em0bre-ol9o-je), a
subdivision of developmental anatomy, concerns developmental
changes that occur before birth.
Some highly specialized branches of anatomy are used
primarily for medical diagnosis and scientific research. For
example, pathological anatomy studies structural changes
caused by disease. Radiographic anatomy studies internal
structures as visualized by X-ray images or specialized scan­
ning procedures.
Studying Anatomy
One essential tool for studying anatomy is a mastery of ana­
tomical terminology. Other tools are observation, manipula­
tion, and, in a living person, palpation (feeling organs with
your hands) and auscultation (listening to organ sounds with a
stethoscope). A simple example illustrates how some of these
tools work together in an anatomical study.
Let’s assume that your topic is freely movable joints of the
body. In the laboratory, you will be able to observe an animal
joint, noting how its parts fit together. You can work the joint
(manipulate it) to determine its range of motion. Using ana-
tomical terminology, you can name its parts and describe how
they are related so that other students (and your instructor) will
have no trouble understanding you. The list of word roots (at
the back of the book) and the glossary will help you with this
special vocabulary.
Although you will make most of your observations with the
naked eye or with the help of a microscope, medical technol­
ogy has developed a number of sophisticated tools that can
peer into the body without disrupting it. See A Closer Look
on pp. 46–47.
Topics of Physiology
Like anatomy, physiology has many subdivisions. Most of them
consider the operation of specific organ systems. For example,
renal physiology concerns kidney function and urine produc­
tion. Neurophysiology explains the workings of the nervous
system. Cardiovascular physiology examines the operation of
the heart and blood vessels. While anatomy provides us with a
static image of the body’s architecture, physiology reveals the
body’s dynamic and animated workings.
Physiology often focuses on events at the cellular or molecu­
lar level. This is because the body’s abilities depend on those
of its individual cells, and cells’ abilities ultimately depend on
the chemical reactions that go on within them. Physiology also
rests on principles of physics, which help to explain electrical
27/07/2022 16:57
 Chapter 1 The Human Body: An Orientation 33

The sharp edges of incisors The flat surfaces of molars (structure)

(structure) make them ideal for make them ideal for grinding, like a
cutting like scissors (function). mortar and pestle (function).

Figure 1.1 Complementarity of structure and function.

currents, blood pressure, and the way muscles use bones to cause body movements,
among other things. We present basic chemical and physical principles in Chapter 2 and
throughout the book as needed to explain physio­logical topics.

Complementarity of Structure and Function

Although it is possible to study anatomy and physiology individually, they are really
inseparable because function always reflects structure. That is, what a structure can do
depends on its specific form. This key concept is called the principle of complementa-
rity of structure and function.
For example, bones can support and protect body organs because they contain hard
mineral deposits. Blood flows in one direction through the heart because the heart
has valves that prevent backflow. Another example is how the various shapes of our
teeth reflect their different actions, as shown in Figure 1.1. Throughout this book, we
accompany a description of a structure’s anatomy with an explanation of its function,
and we emphasize structural characteristics contributing to that function.

Check Your Understanding

1. In what way does physiology depend on anatomy?
2. Would you be studying anatomy or physiology if you investigated how muscles
shorten? If you explored the location of the lungs in the body?
3. APPLY Use the word root definitions located at the back of this book to define each
of the following terms: gastritis, leukocyte, nephropathy.
For answers, see Answers Appendix.

M01_MARI1803_12_GE_C01.indd 33 27/07/2022 16:57

 34 UNIT 1 Organization of the Body

the chemical level, which we study in Chapter 2. At this level,

1.2 The body’s organization ranges
from atoms to the entire organism
Learning Outcomes
✔✔Name the different levels of structural organization that
make up the human body, and explain their relationships.
✔✔List the 11 organ systems of the body, identify their
components, and briefly explain the major function(s) of
each system.
1
The human body has many levels of structural organization
(Figure 1.2). The simplest level of the structural hierarchy is
atoms, tiny building blocks of matter, combine to form mol-
ecules such as water and proteins. Molecules, in turn, associate
in specific ways to form organelles that are the basic compo­
nents of cells. Cells are the smallest units of living things. We
examine the cellular level in Chapter 3. All cells share some
common functions, but individual cells vary widely in size and
shape, reflecting their unique functions in the body.
The simplest living creatures are single cells, but in complex
organisms such as human beings, the hierarchy continues on to
the tissue level. Tissues are groups of similar cells that have a
common function. The four basic tissue types in the human body

Organelle
Atoms Molecules
Smooth muscle cell

Chemical level Cellular level

Atoms combine to form molecules. Cells are made up of molecules.

Smooth muscle tissue

Cardiovascular
Tissue level
system
Tissues consist of similar types of cells.

Heart

Blood
vessels Blood vessel (organ)

Smooth muscle tissue

Connective tissue

Epithelial
tissue

Organ level
Organs are made up of different types of tissues.

Organismal level Organ system level

The human organism is made up of many Organ systems consist of different
organ systems. organs that work together closely.

Figure 1.2 Levels of structural organization. Components of the cardiovascular system are
used to illustrate the levels of structural organization in a human being.

M01_MARI1803_12_GE_C01.indd 34 27/07/2022 16:57

 Chapter 1 The Human Body: An Orientation 35
are epithelial tissue, muscle tissue, connective tissue, and ner­ Like all complex animals, humans maintain their bounda­
vous tissue. ries, move, respond to environmental changes, take in and
Each tissue type has a characteristic role in the body, which digest nutrients, carry out metabolism, dispose of wastes, re­
we explore in Chapter 4. Briefly, epithelial tissue covers the produce themselves, and grow. We will introduce these neces­
body surface and lines its cavities. Muscle tissue provides sary life functions here and discuss them in more detail in later
movement. Connective tissue supports and protects body chapters.
organs. Nervous tissue provides a means of rapid internal com­ We cannot emphasize too strongly that all body cells are
munication by transmitting electrical impulses. interdependent. This interdependence is due to the fact that
An organ is a discrete structure composed of at least two humans are multicellular organisms and our vital body func­
tissue types (four is more common) that performs a specific tions are parceled out among different organ systems. Organ 1
function for the body. The liver, the brain, and a blood vessel systems, in turn, work cooperatively to promote the well-
are very different from the stomach, but each is an organ. You being of the entire body. Figure 1.3 identifies some of the
can think of each organ of the body as a specialized functional organ systems making major contributions to necessary life
center responsible for a necessary activity that no other organ functions. Also, as you read this section, check Figure 1.4 on
can perform. pp. 36–37 for more detailed descriptions of the body’s organ
At the organ level, extremely complex functions become systems.
possible. Let’s take the stomach for an example. Its lining is an
epithelium that produces digestive juices. The bulk of its wall is (Text continues on p. 38.)­
muscle, which churns and mixes stomach contents (food). Its con­
nective tissue reinforces the soft muscular walls. Its nerve fibers
increase digestive activity by stimulating the muscle to contract
more vigorously and the glands to secrete more digestive juices.
The next level of organization is the organ system level.
Digestive system Respiratory system
Organs that work together to accomplish a common purpose Takes in nutrients, breaks them Takes in oxygen and
make up an organ system. For example, the heart and blood down, and eliminates unabsorbed eliminates carbon dioxide
vessels of the cardiovascular system circulate blood continu­ matter (feces)
ously to carry oxygen and nutrients to all body cells. Besides Food O2 CO2
the cardiovascular system, the other organ systems of the body
are the integumentary, skeletal, muscular, nervous, endocrine, Cardiovascular system
lymphatic, respiratory, digestive, urinary, and reproductive sys­ Via the blood, distributes oxygen
tems. (Note that the immune system is closely associated with and nutrients to all body cells and
delivers wastes and carbon
the lymphatic system.) Look ahead to Figure 1.4 on pp. 36–37 dioxide to disposal organs
for an overview of the 11 organ systems.
The highest level of organization is the organism, the living
Blood
human being. The organismal level represents the sum total of CO2
all structural levels working together to keep us alive. O2

Check Your Understanding

Heart
4. What level of structural organization is typical of a Urinary system
Nutrients Eliminates
cytologist’s field of study?
nitrogenous
5. What is the correct structural order for the following terms: wastes and
tissue, organism, organ, cell? Interstitial fluid excess ions
For answers, see Answers Appendix.

1.3 What are the requirements

for life?
Learning Outcomes Nutrients and wastes pass
between blood plasma and
✔✔List the functional characteristics necessary to maintain cells via the interstitial fluid
life in humans.
✔✔List the survival needs of the body.
Integumentary system
Necessary Life Functions Feces Protects the body as a whole Urine
from the external environment
Now that you know the structural levels of the human body, the
question that naturally follows is: What does this highly orga­ Figure 1.3 Examples of interrelationships among body
nized human body do? organ systems.

M01_MARI1803_12_GE_C01.indd 35 27/07/2022 16:57

 36 UNIT 1 Organization of the Body

Hair Skeletal
muscles

Skin Nails

Bones
1

Joint

(a) Integumentary System (b) Skeletal System (c) Muscular System

Forms the external body covering, and
protects deeper tissues from injury.
Synthesizes vitamin D, and houses
cutaneous (pain, pressure, etc.) receptors,
and sweat and oil glands.
Protects and supports body organs, and Allows manipulation of the environment,
provides a framework the muscles use locomotion, and facial expression.
to cause movement. Blood cells are Maintains posture, and produces heat.
formed within bones. Bones store minerals.

Pineal gland
Brain
Pituitary
Thyroid gland
gland Heart
Thymus

Adrenal
gland
Pancreas

Testis

Nerves Ovary Blood

Spinal vessels
cord

(d) Nervous System (e) Endocrine System (f) Cardiovascular System

As the fast-acting control system of the Glands secrete hormones that regulate Blood vessels transport blood, which
body, it responds to internal and external processes such as growth, reproduction, carries oxygen, carbon dioxide,
changes by activating appropriate and nutrient use (metabolism) by body nutrients, wastes, etc. The heart pumps
muscles and glands. cells. blood.

Figure 1.4 The body’s organ systems and their major functions.

M01_MARI1803_12_GE_C01.indd 36 27/07/2022 16:57

 Chapter 1 The Human Body: An Orientation 37

Nasal Oral cavity

Red bone cavity
marrow
Thymus Pharynx Esophagus

Larynx Bronchus
Lymphatic
vessels Trachea
Thoracic
duct Lung Liver
Stomach
Small 1
Spleen intestine

Large
intestine
Lymph nodes Rectum
Anus

(g) Lymphatic System/Immunity (h) Respiratory System (i) Digestive System

Picks up fluid leaked from blood vessels Keeps blood constantly supplied with Breaks down food into absorbable units
and returns it to blood. Disposes oxygen and removes carbon dioxide. that enter the blood for distribution to
of debris in the lymphatic stream. These exchanges occur through body cells. Indigestible foodstuffs are
Houses white blood cells (lymphocytes) the walls of the air sacs of the lungs. eliminated as feces.
involved in immunity. The immune
response mounts the attack against
foreign substances within the body.

Mammary
glands (in
breasts)
Kidney

Ureter Prostate

Ovary
Penis
Urinary
bladder Testis Ductus
deferens Uterine
Urethra Scrotum Uterus
tube
Vagina

(j) Urinary System
Eliminates nitrogenous wastes from the
body. Regulates water, electrolyte, and
acid-base balance of the blood.
(k) Male Reproductive System (l) Female Reproductive System
Overall function is production of offspring. Testes produce sperm and male sex hormone,
and male ducts and glands aid in delivery of sperm to the female reproductive tract. Ovaries
produce eggs and female sex hormones. The remaining female structures serve as sites for
fertilization and development of the fetus. Mammary glands of female breasts produce
milk to nourish the newborn.

Figure 1.4 (continued)

M01_MARI1803_12_GE_C01.indd 37 27/07/2022 16:57

 38 UNIT 1 Organization of the Body
Maintaining Boundaries
Every living organism must maintain its boundaries so that
its internal environment (its inside) remains distinct from the
external environment (its outside). In single-celled organisms,
the external boundary is a limiting membrane that encloses its
contents and lets in needed substances while restricting entry of
potentially damaging or unnecessary substances. Similarly, all
body cells are surrounded by a selectively permeable plasma
membrane.
1 The plasma membrane separates the intracellular fluid
inside cells from the extracellular fluid outside. Part of the
extracellular fluid (blood plasma) is enclosed in blood vessels.
The remainder, the interstitial fluid, surrounds and bathes all of
our cells (see Figure 1.3 on p. 35).
Another important boundary, the integumentary system,
or skin, encloses the body as a whole (Figure 1.4a). This
system protects our internal organs from drying out (a fatal
change), infection, and the damaging effects of heat, sunlight,
and an unbelievable number of chemicals in the external
environment.
Movement
Movement includes the activities promoted by the muscular
system, such as propelling ourselves from one place to another
by running or swimming, and manipulating the external envi­
ronment with our nimble fingers (Figure 1.4c). The skeletal
system provides the bony framework that the muscles pull on
as they work (Figure 1.4b). Movement also occurs when sub­
stances such as blood, foodstuffs, and urine are propelled
through internal organs of the cardiovascular, digestive, and
urinary systems, respectively. On the cellular level, the mus­
cle cell’s ability to move by shortening is more precisely called
contractility.
Responsiveness
Responsiveness, or excitability, is the ability to sense changes
(stimuli) in the environment and then respond to them. For
example, if you cut your hand on broken glass, a withdrawal
reflex occurs—you involuntarily pull your hand away from the
painful stimulus (the broken glass). You don’t have to think
about it—it just happens! Likewise, when carbon dioxide in
your blood rises to dangerously high levels, chemical sensors
respond by sending messages to brain centers controlling respi­
ration, and you breathe more rapidly.
Because nerve cells are highly excitable and communicate
rapidly with each other via electrical impulses, the nervous sys­
tem is most involved with responsiveness (Figure 1.4d). How­
ever, all body cells are excitable to some extent.
Digestion
Digestion is the breaking down of ingested foodstuffs to simple
molecules that can be absorbed into the blood. The nutrient-rich
blood is then distributed to all body cells by the cardiovascular
system. In a simple, one-celled organism such as an amoeba,
the cell itself is the “digestion factory,” but in the multicellular
human body, the digestive system performs this function for the
entire body (Figure 1.4i).
M01_MARI1803_12_GE_C01.indd 38
Metabolism
Metabolism (mĕ-tab9o-lizm; “a state of change”) is a broad
term that includes all chemical reactions that occur within
body cells. It includes breaking down substances into simpler
building blocks (the process of catabolism), synthesizing more
complex substances from simpler building blocks (anabolism),
and using nutrients and oxygen to produce (via cellular res-
piration) ATP, the energy-rich molecules that power cellular
activities. Metabolism depends on the digestive and respiratory
systems to make nutrients and oxygen available to the blood,
and on the cardiovascular system to distribute them through­
out the body (Figure 1.4i, h, and f, respectively). Metabolism
is regulated largely by hormones secreted by endocrine system
glands (Figure 1.4e).
Excretion
Excretion is the process of removing wastes, or excreta
(ek-skre9tah), from the body. If the body is to operate as we
expect it to, it must get rid of nonuseful substances produced
during digestion and metabolism.
Several organ systems participate in excretion. For example,
the digestive system rids the body of indigestible food residues
in feces, and the urinary system disposes of nitrogen-containing
metabolic wastes, such as urea, in urine (Figure 1.4i and j).
Carbon dioxide, a by-product of cellular respiration, is carried
in the blood to the lungs, where it leaves the body in exhaled
air (Figure 1.4h).
Reproduction
Reproduction occurs at the cellular and the organismal level.
In cellular reproduction, the original cell divides, producing two
identical daughter cells that may then be used for body growth
or repair. Reproduction of the human organism, or making a
whole new person, is the major task of the reproductive system.
When a sperm unites with an egg, a fertilized egg forms and
develops into a baby within the mother’s body. The reproduc­
tive system is directly responsible for producing offspring, but
its function is exquisitely regulated by hormones of the endo­
crine system (Figure 1.4e).
Because males produce sperm and females produce
eggs (ova), there is a division of labor in reproduction, and
the reproductive organs of males and females are different
(Figure 1.4k, l). Additionally, the female’s reproductive struc­
tures provide the site for fertilization of eggs by sperm, and then
protect and nurture the developing fetus until birth.
Growth
Growth is an increase in size of a body part or the organism as
a whole. It is usually accomplished by increasing the number of
cells. However, individual cells also increase in size when not
dividing. For true growth to occur, constructive activities must
occur at a faster rate than destructive ones.
Survival Needs
The ultimate goal of all body systems is to maintain life. How­
ever, life is extraordinarily fragile and requires several factors.
27/07/2022 16:57

These survival needs include nutrients (food), oxygen, water,
and appropriate temperature and atmospheric pressure.
●● Nutrients. Nutrients, taken in via the diet, contain the
chemical substances used for energy and cell building. Most
plant-derived foods are rich in carbohydrates, vitamins, and
minerals, whereas most animal foods are richer in proteins
and fats.
Carbohydrates are the major energy fuel for body cells.
Proteins, and to a lesser extent fats, are essential for build­
ing cell structures. Fats also provide a reserve of energy-
rich fuel. Selected minerals and vitamins are required for the
chemical reactions that go on in cells and for oxygen trans­
port in the blood. The mineral calcium helps to make bones
hard and is required for blood clotting.
●● Oxygen. All the nutrients in the world are useless unless
oxygen is also available. Because the chemical reactions
that release energy from foods are oxidative reactions that
require oxygen, human cells can survive for only a few
minutes without oxygen. Approximately 20% of the air we
breathe is oxygen. The cooperative efforts of the respiratory
and cardiovascular systems make oxygen available to the
blood and body cells.
●● Water. Water accounts for 50–60% of our body weight and
is the single most abundant chemical substance in the body.
It provides the watery environment necessary for chemical
reactions and the fluid base for body secretions and excre­
tions. We obtain water from ingested foods and liquids. We
lose it from the body by evaporation from the lungs and skin
and in body excretions.
●● Normal body temperature. If chemical reactions are to
continue at life-sustaining rates, normal body tempera-
ture must be maintained. As body temperature drops
below 37°C (98.6°F), metabolic reactions become slower
and slower, and finally stop. When body temperature is too
high, chemical reactions occur at a frantic pace and body
systems stop functioning. At either extreme, death occurs.
The activity of the muscular system generates most body
heat.
●● Appropriate atmospheric pressure. Atmospheric pressure
is the force that air exerts on the surface of the body. Breath­
ing and gas exchange in the lungs depend on appropriate
atmospheric pressure. At high altitudes, where atmospheric
pressure is lower and the air is thin, gas exchange may be
inadequate to support cellular metabolism.
The mere presence of these survival factors is not sufficient
to sustain life. They must be present in the proper amounts. Too
much and too little may be equally harmful. For example, oxy­
gen is essential, but excessive amounts are toxic to body cells.
Similarly, the food we eat must be of high quality and in proper
amounts. Otherwise, nutritional disease, obesity, or starvation
is likely. Also, while the needs listed here are the most crucial,
they do not even begin to encompass all of the body’s needs.
For example, we can live without gravity if we must, but the
quality of life suffers.
M01_MARI1803_12_GE_C01.indd 39
Chapter 1 The Human Body: An Orientation 39
Check Your Understanding
6. What separates living beings from nonliving objects?
7. What name is given to all chemical reactions that occur
within body cells?
8. The image below shows tissue cells and part of a blood
vessel. The cells’ nutrients and wastes are exchanged across
an important boundary between two fluid compartments.
Name the boundary (a) and the fluid in the compartments
(b and c). Be specific.
1
a
Tissue cells
b
c
Blood vessel
For answers, see Answers Appendix.
1.4 Homeostasis is maintained
by negative feedback
Learning Outcomes
✔✔Define homeostasis and explain its significance.
✔✔Describe how negative and positive feedback maintain
body homeostasis.
✔✔Describe the relationship between homeostatic imbalance
and disease.
When you think about the fact that your body contains tril­
lions of cells in nearly constant activity, and that remarkably
little usually goes wrong with it, you begin to appreciate what a
marvelous machine your body is. Walter Cannon, an American
physiologist of the early twentieth century, spoke of the “wis­
dom of the body,” and he coined the word homeostasis (ho0me-
o-sta9sis) to describe its ability to maintain relatively stable
internal conditions even though the outside world changes
continuously.
Although the literal translation of homeostasis is “unchang­
ing,” the term does not really mean a static, or unchanging,
state. Rather, it indicates a dynamic state of equilibrium, or a
balance, in which internal conditions vary, but always within
relatively narrow limits. In general, the body is in homeosta­
sis when its needs are adequately met and it is functioning
smoothly.
Maintaining homeostasis is more complicated than it
appears at first glance. Virtually every organ system plays a
role in maintaining the constancy of the internal environment.
Adequate blood levels of vital nutrients must be continuously
present, and heart activity and blood pressure must be con­
stantly monitored and adjusted so that the blood is propelled to
all body tissues. Also, wastes must not be allowed to accumu­
late, and body temperature must be precisely controlled. A wide
variety of chemical, thermal, and neural factors act and interact
in complex ways—sometimes helping and sometimes hindering
the body as it works to maintain its “steady rudder.”
27/07/2022 16:57
 40 UNIT 1 Organization of the Body
Homeostatic Control
Communication within the body is essential for homeostasis.
Communication is accomplished chiefly by the nervous and en­
docrine systems, which use neural electrical impulses or blood­
borne hormones, respectively, as information carriers. We cover
the details of how these two great regulating systems operate in
later chapters, but here we explain the basic characteristics of
control systems that promote homeostasis.
The variable is the factor or event being regulated. All
1 triggered ON when the house temperature drops below that
homeostatic control mechanisms are processes involving at
least three components that work together to regulate the vari­
able (Figure 1.5).
1. The receptor is the first component. It is a sensor that moni­
tors the environment. It responds to stimuli (changes) by
sending information (input) along the afferent pathway to
the second component, the control center.
2. The control center determines the set point, which is the level
(or range of levels) at which a variable is to be maintained. It
analyzes the input it receives by comparing it to the set point
and determines the appropriate response. Infor­mation (output)
then flows from the control center along the efferent pathway
to the third component, the effector. (To help you remember the
difference between “afferent” and “efferent,” note that informa­
tion traveling along the afferent pathway approaches the control
center and efferent information exits from the control center.)
3. The effector carries out the control center’s response to the
stimulus. The results of the response then feed back to influ­
ence the effect of the stimulus, either reducing it so that the
whole control process is shut off, or enhancing it so that the
whole process continues at an even faster rate.
Negative Feedback Mechanisms
Most homeostatic control mechanisms are negative feedback
mechanisms. In these systems, the output shuts off the
3 Input: Information
sent along afferent Control
pathway to control Center
center.
Afferent
pathway
Receptor
2 Receptor
detects change.
IMB
AL
1 Stimulus AN
CE
produces
change in
BALANCE
variable.
Figure 1.5 Interactions among the elements of a homeostatic control system
maintain stable internal conditions.
M01_MARI1803_12_GE_C01.indd 40
original effect of the stimulus or reduces its intensity. These
mechanisms cause the variable to change in a direction
opposite to that of the initial change, returning it to its “ideal”
value.
Let’s start with an example of a nonbiological nega­
tive feedback system: a home heating system connected to
a ­temperature-sensing thermostat. The thermostat houses
both the receptor (thermometer) and the control center. If
the thermostat is set at 20°C, the heating system (effector) is
setting. As the furnace produces heat and warms the air, the
temperature rises, and when it reaches 20°C or slightly higher,
the thermostat triggers the furnace OFF. This process results
in a cycling of the furnace between “ON” and “OFF” so that
the temperature in the house stays very near the desired tem­
perature. Your body “thermostat,” located in a part of your
brain called the hypothalamus, operates in a similar fashion
(Figure 1.6).
Regulation of body temperature is only one of the many
ways the nervous system maintains the constancy of the internal
environment. Another type of neural control mechanism is seen
in the withdrawal reflex mentioned earlier, in which the hand is
jerked away from a painful stimulus such as broken glass.
The endocrine system is equally important in maintaining
homeostasis. A good example of a hormonal negative feedback
mechanism is the control of blood sugar (glucose) by insulin.
As blood sugar rises, receptors in the body sense this change,
and the pancreas (the control center) secretes insulin into the
blood. This change in turn prompts body cells to absorb more
glucose, removing it from the bloodstream. As blood sugar
falls, the stimulus for insulin release ends.
The body’s ability to regulate its internal environment is
fundamental. All negative feedback mechanisms have the same
goal: preventing severe changes within the body. Body temper­
ature and blood sugar are only two of the variables that need to
4 Output: Information
sent along efferent
pathway to effector.
Efferent
pathway
Effector
5 Response
of effector feeds
back to reduce
the effect of
stimulus and
returns variable
to homeostatic
level.
IMB
AL
AN
CE
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 Chapter 1 The Human Body: An Orientation 41

Control Center
(thermoregulatory
center in brain)

Afferent Efferent
pathway pathway

Receptors
Temperature-sensitive Effectors
cells in skin and brain Sweat glands
1
Sweat glands activated

IMB Response
AL Evaporation of sweat
Body temperature AN
CE Body temperature falls;
rises stimulus ends
Stimulus: Heat BALANCE

Stimulus: Cold
Response
Body temperature rises; IMB Body temperature
AL falls
stimulus ends AN
CE

Effectors Receptors
Skeletal muscles Temperature-sensitive
cells in skin and brain

Efferent Afferent
Shivering begins pathway pathway

Control Center
(thermoregulatory
center in brain)

Figure 1.6 Body temperature is regulated by a negative feedback mechanism.

be regulated. There are many! Other negative feedback mech­
anisms regulate heart rate, blood pressure, the rate and depth
of breathing, and blood levels of oxygen, carbon dioxide, and
minerals.
Positive Feedback Mechanisms
In positive feedback mechanisms, the initial response
enhances the original stimulus so that further responses are
even greater. This feedback mechanism is “positive” because
the change that results proceeds in the same direction as the
initial change, causing the variable to deviate further and further
from its original value or range.
In contrast to negative feedback controls, which maintain
some physiological function or keep blood chemicals within
narrow ranges, positive feedback mechanisms usually control
infrequent events that do not require continuous adjustments.
Typically, they set off a linked sequence of events. Once ini­
tiated, the results of each reaction feed into the next like a
series of waterfalls on a river. Because of these character­
istics, positive feedback mechanisms are often referred to
as cascades (from the Italian word meaning “to fall”) that
amplify the original stimulus. Two familiar examples are the
enhancement of labor contractions during birth and blood
clotting.
Chapter 28 describes the positive feedback mechanism in
which oxytocin, a hypothalamic hormone, intensifies labor con­
tractions during the birth of a baby (see Figure 28.16, p. 1144).
Oxytocin causes the contractions to become both more frequent
and more powerful. The increased contractions cause more oxy­
tocin to be released, which causes more contractions, and so on
until the baby is born. The birth ends the stimulus for oxytocin
release and shuts off the positive feedback mechanism.

M01_MARI1803_12_GE_C01.indd 41 27/07/2022 16:57

 42 UNIT 1 Organization of the Body

1 Break or tear
Another important source of homeostatic imbalance occurs
occurs in blood when the usual negative feedback mechanisms are over­
vessel wall. whelmed and destructive positive feedback mechanisms take
over. Some instances of heart failure reflect this phenomenon.
Examples of homeostatic imbalance appear throughout this
book to enhance your understanding of normal physiological
Positive feedback mechanisms. This symbol introduces the homeostatic
cycle is initiated.
imbalance sections and alerts you to the fact that we are de­
scribing an abnormal condition. Each Homeostatic Imbalance
1 section is numbered to correspond with critical thinking ques­
tions available in the Study Area of —visit the
3 Released 2 Platelets
chemicals adhere to site
website to find Homeostatic Imbalance questions and other
attract more Positive and release helpful study tools.
platelets. feedback chemicals.
loop

Check Your Understanding

9. What process allows us to adjust to either extreme heat or
extreme cold?
10. Why is the control system shown in Figure 1.7 called a
Feedback cycle ends
when plug is formed. positive feedback mechanism? What event ends it?
11. APPLY When we begin to get dehydrated, we usually get
thirsty, which causes us to drink fluids. Is thirst part of a
4 Platelet plug is negative or a positive feedback control system? Explain
fully formed. your choice.
For answers, see Answers Appendix.

Figure 1.7 A positive feedback mechanism regulates

formation of a platelet plug.
Blood clotting is a normal response to a break in the wall
of a blood vessel and is an excellent example of an important
body function controlled by positive feedback. Once a vessel
has been damaged, blood elements called platelets immediately
begin to cling to the injured site and release chemicals that
attract more platelets. This rapidly growing pileup of platelets
temporarily “plugs” the tear and initiates the sequence of events
that finally forms a clot (Figure 1.7).
Positive feedback mechanisms are likely to race out of con­
trol, so they are rarely used to promote the moment-to-moment
well-being of the body. Some positive feedback mechanisms,
including this one, may have only local effects. For example,
blood clotting is accelerated in injured vessels, but does not
normally spread to the entire circulation.
Homeostatic Imbalance
Homeostasis is so important that most disease can be regarded
as a result of its disturbance, a condition called homeostatic
imbalance. As we age, our body’s control systems become less
efficient, and our internal environment becomes less and less
stable. These events increase our risk for illness and produce
the changes we associate with aging.
1.5 Anatomical terms describe body
directions, regions, and planes
Learning Outcomes
✔✔Describe the anatomical position.
✔✔Use correct anatomical terms to describe body directions,
regions, and body planes or sections.
Most of us are naturally curious about our bodies, but our
interest sometimes dwindles when we are confronted with the
terminology of anatomy and physiology. Let’s face it—you
can’t just pick up an anatomy and physiology book and read
it as though it were a novel. Unfortunately, confusion is likely
without precise, specialized terminology. To prevent misunder­
standing, anatomists use universally accepted terms to identify
body structures precisely and with a minimum of words. We
present and explain the language of anatomy next.
Anatomical Position and Directional Terms
To describe body parts and position accurately, we need an ini­
tial reference point, and we must indicate direction. The ana­
tomical reference point is a standard body position called the
anatomical position. In the anatomical position, the body is
erect with feet slightly apart. This position is easy to remem­
ber because it resembles “standing at attention,” except that
the palms face forward and the thumbs point away from the
body. You can see the anatomical position in Figure 1.8a and
Table 1.1 (top) on p. 44.
It is essential to understand the anatomical position because
most of the directional terms used in this book refer to the body

M01_MARI1803_12_GE_C01.indd 42 27/07/2022 16:57

 Chapter 1 The Human Body: An Orientation 43
Cephalic Cephalic
Frontal Otic
Orbital Occipital (back
Nasal of head)
Buccal (cheek) Upper limb
Oral Acromial Cervical
Mental (chin) Brachial (arm)
Cervical Antecubital
Thoracic Olecranal
Back (dorsal)
Sternal Antebrachial Scapular
Axillary (forearm) 1
Mammary Carpal (wrist)
Vertebral
Abdominal
Umbilical Lumbar
Manus (hand)
Pelvic Metacarpal Sacral
Inguinal Palmar
(groin) Pollex Gluteal
Digital
Perineal (between
Lower limb anus and external
Coxal (hip) genitalia)
Pubic (genital) Femoral (thigh)
Patellar
Popliteal
Crural (leg)
Sural (calf)
Fibular or peroneal

Pedal (foot)
Thorax
Tarsal (ankle)
Abdomen Calcaneal
Back (Dorsum) Metatarsal
Digital
Plantar
Hallux

(a) Anterior/Ventral (b) Posterior/Dorsal

Figure 1.8 Regional terms used to designate specific body areas. Common terms
are shown in parentheses. (a) Anatomical position. (b) The heels are raised to show the
plantar surface of the foot.

as if it were in this position, regardless of its actual position. Regional Terms

Another point to remember is that the terms “right” and “left”
The two fundamental divisions of our body are its axial and
refer to those sides of the person or the cadaver being viewed—
appendicular (ap0en-dik9u-lar) parts. The axial part, which
not those of the observer.
makes up the main axis of our body, includes the head, neck,
Directional terms allow us to explain where one body struc­
and trunk. The appendicular part consists of the appendages,
ture is in relation to another. For example, we could describe
or limbs, which are attached to the body’s axis. Regional terms
the relationship between the ears and the nose by stating, “The
used to designate specific areas within these major body divi­
ears are located on each side of the head to the right and left of
sions are indicated in Figure 1.8.
the nose.” Using anatomical terminology, this becomes “The
ears are lateral to the nose.” Using anatomical terms saves
words and is less ambiguous. Body Planes and Sections
Commonly used orientation and directional terms are de­ For anatomical studies, the body is often cut, or sectioned,
fined and illustrated in Table 1.1. Many of these terms are also along a flat surface called a plane. The most frequently used
used in everyday conversation, but remember as you study them body planes are sagittal, frontal, and transverse planes, which
that their anatomical meanings are very precise.

M01_MARI1803_12_GE_C01.indd 43 27/07/2022 16:57

 44 UNIT 1 Organization of the Body

Table 1.1 Orientation and Directional Terms

TERM DEFINITION EXAMPLE
Superior (cranial) Toward the head end or upper The head is superior to the
part of a structure or the body; abdomen.
above

1 Inferior (caudal) Away from the head end or The navel is inferior to the chin.
toward the lower part of a
structure or the body; below

Anterior (ventral)* Toward or at the front of the The breastbone is anterior to

body; in front of the spine.

Posterior (dorsal)* Toward or at the back of the The heart is posterior to the
body; behind breastbone.

Medial Toward or at the midline of the The heart is medial to the arm.
body; on the inner side of

Lateral Away from the midline of the The arms are lateral to the
body; on the outer side of chest.

Intermediate Between a more medial and a The collarbone is intermediate

more lateral structure between the breastbone and
shoulder.

Proximal Closer to the origin of the body The elbow is proximal to the
part or the point of attachment wrist.
of a limb to the body trunk

Distal Farther from the origin of The knee is distal to the thigh.
a body part or the point of
attachment of a limb to the
body trunk

Superficial (external) Toward or at the body surface The skin is superficial to the
skeletal muscles.

Deep (internal) Away from the body surface; The lungs are deep to the skin.
more internal

*The terms ventral and anterior are synonymous in humans, but this is not the case in four-legged animals. Anterior refers to the leading portion of the
body (abdominal surface in humans, head in a cat), but ventral specifically refers to the “belly” of a vertebrate animal, so it is the inferior surface of four-
legged animals. Likewise, although the dorsal and posterior surfaces are the same in humans, the term dorsal specifically refers to an animal’s back (as in
the dorsal fin of a shark). Thus, the dorsal surface of four-legged animals is their superior surface.

M01_MARI1803_12_GE_C01.indd 44 27/07/2022 16:57

Another random document with
no related content on Scribd:
reduced. It is like proposing a riddle, and then, after playing with the
curiosity and impatience of the company for some time, giving the
solution, which nobody else has the wit to find out. We never saw
fuller attendances or more profound attention than at the Tron
Church in Glasgow—it was like a sea of eyes, a swarm of heads,
gaping for mysteries, and staring for elucidations—it was not the
sublime or beautiful; the secret was that which has been here
explained, a desire to get rid of the difficult, the disagreeable, the dry,
and the discordant matter that had been conjured up in the
imagination. Dr. Chalmers, then, succeeds by the force of sophistry
and casuistry, in our humble judgment. Riddles (of which we spoke
just now) are generally traditional: those that Dr. Chalmers unfolds
from the pulpit, are of his own invention, or at least promulgation.
He started an objection to the Christian religion (founded on its
supposed inconsistency with the Newtonian philosophy) which
objection had never been noticed in books, on purpose that he might
answer it. ‘Well,’ said a Scotchman, ‘and if the answer was a good
one, was he not right?’ ‘No, assuredly,’ we should answer, ‘for there is
no faith so firm as that which has never been called in question.’ The
answer could only satisfy those who had been unsettled by the
question; and there would be many who would not be convinced by
the Doctor’s reasoning, however he might plume himself on his
success. We suspect that this is looking after a reputation for literary
ingenuity and philosophical depth, rather than the peace of
consciences or the salvation of souls; which, in a Christian minister,
is unbecoming, and savours of the Mammon of unrighteousness. We
ourselves were staggered by the blow (either then or long before) and
still gasp for a reply, notwithstanding Dr. Chalmers’s nostrum. Let
the reader briefly judge:—The Doctor tells us, it may be said, that the
Christian Dispensation supposes that the counsels of God turn upon
this world as its center; that there is a heaven above and an earth
beneath; and that man is the lord of the universe, the only creature
made in the divine likeness, and over whom Providence watches, and
to whom revelations are given, and an inheritance everlasting. This
agrees with the cosmogony of Moses, which makes the earth the
center of all things, and the sun, moon, and stars, little shining spots
like silver sixpences moving round it. But it does not so well agree
with Newton’s Principia (we state Dr. Chalmers’s objection) which
supposes the globe we inhabit to be but a point in the immensity of
the universe; that ours is but one, and that the most insignificant
(perhaps) among innumerable worlds, filled, probably, with created
intelligences, rational and fallen souls, that share the eye of God with
us, and who require to know that their Redeemer liveth. We alone (it
would appear) cannot pretend to monopolize heaven or hell: there
are other contingent candidates besides us. Jacob’s dream was
poetical and natural, while the earth was supposed to be a flat
surface and the blue sky hung over it, to which angels might ascend
by a ladder, and the face of God be seen at the top, as his lofty and
unchangeable abode; but this beautiful episode hardly accords with
the Antipodes. Sir Isaac turned the world upon its back, and divided
heaven from itself, and removed it far from every one of us. As we
thought the universe turned round the earth as its pivot, so religion
turned round man as its center, as the sole, important, moral and
accountable agent in existence. But there are other worlds revolving
in infinite space, to which this is a speck. Are they all desert,
worthless? Were they made for us? Have they no especial
dispensations of life and light? Have we alone a God, a Saviour,
revealed to us? Is religion triumphant only here, or is it itinerant
through each? It can hardly seem that we alone have occupied the
thoughts or been the sole objects of the plans of infinite wisdom from
eternity—that our life, resurrection, and judgment to come, are the
whole history of a wide-seeing Providence, or the loftiest events in
the grand drama of the universe, which was got up as a theatre only
for us to perform our petty parts in, and then to be cast, most of us,
into hell fire? Dr. Chalmers’s Astronomical Discourses indeed may
be said to dwarf his mighty subject, and make mankind a very
Lilliputian race of beings, which this Gulliver in vain dandles in the
hard, broad, brawny hand of school divinity, and tries to lift into
their bigotted self-sufficiency and exclusive importance again. How
does he answer his own objection, and turn the tables on himself—
how reverse this pitiful, diminished perspective, and aggrandise us in
our own estimation once more as undoubted heirs of heaven or of
hell—the sole favoured or reprobated sons of God? Why, his answer
is this—that the microscope has done as much to lift man in the scale
of being, and to enlarge the bounds of this atom the earth, as the
telescope has done to circumscribe and lessen it; that there are
infinite gradations BELOW man, worlds within worlds, as there are
degrees of being above, and stars and suns blazing round each other;
that, for what we know, a speck, a lucid drop circulating in a flea’s
back, may be another habitable globe like this!—And has that, too, a
revelation of its own, an avenging God, and a Christ crucified? Does
every particle in a flea’s back contain a Mosaic dispensation, a Popish
and a Protestant religion? Has it its Tron Church and its Caledonian
Chapel, and Dr. Chalmers’s Discourses and Mr. Irving’s Orations in
little? This does not seem to obviate the difficulty, but to increase it a
million-fold. It is his objection and his answer to it, not ours: if
blasphemy, it is his; and, if orthodoxy, he is entitled to all the credit
of it. But his whole scheme shows how impossible it is to reconcile
the faith delivered to the saints with the subtleties and intricacies of
metaphysics. It displays more pride of intellect than simplicity of
heart, is an insult equally on the understandings or prejudices of
men, and could only have been hit upon by that personification and
abstraction of cross-purposes, a Scotch metaphysical divine. In his
general preaching, Dr. Chalmers is a great casuist, and a very
indifferent moralist. He states the pros and cons of every question
with extreme pertinacity, and often ‘spins the thread of his verbosity
finer than the staple of his argument.’ He assigns possible reasons,
not practical motives, for conduct; and vindicates the ways of God,
and his own interpretation of the Scriptures, to the head, not to the
heart. The old school-divines set this practice afoot; for being
accustomed to hear the secrets of confession, and to salve the tender
consciences of the great and powerful, they had to bandy all sorts of
questions about; and if they could find out ‘a loop or peg to hang a
doubt on,’ were well rewarded for their trouble; they were constantly
reduced to their shifts, and forced to go on the forlorn hope of
morality by the ticklish cases referred to them for arbitration; and
when they had exhausted the resources of humanity and natural
sentiment, endeavoured to find new topics within the range of
abstract reason and possibility. Dr. Chalmers’s reasoning is as unlike
as possible to a chapter in the Gospels: but he may do very well to
comment on the Apocalypse or an Epistle of St. Paul’s. We do not
approve of this method of carving out excuses or defences of
doctrinal points from the dry parchment of the understanding or the
cobwebs of the brain. Whatever sets or leaves the dogmas of religion
at variance with the dictates of the heart, hardens the last, and lends
no advantage to the first.
 Mr. Irving is a more amiable moralist, and a more practical
reasoner. He throws a glancing, pleasing light over the gloomy
ground of Calvinism. There is something humane in his appeals,
striking in his apostrophes, graceful in his action, soothing in the
tones of his voice. He is not affected and theatrical; neither is he
deeply impassioned or overpowering from the simple majesty of his
subject. He is above common-place both in fancy and argument; yet
he can hardly rank as a poet or philosopher. He is a modernised
covenanter, a sceptical fanatic. We do not feel exactly on sure ground
with him—we scarcely know whether he preaches Christ crucified, or
himself. His pulpit style has a resemblance to the florid gothic. We
are a little mystified when a man with one hand brings us all the nice
distinctions and air-drawn speculations of modern unbelievers, and
arms the other with ‘fire hot from Hell,’—when St. Paul and Jeremy
Bentham, the Evangelists and the Sorrows of Werter, Seneca,
Shakespear, the author of Caleb Williams and the Political Justice,
are mingled together in the same passage, and quoted in the same
breath, however eloquent that breath may be. We see Mr. Irving
smile with decent scorn at this remark, and launch one more
thunderbolt at the critics. He is quite welcome, and we should be
proud of his notice. In the discourses he has lately delivered, and
which have drawn crowds to admire them, he has laboured to
describe the Sensual Man, the Intellectual Man, the Moral Man, and
the Spiritual Man; and has sacrificed the three first at the shrine of
the last. He gave certainly a terrific picture of the death-bed of the
Sensual Man—a scene where few shine—but it is a good subject for
oratory, and he made the most of it. He described the Poet well,
walking by the mountain side, in the eye of nature—yet oppressed,
panting rather than satisfied, with beauty and sublimity. Neither
Fame nor Genius, it is most true, are all-sufficient to the mind of
man! He made a fair hit at the Philosophers; first, at the Political
Economist, who draws a circle round man, gives him so many feet of
earth to stand upon, and there leaves him to starve in all his nobler
parts and faculties: next, at the great Jurisconsult, who carves out a
mosaic work of motives for him, cold, hard, and dry, and expects him
to move mechanically in right lines, squares, and parallelograms,
drills him into perfection, and screws him into utility. He then fell
foul of the Moralist and Sentimentalist, weighed him in the balance
and found him wanting—deficient in clearness of sight to discern
good, in strength of hand and purpose to seize upon it when
discerned. But Religion comes at last to the aid of the Spiritual Man,
couches the blind sight, and braces the paralytic limb; the Lord of
Hosts is in the field, and the battle is won, his countenance pours
light into our souls, and his hand stretched out imparts strength to
us, by which we tower to our native skies! In treating of this subject,
Mr. Irving introduced several powerful images and reflections, to
show how feeble moral and intellectual motives are to contend with
the allurements of sense and the example of the world. Reason alone,
he said, was no more able to stem the tide of prejudice and fashion,
than the swimmer with his single arm (here he used an appropriate
and spirited gesture, which reminded us of the description of the
heroic action of the swimmer in Sir Philip Sidney’s Arcadia) is able to
oppose the raging torrent, as the voice of conscience was only heard
in the tumultuous scenes of life like the faint cry of the sea-bird in
the wide world of waters. He drew an animated but mortifying sketch
of the progress of the Patriot and Politician, weaned by degrees from
his attachment to young Liberty to hug old Corruption; and showed
(strikingly enough) that this change from youthful ardour to a hoary,
heartless old age of selfishness and ridicule (there were several
Members of the Honourable House present) was not owing to
increased wisdom or strength of sight, but to faltering resolution and
weakness of hand, that could no longer hold out against the bribes,
the snares, and gilded chains prepared for it. The romantic Tyro was
right and free, the callous Courtier was a slave and self-conceited. All
this was true; it was honest, downright, and well put. There was no
cant in it, as far as regards the unequal odds and the hard battle that
reason has to fight with pleasure, or ambition, or interest, or other
antagonist motives. But does the objection apply to morality solely,
or has not religion its share in it? Man is not what he ought to be—
Granted; but is he not different from this ideal standard, in spite of
religion as well as of morality? Is not the religious man often a slave
to power, the victim of pleasure, the thrall of avarice, hard of heart, a
sensual hypocrite, cunning, mercenary, miserable? If it be said that
the really religious man is none of these, neither is the truly moral
man. Real morality, as well as vital Christianity, implies right
conduct and consistent principle. But the question simply at issue is,
whether the profession or the belief of sound moral opinion implies
these; and it certainly does it no more than the profession or belief of
orthodox religious opinions does. The conviction of the good or ill
consequences of our actions in this life does not absolutely conform
the will or the desires to good; neither does the apprehension of
future rewards or punishments produce this effect completely or
necessarily. The candidate for Heaven is a backslider; the dread of
eternal torments makes but a temporary impression on the mind.
This is not a reason, in our judgment, for neglecting or giving up in
despair the motives of religion or morality, but for strengthening and
cultivating both. With Mr. Irving, it is a triumphant and
unanswerable ground for discarding and denouncing morality, and
for exalting religion, as the sovereign cure for all wounds, as the
thaumaturgos, or wonder-worker, in the reform of mankind! We are
at a loss to understand how this exclusive and somewhat intolerant
view of the subject is reconcileable with sound reason or with history.
Religion is no new experiment now first making on mankind; we live
in the nineteenth century of the Christian æra; it is not as if we lived
in the age of apostles, when we might (from novelty and inexperience
of the intended dispensations of Providence) expect the earth to wear
a new face, and darkness suddenly to flee away before the light of the
gospel: nor do we apprehend that Mr. Irving is one of those who
believe with Mr. Croly, that the millennium actually commenced
with the battle of Waterloo; that event seems as far off, to all outward
appearance, as it was two thousand years ago. What does this make
against the doctrines of Christianity? Nothing; if, as far as they are
implanted and take root, they bear fruit accordingly,
notwithstanding the repugnance and thanklessness of the soil. Why
then is Mr. Irving so hard upon the labours of philosophers,
moralists, and men of letters, because they do not do all their work at
once? Bishop Butler indeed wrote a most able and learned quarto
volume, to prove that the slow growth and imperfect influence of
Christianity was a proof of its divine origin, and that in this respect
we had a right to look for a direct analogy between the operations of
the world of grace and nature, both proceeding as they did from the
same Almighty hands! Our deservedly popular preacher has,
however, an answer to what we have here stated: he says, ‘the time
MUST and WILL shortly come!’ We never contradict prophecies; we
only speak to facts. In addressing himself to this point, Mr. Irving
made a spirited digression to the Missionary Societies, and the
impending propagation of the Gospel at home and abroad—all
obstacles to it would speedily be surmounted:—‘The Negro slave was
not so enchained but that the Gospel would set him free; the
Hottentot was not so benighted but that its light would penetrate to
him; the South Sea Islander was not so indolent and voluptuous but
that he would rouse himself at its call; neither the cunning of the
Italian, nor the superstition of the Spaniard, nor the tameness of the
German, nor the levity of the French, nor the buoyancy of the Irish,
nor the indomitable pride of the English, nor the fiery manhood of
the Scotch, would be long able to withstand its all-pervading
influence!’ We confess, when our Caledonian pastor launched his
canoe from the South Sea Isles and landed on European terra firma,
taking measure of the vices of each nation that were opposed to the
spirit of Christianity, we did prick up our ears to know what fault he
would, in due course of argument, find with his native country—it
would go against the grain, no doubt, but still he had undertaken it,
and he must speak out—When lo! for some sneaking vice or sordid
pettifogging disposition, we have our own ‘best virtue’ palmed upon
us as the only failing of the most magnanimous natives of the North
—fiery manhood, quotha! The cold sweat of rankling malice,
hypocrisy, and servility, would be nearer the mark—Eh! Sir Walter?
Nay, good Mr. Blackwood, we meant no offence to you! ‘Fiery
manhood’ is the Anti-Christian vice or virtue of the Scotch that meets
true religion on the borders, and beats her back with suffocating
breath! Is Christianity still then to be planted like oak timber in
Scotland? What will Dr. Chalmers and the other labourers in the
vineyard say to this?—‘We pause for a reply!’ The best and most
impressive part of Mr. Irving’s discourse (Sunday, the 22nd June)
was that, in which he gave a very beautiful account of what
Christianity had done, or rather might do, in aid of morality and the
regeneration of the spirit of man. It had made ‘corruption blossom,’
‘annihilated time in the prospect of eternity,’ and ‘changed all nature,
from a veil hiding the face of God, into a mirror reflecting his power
and beneficence.’ We do not, however, see why in the fervour of his
enthusiasm he should affirm ‘that Jesus Christ had destroyed
melody,’ nor why, by any allowed licence of speech, he should talk of
‘the mouth of God being muzzled by man.’ We might not perhaps
have noticed this last expression, considering it as a slip of the
tongue; but Mr. Irving preaches from written notes, and his style is,
on the whole, polished and ambitious. We can conceive of a deeper
strain of argument, of a more powerful and overwhelming flood of
eloquence; but altogether we deem him an able and attractive
expounder of Holy Writ; and farther, we believe him to be an honest
man. We suspect there is a radical ‘taint in him,’ and that Mr.
Canning will be advised to withdraw himself from the congregation.
His strokes aimed at iniquity in high places are bold, unsparing, and
repeated. We would however suggest to him the propriety of
containing his indignation at the advancement of the secular
priesthood by ‘the powers that be;’ it is a thing of course, and his
impatience of their elevation may be invidiously construed into a
jealousy of the spoil. When we compare Mr. Irving with some other
preachers that we have heard, and particularly with that crawling
sycophant Daniel Wilson (who tendered his gratuitous submission to
Nero the other day in the excess of his loyalty to George IV.) we are
sorry that we have not been able to make our tribute of approbation
unqualified as it is cordial, and to stifle their venal breath with the
applauses bestowed upon him. ‘Oh! for an eulogy to kill’ all such
with!
 ARGUING IN A CIRCLE

The Liberal.]
[1823.

There was an account in the newspapers the other day of a fracas

in the street, in which a Lord and one or two Members of Parliament
were concerned. It availed them nought to plead the privilege of
Peerage, or to have made speeches in the House—they were held to
bail, like the vilest of the rabble, and the circumstance was not
considered one to come before the public. Ah! it is that public that is
the sad thing. It is the most tremendous ring that ever was formed to
see fair play between man and man; it puts people on their good
behaviour immediately; and wherever it exists, there is an end of the
airs and graces which individuals, high in rank, and low in
understanding and morals, may chuse to give themselves. While the
affair is private and can be kept in a corner, personal fear and favour
are the ruling principles, might prevails over right: but bring it
before the world, and truth and justice stand some chance. The
public is too large a body to be bribed or browbeat. Its voice, deep
and loud, quails the hearts of princes: its breath would make the
feather in a lord’s cap bend and cower before it, if its glance,
measuring the real magnitude of such persons with their lofty, tiptoe,
flaunting pretensions, had not long since taken the feathers out of
their caps. A lord is now dressed (oh! degenerate world) like any
other man; and a watchman will no sooner let go his grasp of his
plain collar than he will that of a Commoner or any other man, who
has his ‘fancies and good-nights.’ What a falling off is here from the
time when if a ‘base cullionly fellow’ had dared to lay hands on a
nobleman, on ‘one of quality,’ he would have whipped his sword out
of its scabbard and run him through the body; the ‘beggarly,
unmannered corse’ would have been thrown into the Thames or the
next ditch; and woe to any person that should have attempted to
make a stir in the matter! ‘The age of chivalry is gone, that of
constables, legislators, and Grub-street writers, has succeeded, and
the glory of heraldry is extinguished for ever.’
‘The melancholy Jacques grieves at that.’

Poor Sir Walter! the times are changed indeed, since a Duke of
Buckingham could send a couple of bullies, equipped in his livery,
with swords and ribbons, to carry off a young lady from a Peveril of
the Peak, by main force, in the face of day, and yet the bye-standers
not dare to interfere, from a dread of the Duke’s livery and the High
Court of Star Chamber! It is no wonder that the present Duke of
Buckingham (the old title new revived) makes speeches in the Upper
House to prove that legitimate monarchs have a right, whenever they
please, to run their swords through the heart of a nation and pink the
liberties of mankind, thinking if this doctrine were once fully
restored, the old times of his predecessor might come again,—
‘New manners and the pomp of elder days!’

It is in tracing the history of private manners that we see (more than

any thing else) the progress that has been made in public opinion
and political liberty, and that may be still farther made. No one
individual now sets up his will as higher than the law: no noble Duke
or Baron bold acts the professed bully or glories in the character of a
lawless ruffian, as a part of the etiquette and privileges of high rank:
no gay, gaudy minion of the court takes the wall of the passengers,
sword in hand, cuts a throat, washes his white, crimson-spotted
hands, and then to dinner with the king and the ladies.—That is over
with us at present; and while that is the case, Hampden will not have
bled in the field, nor Sydney on the scaffold, in vain! Even the
monarch in this country, though he is above the law, is subject to
opinion; ‘submits,’ as Mr. Burke has it, both from choice and
necessity, ‘to the soft collar of social esteem, and gives a domination,
vanquisher of laws, to be subdued by manners!’
It is this which drives the Despots of the Continent mad, and
makes their nobles and chief vassals league together, like a herd of
tygers, to destroy the example of liberty which we (the people of
England) have set to the rest of the world. They are afraid that if this
example should spread and things go on much farther in the road
they have taken, they will no longer be able to give their subjects and
dependants the knout, to send them to the galleys or a dungeon
without any warrant but their own unbridled will, and that a lord or a
king will be no more above the law than any other man. Mankind, in
short, till lately and except in this country, were considered as a herd
of deer which the privileged classes were to use for their pleasure, or
which they were to hunt down for spite or sport, as liked them best.
That they should combine together with a knot of obscure
philosophers and hair-brained philanthropists, to set up a plea not to
be used at any man’s pleasure, or hunted down like vermin for any
man’s sport, was an insult to be avenged with seas of blood, an attack
upon the foundations of social order, and the very existence of all
law, religion, and morality. In all the legitimate governments of
Europe, there existed, and there still exist, a number of individuals
who were exempted (by birth and title) from the law, who could offer
every affront to religion, and commit every outrage upon morality
with impunity, with insolence and loud laughter, and who pretended
that in asserting this monstrous privilege of theirs to the very letter,
the essence of all law, religion, and morality consisted. This was the
case in France till the year 1789. The only law was the will of the rich
to insult and harass the poor, the only religion a superstitious
mummery, the only morality subserviency to the pleasures of the
great. In the mild reign of Louis XV. only, there were fifteen thousand
lettres de cachet issued for a number of private, nameless offences,
such as the withholding a wife or daughter from the embraces of
some man of rank, for having formerly received favours from a king’s
mistress, or writing an epigram on a Minister of State. It was on the
ruins of this flagitious system (no less despicable than detestable)
that the French Revolution rose; and the towers of the Bastille, as
they fell, announced the proud truth in welcome thunder to the
human race—to all but those who thought they were born, and who
only wished to live, to exercise their sweeping, wholesale, ruthless
tyranny, or to vent the workings of their petty, rankling spleen, pride,
bigotry, and malice, in endless, tormenting details on their fellow-
creatures.
It will, I conceive, hereafter be considered as the greatest enormity
in history, the stupidest and the most barefaced insult that ever was
practised on the understandings or the rights of men, that we should
interfere in this quarrel between liberty and slavery, take the wrong
side, and endeavour to suppress the natural consequences of that
very example of freedom we had set. That we should do this, we who
had ‘long insulted the slavery of Europe by the loudness of our boasts
of freedom,’ who had laughed at the Grand Monarque for the last
hundred and fifty years, and treated his subjects with every indignity,
as belonging to an inferior species to ourselves, for submitting to his
cruel and enervated sway; that the instant they took us at our word
and were willing to break the chains of Popery and Slavery that we
never ceased to taunt them with, we should turn against them, stand
passive by ‘with jealous leer malign,’ witnessing the machinations of
despots to extinguish the rising liberties of the world, and with the
first plausible protest, the first watch-word given (the blow aimed at
the head of a king confederate with the enemies of his country
against its freedom) should join the warwhoop, and continue it
loudest and longest, and never rest, under one hollow, dastard,
loathsome pretence or other, till we had put down ‘the last example
of democratic rebellion’ (we, who are nothing but rebellion all over,
from the crown of the head to the sole of the foot!) and had restored
the doctrine of Divine Right, that had fallen headless from its throne
of Ignorance and Superstition with the First Charles, long before it
was condemned to the same fate in the person of the French king;
that we should do this, and be led, urged on to the unhallowed task
by a descendant of the House of Brunswick, who held his crown in
contempt of the Stuarts, and grew old, blind, and crazed in the
unsated, undiverted, sacred thirst of Legitimacy, is a thing that
posterity will wonder at. We pretend to have interfered to put down
the horrors of the French Revolution, when it was our interference
(with that of others) that produced those horrors, of which we were
glad as an excuse to justify our crooked policy and to screen the
insidious, deadly, fatal blow aimed at liberty. No; the ‘cause was
hearted’ in the breasts of those who reign, or who would reign, in
contempt of the people, and with whom it rests to make peace or
war. Is not the same principle at work still? What horrors have the
Holy Alliance to plead in vindication of their interference with
Spain? They have not a rag, a thread of all their hideous tissue of
sophistry and lies to cover ‘the open and apparent shame’ of this
sequel and consistent comment on their former conduct. It is a
naked, barefaced, undisguised attack upon the rights and liberties of
the world: it is putting the thing upon its true and proper footing—
the claim of Kings to hold mankind as a property in perpetuity. There
are no horrors, real or pretended, to warrant this new outrage on
common sense and human nature. It stands on its own proud basis
of injustice—it towers and mocks the skies in all the majesty of regal
wrong. ‘The shame, the blood be upon their heads.’ If there are no
horrors ready-made to their hands, they stand upon their privilege to
commit wanton outrage and unqualified aggression; and if by these
means they can provoke horrors, then the last are put first as the
most plausible plea, as a handsome mask and soft lining to the hard
gripe and features of Legitimacy—Religion consecrates, and Loyalty
sanctions the fraud! But, should the scheme fail in spite of every art
and effort, and the wrong they have meditated be retorted on their
own heads, then we shall have, as before, an appeal made to Liberty
and Humanity—the motto of despots will once more be peace on
earth and good will to men—and we too shall join in the yell of blood
and the whine of humanity. We are only waiting for an excuse now—
till the threats and insults and cruelties of insolent invaders call forth
reprisals, and lead to some act of popular fury or national justice that
shall serve as a signal to rouse the torpid spirit of trade in the city, or
to inflame the loyalty of country gentlemen deaf for the present to all
other sounds but that appalling one of Rent! We must remain neuter
while a grievous wrong is acting, unless we can get something by the
change, or pick a quarrel with the right. We are peaceable, politic,
when a nation’s liberty only is at stake, but were it a monarch’s
crown that hung tottering in the air, oh! how soon would a patriot
senate and people start out to avenge the idle cause: a single speech
from the throne would metamorphose us into martyrs of self-
interest, saviours of the world, deliverers of Europe from lawless
violence and unexampled wrong. But here we have no heart to stir,
because the name of liberty alone (without the cant of loyalty) has
lost its magic charm on the ears of Englishmen—impotent to save,
powerful only to betray and destroy themselves and others!
We want a Burke to give the thing a legitimate turn at present. I
am afraid the Editor of the New Times can hardly supply his place.
They could hardly have done before, without that eloquent apostate,
that brilliant sophist, to throw his pen into the scale against truth
and liberty. He varnished over a bad cause with smooth words, and
had power to ‘make the worse appear the better reason’—the devil’s
boast! The madness of genius was necessary to second the madness
of a court; his flaming imagination was the torch that kindled the
smouldering fire in the inmost sanctuary of pride and power, and
spread havoc, dismay, and desolation through the world. The light of
his imagination, sportive, dazzling, beauteous as it seemed, was
followed by the stroke of death. It so happens that I myself have
played all my life with his forked shafts unhurt, because I had a
metaphysical clue to carry off the noxious particles, and let them sink
into the earth, like drops of water. But the English nation are not a
nation of metaphysicians, or they would have detected, and smiled or
wept over the glittering fallacies of this half-bred reasoner, but, at the
same time, most accomplished rhetorician that the world ever saw.
But they are perplexed by sophistry, stupified by prejudice, staggered
by authority. In the way of common sense and practical inquiry, they
do well enough; but start a paradox, and they know not what to make
of it. They either turn from it altogether, or, if interest or fear give
them motives to attend to it, are fascinated by it. They cannot
analyze or separate the true from the seeming good. Mr. Pitt, with
his deep-mouthed common-places, was able to follow in the same
track, and fill up the cry; but he could not have given the tone to
political feeling, or led on the chase with ‘so musical a discord, such
sweet; thunder.’ Burke strewed the flowers of his style over the rotten
carcase of corruption, and embalmed it in immortal prose: he
contrived, by the force of artful invective and misapplied epithets, to
persuade the people of England that Liberty was an illiberal, hollow
sound; that humanity was a barbarous modern invention, that
prejudices were the test of truth; that reason was a strumpet, and
right a fiction. Every other view of the subject but his (‘so well the
tempter glozed’) seemed to be without attraction, elegance, or
refinement. Politics became poetry in his hands, his sayings passed
like proverbs from mouth to mouth, and his descriptions and similes
were admired and repeated by the fashionable and the fair. Liberty
from thenceforward became a low thing: philosophy was a spring-
nailed, velvet-pawed tyger-cat, with green eyes, watching its
opportunity to dart upon its prey: humanity was a lurking assassin.
The emblems of our cardinal and favourite virtues were overturned:
the whole vocabulary of national watch-words was inverted or
displaced. This was a change indeed in our style of thinking, more
alarming than that in our calendar formerly: and this change was
brought about by Mr. Burke, who softened down hard reasons in the
crucible of his fancy, and who gave to his epithets the force of
nicknames. Half the business was done by his description of the
Queen of France. It was an appeal to all women of quality; to all who
were, or would be thought, cavaliers or men of honour; to all who
were admirers of beauty, or rank, or sex. Yet what it had to do with
the question, it would be difficult to say. If a woman is handsome, it
is well: but it is no reason why she should poison her husband, or
betray a country. If, instead of being young, beautiful, and free of
manners, Marie Antoinette had been old, ugly, and chaste, all this
mischief had been prevented. The author of the Reflections had seen
or dreamt he saw a most delightful vision sixteen years before, which
had thrown his brain into a ferment; and he was determined to
throw his readers and the world into one too. It was a theme for a
copy of verses, or a romance; not for a work in which the destinies of
mankind were to be weighed. Yet she was the Helen that opened
another Iliad of woes; and the world has paid for that accursed
glance at youthful beauty with rivers of blood. If there was any one of
sufficient genius now to deck out some Castilian maid, or village girl
in the Army of the Faith, in all the colours of fancy, to reflect her
image in a thousand ages and hearts, making a saint and a martyr of
her; turning loyalty into religion, and the rights and liberties of the
Spanish nation, and of all other nations, into a mockery, a bye-word,
and a bugbear, how soon would an end be put to Mr. Canning’s
present bizarre (almost afraid to know itself) situation! How gladly
he would turn round on the pivot of his forced neutrality, and put all
his drooping tropes and figures on their splendid war-establishment
again!
Mr. Burke was much of a theatrical man. I do not mean that his
high-wrought enthusiasm or vehemence was not natural to him; but
the direction that he gave to it, was exceedingly capricious and
arbitrary. It was for some time a doubtful question which way he
should turn with respect to the French Revolution, whether for or
against it. His pride took the alarm, that so much had been done with
which he had nothing to do, and that a great empire had been
overturned with his favourite engines, wit and eloquence, while he
had been reforming the ‘turn-spit of the king’s kitchen,’ in set
speeches far superior to the occasion. Rousseau and the
Encyclopædists had lamentably got the start of him; and he was
resolved to drag them back somehow by the heels, and bring what
they had effected to an untimely end,—
‘Undoing all, as all had never been.’

The ‘Reflections on the French Revolution’ was a spiteful and dastard

but too successful attempt to put a spoke in the wheels of knowledge
and progressive civilization, and throw them back for a century and a
half at least. In viewing the change, in the prospects of society, in
producing which he had only a slight and indirect hand by his efforts
in the cause of American freedom, he seemed to say, with Iago in the
play,—
‘Though that their joy be joy,
Yet will I contrive
To throw such changes of vexations on it;
As it may lose some colour.’

He went beyond his own most sanguine hopes, but did not live to
witness their final accomplishment, by seeing France literally
‘blotted out of the map of Europe.’ He died in the most brilliant part
of Buonaparte’s victorious and captain-like campaigns in Italy. If it
could have been foreseen what an ‘ugly customer’ he was likely to
prove, the way would have been to have bribed his vanity (a great
deal stronger than his interest) over to the other side, by asking his
opinion; and, indeed, he has thrown out pretty broad hints in the
early stage of his hostility, and before the unexpected success of the
French arms, and the whizzing arrows flung at him by his old friends
and new antagonists had stung him to madness, that the great error
of the National Assembly was in not having consulted able and
experienced heads on this side the water, as to demolishing the old,
and constructing the new edifice. If he had been employed to lay the
first stone, or to assist, by an inaugural dissertation, at the baptism of
the new French Constitution, the fabric of the Revolution would
thenceforth have risen,—
‘Like an exhalation of rich distilled perfumery,’

without let or molestation from his tongue or pen. But he was

overlooked. He was not called from his closet, or from his place in
the House (where, it must be confessed, he was out of his place) to
‘ride in the whirlwind and direct the storm’; and therefore he tried,
like some malicious hag, to urge the veering gale into a hurricane; to
dash the labouring vessel of the state in pieces, and make shipwreck
of the eternal jewel of man’s happiness, which it had on board—
Liberty. The stores of practical and speculative knowledge which he
had been for years collecting and digesting, and for which he had no
use at home, were not called into play abroad. His genius had
hitherto been always too mighty for the occasion; but here his utmost
grasp of intellect would hardly have been sufficient to grapple with it.
What an opportunity was lost! Something, therefore, was to be done,
to relieve the galling sense of disappointed ambition and mortified
self-consequence. Our political Busy body turned Marplot; and
maliciously, and like a felon, strangled the babe that he was not
professionally called in to swaddle, and dandle, and bring to
maturity. He had his revenge: but so must others have their’s on his
memory.
Burke was not an honest man. There was always a dash of
insincerity, a sinister bias in his disposition. We see, from the letters
that passed between him and his two brothers, and Barry the painter,
that there was constantly a balancing of self-interest and principle in
his mind; a thanking of God that he was in no danger of yielding to
temptation, yet as if it were a doubtful or ticklish point; and a
patient, pensive expectation of place and emolument, till he could
reconcile it with integrity and fidelity to his party; which might easily
be construed into a querulous hankering after it, and an opinion that
this temporary self-denial implied a considerable sacrifice on his
part, or that he displayed no small share of virtue in not immediately
turning knave. All this, if narrowly looked into, has a very suspicious
appearance. Burke, with all his capricious wildness and flighty
impulses, was a self-seeker and more constant in his enmities than in
his friendships. He bore malice, and did not forgive to the last. His
cold, sullen behaviour to Fox, who shed tears when they had a
quarrel in the House, and his refusal to see him afterwards, when the
latter came to visit him on his death-bed, will for ever remain a
stigma on his memory. He was, however, punished for his fault. In
his latter writings, he complains bitterly of the solitariness of his old
age, and of the absence of the friends of his youth—whom he had
deserted. This is natural justice, and the tribute due to apostacy. A
man may carry over his own conscience to the side of his vanity or
interest, but he cannot expect, at the same time, to carry over along
with him all those with whom he has been connected in thought and
action, and whose society he will miss, sooner or later. Mr. Burke
could hardly hope to find, in his casual, awkward, unaccountable
intercourse with such men as Pitt or Dundas, amends for the loss of
his old friends, Fox and Sheridan, to whom he was knit not only by
political ties, but by old habitudes, lengthened recollections, and a
variety of common studies and pursuits. Pitt was a mere politician;
Dundas, a mere worldling. What would they care about him, and his
‘winged words’? No more of talk about the meetings at Sir Joshua’s—
the Noctes cœnæque Deûm; about the fine portraits of that great
colourist; about Johnson or Goldsmith, or Dunning or Barrè; or their
early speeches; or the trying times in the beginning of the American
war; or the classic taste and freeborn spirit of Greece and Rome;—
‘The beautiful was vanish’d, and return’d not.’

Perhaps, indeed, he would wish to forget most of these, as ungrateful

topics; but when a man seeks for repose in oblivion of himself, he
had better seek it, where he will soonest find it,—in the grave!
Whatever the talents, or the momentary coincidence of opinion of his
new allies, there would be a want of previous sympathy between
them. Their notions would not amalgamate, or they would not be
sure that they did. Every thing would require to be explained, to be
reconciled. There would be none of the freedom of habitual intimacy.
Friendships, like the clothes we wear, become the easier from
custom. New friendships do not sit well on old or middle age.
Affection is a science, to which it is too late to serve an
apprenticeship after a certain period of life. This is the case with all
patched-up, conventional intimacies; but it is worse when they are
built on inveterate hostility and desertion from an opposite party,
where their naturally crude taste is embittered by jealousy and
rankling wounds. We think to exchange old friends and connections
for new ones, and to be received with an additional welcome for the
sacrifice we have made; but we gain nothing by it but the contempt of
those whom we have left, and the suspicions of those whom we have
joined. By betraying a cause, and turning our backs on a principle,
we forfeit the esteem of the honest, and do not inspire one particle of
confidence or respect in those who may profit by and pay us for our
treachery.
Deserters are never implicitly trusted. There is, besides the
sentiment or general principle of the thing, a practical reason for
this. Their zeal, their eagerness to distinguish themselves in their
new career, makes them rash and extravagant; and not only so, but
there is always a leaven of their old principles remaining behind,
which breaks out in spite of themselves, and which it is difficult for
their encouragers and patrons to guard against. This was remarkably
the case with the late Mr. Windham. He was constantly running a-
muck at some question or other, and committing the Ministers. His
old, free-thinking, opposition habits returned upon him before he
was aware of it; and he was sure to hazard some paradox, or stickle
for some objectionable point, contrary to the forms of office. The
cabinet had contemplated no such thing. He was accordingly kept in
check, and alarmed the treasury-bench whenever he rose. He was
like a dog that gives mouth before the time, or is continually running
on a stray scent: he was chid and fed! The same thing is observable in
the present Poet-Laureat, whose jacobinical principles have taken
such deep root in him (intus et in cute) that they break out even in
his Court poems, like ‘a thick scurf’ on loyalty; and he presents them
unconsciously, (as an offering of ‘sweet smelling gums,’) at the very
foot of the throne. He at present retains his place apparently on
condition of holding his tongue. He writes such Odes on kings, that it
is next to impossible not to travestie them into lampoons!
The remarks I have made above apply strongly to him and some of
his associates of the Lake School. I fancy he has felt, as much as
anyone, the inconvenience of drawing off from a cause, and that by
so doing we leave our oldest and our best friends behind. There are
those among the favourers and admirers of his youth, whom his dim
eyes discover not, and who do not count his grey hairs. Not one or
two, but more;—men of character and understanding, who have
pledged mutual faith, and drank the cup of freedom with him, warm
from the wine-press, as well as the ‘dews of Castalie.’ He gave up a
principle, and one left him;—he insulted a feeling, and another fled;
he accepted a place, and received the congratulations of no one but
Mr. Croker. He looks round for them in vain, with throbbing heart,
(the heart of a poet can never lie still; he should take the more care
what it is that agitates it!)—sees only the shadows or the carcases of
old friendships; or stretches out his hand to grasp some new patron,
and finds that also cold. If our friends are sometimes accused of
short memories, our enemies make it up by having long ones. We
had better adhere to the first; for we must despair of making cordial
converts of the last. This double desolation is cheerless, and makes a
man bethink himself. We may make a shift (a shabby one) without
our self-respect; but it will never do to have it followed by the loss of
the respect of those whose opinion we once valued most. We may
tamper with our own consciences; but we feel at a loss without the
testimony of others in our favour, which is seldom paid, except to
integrity of purpose and principle. Perhaps, however, Mr. Southey
consoles himself for a certain void without and within, by receiving
the compliments of some Undergraduate of either of our
Universities, on his last article in defence of Rotten Boroughs, in the
Quarterly Review; or of a Dignitary of the Church, on his share in the
Six Acts, and for suggesting to Lord Sidmouth the propriety of
punishing the second conviction for libel with banishment. We do
not know how this may be: but with us, it would barb the dart.
It would not matter, if these turn-coats were not in such violent
extremes. Between the two, they must be strangely perplexed in their
own minds, and scarcely know what to make of themselves. They
must have singular qualms come over them at times—the apparitions
of former acquaintance and opinions. If they were contented to
correct, to qualify their youthful extravagancies, and to be taught by
experience to steer a middle course, and pay some deference to the
conclusions of others, it would be mighty well; but this is not their
humour. They must be conspicuous, dogmatical, exclusive,
intolerant, on whichever side they are: the mode may be different,
the principle is the same. A man’s nature does not change, though he
may profess different sentiments. A Socinian may become a
Calvinist, or a Whig a Tory: but a bigot is always a bigot; an egotist
never becomes humble. Besides, what excuse has a man, after thirty,
to change about all of a sudden to the very opposite side? If he is an
uneducated man, he may indeed plead ignorance yesterday of what
he has learnt to-day: but a man of study and reading can’t pretend
that a whole host of arguments has suddenly burst upon him, of
which he never heard before, and that they have upset all his earlier
notions: he must have known them long before, and if they made no