Table of Contents

Titles of related interest

Website

Dedication

Title page

About the Series

Contributors

Preface

Anatomy and Physiology
The Nursing and Midwifery Council
Chapter Content
Web-Based Materials
References

Acknowledgements

How to Use Your Textbook

Features Contained within Your Textbook
The Anytime, Anywhere Textbook

About the Companion Website

Chapter 1: The Child in Society: Enhancing Health and Wellbeing

Aim
Introduction
The Concept of Childhood
The Child's ‘Voice’
Fundamental Aspects of Children's Lives
Children's Health and Wellbeing
Child Public Health
Promoting Child Health: The Role of the Children's Nurse
Morbidity and Mortality
Conclusion
References

Chapter 2: Homeostasis

Aim
Introduction
Regulation of Homeostasis
Homeostatic Mechanisms
Energy Production
Systematic Approach to Homeostasis
Thermoregulation
Conclusion
Activities
References

Chapter 3: Scientific Principles

Aim
Introduction
Levels of Organization
Characteristics of Life
Bodily Requirements
Atoms
Units of Measurement
Conclusion
Activities
References

Chapter 4: The Cell

Aim
Introduction
Characteristics of the Cell
The Structure of the Cell
The Organelles
Fluids and the Body
Conclusion
Activities
References

Chapter 5: Genetics

Aim
Introduction
Genes
From DNA to Proteins
The Transference of Genes
Mendelian Genetics
Conclusion
Activities
References

Chapter 6: Tissues

Aim
Introduction
Types of Tissues
Tissue Repair
Children and Tissue Development
Conclusion
Activities
References

Chapter 7: The Immune System

Aim
Introduction
Blood Cell Development
The Organs and Tissues of the Immune System
Types of Immunity
Immunoglobulins (Antibodies)
Actions of Antibodies
Immunizations
Conclusion
Activities
References

Chapter 8: Blood

Aim
Introduction
Composition of Blood
Functions of Blood
Constituents of Blood
Blood Vessels
Structure and Function of Blood Vessels
Conclusion
Activities
References

Chapter 9: The Cardiac System

Aim
Body Map
Introduction
Fetal Circulation
Changes at Birth
Position and Size of the Heart
Structures of the Heart
The Electrical Pathway through the Heart
Electrocardiogram
The Cardiac Cycle
Cardiac Output
Factors Affecting the Heart Rate
Conclusion
Conditions to Consider in Relation to the Cardiac System
Activities
References

Chapter 10: The Respiratory System

Aim
Body Map
Introduction
The Airway
The Lungs
Conclusion
Activities
References

Chapter 11: The Endocrine System

Aim
Introduction
Physiology of the Endocrine System
Anatomy of the Endocrine System
Conclusion
Activities
References

Chapter 12: The Digestive System and Nutrition

Aim
Body Map
Introduction
Fetal Development and Infant Nutrition
The Anatomy and Physiology
Conclusion
Activities
References

Chapter 13: The Renal System

Aim
Introduction
The Renal System
The Kidney
Functions of the Kidney
Blood Supply to the Kidneys
Formation of Urine
Composition of Urine
The Ureters
The Bladder
The Urethra
Function of the Bladder and Micturition
Conclusion
Activities
References

Chapter 14: The Reproductive Systems

Aim
Introduction
Fetal Embryology: Sexual Differentiation
The Male Reproductive System
The Female Reproductive System
Conclusion
Activities
References

Chapter 15: The Nervous System

Aim
Introduction
Organization of the Nervous System
Cellular Structure of the Nervous System
Transmission of Nerve Impulses
Fetal Development
Childhood Development
Central Nervous System
Peripheral Nervous System
Conclusion
‘Did You Know’ Information
Activities
References

Chapter 16: The Muscular System

Aim
Introduction
Muscle Development in Early Life
Types of Muscle Tissue
Function of Musculature System
Gross Anatomy of Skeletal Muscle
The Micro-Anatomy of the Muscle
Types of Muscle Fibres
Skeletal Muscle Relaxation and Contraction
Energy Requirements for Muscle Contraction
Organization of Skeletal Muscle
Conclusion
Activities
References

Chapter 17: The Skeletal System

Aim
Body Map
Introduction
The Function of the Skeleton
Bone Structure and Growth
Bone Healing
Bone Classification
Joints
Conclusion
Activities
References

Chapter 18: The senses

Aim
Introduction
The Sense of Smell (Olfaction)
The Sense of Taste (Gustation)
The Ear
Sight
Conclusion
Activities
References

Chapter 19: The Skin

Aim
Introduction
The Structure of Skin
Functions of the Skin
Conclusion
Activities
References

Self-assessment Answers

Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19

Index

End User License Agreement

List of Tables

Table 1.1 Key documents that advocate the involvement of children.

Table 2.1 Normal blood gas values. Source: Adapted from Higgins (2007) and Moules and Ramsay (2008).

Table 2.2 Essential and non-essential amino acids in children. Source: Adapted from Waugh and Grant (2010) and Cedar (2012).

Table 3.1 The fundamental SI units and other common SI units. Source: Peate and Nair (2011), Tables 1.1 and 1.2, p. 21. Reproduced with permission of John Wiley and Sons, Ltd.

Table 3.2 Multiples of SI units. Source: Peate and Nair (2011), Table 1.3, pp. 21–22. Reproduced with permission of John Wiley and Sons, Ltd.

Table 3.3 Measures of weight, volume, length and energy. Source: Peate and Nair (2011), Tables 1.4–1.7, pp. 22–23. Reproduced with permission of John Wiley and Sons, Ltd.

Table 4.1 Cellular compartments and their functions. Source: Peate and Nair (2011), Table 2.1, p. 36. Reproduced with permission of John Wiley and Sons, Ltd.

Table 4.2 Principal electrolytes and their functions. Source: Peate and Nair (2011), Table 2.2, p. 49. Reproduced with permission of John Wiley and Sons, Ltd.

Table 6.1 The major primary blast cells and their connective tissue type. Source: Peate and Nair (2011), Table 4.1, p. 112. Reproduced with permission of John Wiley and Sons, Ltd.

Table 6.2 Types of connective tissue proper – their main constituents, functions and locations. Source: Peate and Nair (2011), Table 4.2, p. 114. Reproduced with permission of John Wiley and Sons, Ltd.

Table 8.1 Haematological values for infants and children.

Table 8.2 The normal value of Hb at different ages.

Table 8.3 Plasma coagulation factors.

Table 8.4 Blood groups and who they can donate to and receive from.

Table 8.5 Differences between arteries and veins. Source: Peate and Nair (2011), Table 12.3, p. 388. Reproduced with permission of John Wiley and Sons, Ltd.

Table 8.6 BP (mmHg) by gender and age for the 95th centile.

Table 11.1 Hormones of the hypothalamus.

Table 11.2 Hormones of the pituitary gland.

Table 11.3 Hormones of the pineal gland.

Table 11.4 Hormones of the thyroid gland.

Table 11.5 Hormones of the parathyroid glands.

Table 11.6 Hormones of the thymus gland.

Table 11.7 Hormones of the adrenal glands.

Table 11.8 Hormones of the pancreas.

Table 11.9 Hormones of the testes and ovaries.

Table 11.10 Hormones of other organs in the body and their functions.

Table 12.1 Vitamins and minerals required for growth and development, the food from which they are derived and the effect of deficit (adapted from Clancy and McVicar (2009) and Tortora and Grabowski (2000)).

Table 12.2 Pancreatic enzymes and enzyme precursors.

Table 13.1 Renal function in the newborn-key points. Adapted from Lissauer and Fanaroff (2011).

Table 13.2 Function of the structures within the nephron. Adapted from Marieb and Hoehn (2010).

Table 13.3 Functions of the kidney.

Table 13.4 Outcome of simple filtration.

Table 13.5 Composition of urine.

Table 13.6 Urine output in 24 h for infants and children.

Table 15.1 Cranial nerves.

Table 15.2 Effects of the sympathetic and parasympathetic divisions of the autonomic nervous system. Source: Peate and Nair (2011), Table 6.2, p. 178. Reproduced with permission of John Wiley and Sons, Ltd.

Table 16.1 Summary of the muscle tissue. Adapted from Peate and Nair (2011).

Table 16.2 Principal movement functions of muscles. Adapted from Kingston (2005).

Table 16.3 The organization and function of the components of skeletal muscle fibres.

Table 16.4 Muscles of facial expression. Adapted from Martini et al., (2012).

Table 16.5 The muscles of chewing and of the tongue. Adapted from Martini et al., (2012).

Table 16.6 Muscles of the neck – function, origin and insertion. Adapted from Kingston (2005) and Jarman (2003).

Table 16.7 Muscles of the shoulder – function, origin and insertion. Adapted from Jarman (2003) and Kingston (2005).

Table 16.8 Muscles of the arm and hand – function, origin and insertion. Adapted from Kingston (2005) and Jarman (2003).

Table 16.9 Muscles of the thorax and abdomen – function, origin and insertion. Adapted from Kingston (2005).

Table 16.10 The function of the hip and pelvis muscles. Adapted from Kingston 2005 and Jarmey 2003.

Table 16.11 Function, origin and insertion of the muscles of the thigh, lower leg and foot. Adapted from Kingston (2005).

Table 17.1 The bones of the axial skeleton. Source: Peate and Nair (2011), Table 8.1, p. 227. Reproduced with permission of John Wiley and Sons, Ltd.

Table 17.2 The bones of the appendicular skeleton. Source: Peate and Nair (2011), Table 8.2, p. 227. Reproduced with permission of John Wiley and Sons, Ltd.

Table 17.3 Ossification. Adapted from Knipe et al., (http://radiopaedia.org/articles/ossification-centres-of-the-wrist) as cited in Butler et al., (2012).

Table 17.4 Some factors impacting on bone structure. Source: Peate and Nair (2011), Table 8.4, p. 236. Reproduced with permission of John Wiley and Sons, Ltd.

Table 17.5 Six types of joint. Source: Peate and Nair (2011), Table 8.5, pp. 244–246. Reproduced with permission of John Wiley and Sons, Ltd.

Table 19.1 The layers of the epidermis.

Table 19.2 The location and function of the glands of the dermis.

List of Illustrations

Figure 2.1 (a) Cellular respiration. (b) Overview of Krebs cycle.
Source: Tortora and Derrickson 2009, Figure 26.6, p. 984. Reproduced with permission of John Wiley and Sons, Inc.

Figure 2.2 Oxygen–haemoglobin dissociation curves showing the effect of (a) pH on affinity of haemoglobin for oxygen, (b) PCO₂ on affinity of haemoglobin for oxygen and (c) Temperature changes.
Source: Tortora and Derrickson 2009, Figures 23.20 and 23.21, pp. 902 and 903. Reproduced with permission of John Wiley and Sons, Inc.

Figure 2.3 Hormonal regulation of sodium and chloride reabsorption.
Source: Tortora and Derrickson 2009, Figure 27.4, p. 1066. Reproduced with permission of John Wiley and Sons, Inc.

Figure 2.4 Regulation of aldosterone by the renin–angiotensin–aldosterone pathway.
Source: Tortora and Derrickson 2009, Figure 18.16, p. 667. Reproduced with permission of John Wiley and Sons, Inc.

Figure 2.5 Effect of aldosterone on fluid balance.

Figure 2.6 Regulation of the secretion and action of antidiuretic hormone.
Source: Tortora and Derrickson 2009, Figure 18.9, p. 657. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.1 Levels of organization of the body.
Source: Tortora and Derrickson (2009), Figure 1.1, p. 3. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.2 The atom.
Source: Peate and Nair (2011), Figure 1.2, p. 5. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 3.3 Schematic diagram of an atom.
Source: Peate and Nair (2011), Figure 1.3, p. 5. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 3.4 Different atoms.
Source: Tortora and Derrickson (2009), Figure 2.2, p. 31. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.5 Ionic bonding of a sodium and a chlorine atom to form a sodium chloride molecule.
Source: Tortora and Derrickson (2009), Figure 2.4, p. 33. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.6 Covalent bond.
Source: Tortora and Derrickson (2009), Figure 2.5, p. 34. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.7 Hydrogen bonds and water.
Source: Tortora and Derrickson (2009), Figure 2.6, p. 35. Reproduced with permission of John Wiley and Sons, Inc.

Figure 3.8 Pictorial depiction of the chemical equation (reaction) producing water.
Source: Tortora and Derrickson (2009), Figure 2.7, p. 36. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.1 Examples of some cells of the human body.
Source: Tortora and Derrickson (2009), Figure 3.35, p. 100. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.2 Structure of the cell.
Source: Tortora and Derrickson (2009), Figure 3.1, p. 62. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.3 Cell membrane.
Source: Tortora and Derrickson (2009), Figure 3.2, p. 63. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.4 Facilitated diffusion.
Source: Tortora and Derrickson (2009), Figure 3.5, p. 67. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.5 Effect of solute concentration on a red blood cell.
Source: Tortora and Derrickson (2009), Figure 3.9(a), p. 71. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.6 Active transport system.
Source: Tortora and Derrickson (2009), Figure 3.10, p. 72. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.7 Pinocytosis, phagocytosis and receptor-mediated endocytosis.
Source: Peate and Nair (2011), Figure 2.8, p. 42. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 4.8 Exocytosis.
Source: Peate and Nair (2011), Figure 2.9, p. 43. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 4.9 Endoplasmic reticulum.
Source: Tortora and Derrickson (2009), Figure 3.19, p. 81. Reproduced with permission of John Wiley and Sons, Inc.

Figure 4.10 The cytoskeleton.

Figure 4.11 Fluid compartments and distribution.
Source: Peate and Nair (2011), Figure 2.10, p. 44. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 4.12 Capillary hydrostatic and osmotic pressures.
Source: Peate and Nair (2011), Figure 2.11, p. 45. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 5.1 The cell nucleus.
Source: Tortora and Derrickson (2009), Figure 3.26, p. 88. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.2 A pictorial representation of a portion of the double helix.
Source: Tortora and Derrickson (2009), Figure 3.31, p. 94. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.3 DNA from double helix to chromosome.
Source: Tortora and Derrickson (2009), Figure 3.25, p. 87. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.4 Male human chromosomes.
Source: Lister Hill National Center for Biomedical Communications (2010), figure on p. 16 (http://ghr.nlm.nih.gov/handbook/basics/howmanychromosomes).

Figure 5.5 The separation of DNA and production of further DNA.
Source: Tortora and Derrickson (2009), Figure 3.31, p. 94. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.6 mRNA becomes associated with small ribosomal subunit.
Source: Tortora and Derrickson (2009), Figure 3.28, p. 91. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.7 Summary of the movement of the ribosome along mRNA.
Source: Tortora and Derrickson (2009), Figure 3.29, p. 92. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.8 Brief summary of protein synthesis.
Source: Peate and Nair (2011), Figure 17.8, p. 563. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 5.9 The cell cycle.
Source: Tortora and Derrickson (2009), Figure 3.30, p. 93. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.10 Mitosis.
Source: Tortora and Derrickson (2009), Figure 3.32, p. 95. Reproduced with permission of John Wiley and Sons, Inc.

Figure 5.11 Gene crossover.
Source: Peate and Nair (2011), Figure 17.11, p. 568. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 5.12 Genetic inheritance.
Source: Peate and Nair (2011), Figure 17.12, p. 570. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 5.13 X-linked inheritance.
Source: Peate and Nair (2011), Figure 17.13, p. 574. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.1 Types of cells.
Source: Nair and Peate (2013), Figure 1.12, p. 18. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.2 Simple epithelium.
Source: Nair and Peate (2013), Figure 1.13, p. 20. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.3 Simple epithelia types.
Source: Tortora and Derrickson (2009), Figure 4.3, p. 113. Reproduced with permission of John Wiley and Sons, Inc.

Figure 6.4 Stratified epithelium.
Source: Nair and Peate (2013), Figure 1.14, p. 20. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.5 Connective tissue reinforces epithelial tissue.
Source: Tortora and Derrickson (2009), Figure 4.2, p. 112. Reproduced with permission of John Wiley and Sons, Inc.

Figure 6.6 Where cartilage is found in the body.
Source: Jenkins and Tortora (2013), Figure 4.6, p. 125. Reproduced with permission of John Wiley and Sons, Inc.

Figure 6.7 Synovial membranes fill joint cavities.
Source: Tortora and Derrickson (2009), Figure 4.7, p. 136. Reproduced with permission of John Wiley and Sons, Inc.

Figure 6.8 Skeletal muscle cells taken.
Source: Nair and Peate (2013), Figure 1.12, p. 18. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.9 Smooth muscle.
Source: Nair and Peate (2013), Figure 1.12, p. 18. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 6.10 Peristalsis.

Figure 6.11 Nerve cell.
Source: Nair and Peate (2013), Figure 1.12, p. 18. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 7.1 Organs and tissues of the immune system.

Figure 7.2 Haemopoiesis. Adapted from MacPherson and Austyn (2012).

Figure 7.3 Distribution of lymph vessels and nodes.

Figure 7.4 Organs of lymphocyte production in the fetus. Adapted from Nairn and Helbert (2007).

Figure 7.5 Location of thymus gland.
Source: Tortora and Derrickson (2009), Figure 22.5(a), p. 837. Reproduced with permission of John Wiley and Sons, Inc.

Figure 7.6 Simplified drawing of a lymph node.
Source: adapted from Tortora and Derrickson (2009), Figure 22.6, p. 838. Reproduced with permission of John Wiley and Sons, Inc.

Figure 7.7 Stages of phagocytosis: (a) stage 1, (b) stage 2 and (c) stage 3.
Source: Peate and Nair (2011), Figures 3.5, 3.6 and 3.7, pp. 74–75. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 7.8 Inflammation and the stages that occur.
Source: Tortora and Derrickson (2009), Figure 22.10, p. 845. Reproduced with permission of John Wiley and Sons, Inc.

Figure 7.9 Flowchart of inflammatory events.
Source: Adapted from Marieb, 2012.

Figure 7.10 Development of B cell lymphocytes.

Figure 7.11 Cellular and humoral immune responses.
Source: Tortora and Derrickson (2009), Figure 22.11, p. 847. Reproduced with permission of John Wiley and Sons, Inc.

Figure 7.12 Primary and secondary responses to infection.
Source: Peate and Nair (2011), Figure 3.14, p. 89. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 7.13 Acquired (specific) immunity. Adapted from Taylor and Cohen (2013).

Figure 8.1 Cells of the blood.
Source: Tortora and Derrickson (2009), Figure 19.1, p. 691. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.2 Composition of blood in percentages.
Source: Tortora and Derrickson (2009), Figure 19.1, p. 691. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.3 The development of blood cells.
Source: Tortora and Derrickson (2009), Figure 19.3, p. 694. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.4 Red blood cells.
Source: Tortora and Derrickson (2009), Figure 19.4(a), p. 696. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.5 Destruction of the red blood cell.
Source: Tortora and Derrickson (2009), Figure 19.5, p. 697. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.6 Negative feedback mechanism for erythropoeisis.
Source: Peate and Nair (2011), Figure 12.7, p. 377. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 8.7 Platelet plug formation.

Figure 8.8 Blood coagulation, simplified.

Figure 8.9 ABO blood groups.
Source: Tortora and Derrickson (2009), Figure 19.12, p. 709. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.10 Schematic of blood vessels.
Source: Peate and Nair (2011), Figure 12.15, p. 386. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 8.11 Basic structure of an artery and vein.
Source: Peate and Nair (2011), Figure 12.17, p. 388. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 8.12 Walls of blood vessels.
Source: Tortora and Derrickson (2009), Figure 21.1(a–c), p. 762. Reproduced with permission of John Wiley and Sons, Inc.

Figure 8.13 Capillary networks.
Source: Tortora and Derrickson (2009), Figure 21.3(a), p. 765. Reproduced with permission of John Wiley and Sons, Inc.

Figure 9.1 The fetal circulation.

Figure 9.2 Transposition of the great arteries. The aorta takes blood from the right ventricles and the pulmonary artery takes blood from the left ventricle.

Figure 9.3 Heart position – adult and child.

Figure 9.4 Diagrammatic representation of the blood flow through the heart.

Figure 9.5 The layers of the heart wall.

Figure 9.6 The electrical pathway through the heart.

Figure 9.7 The ECG tracing.

Figure 9.8 The blood pressure cuff.

Figure 10.1 An overview of the respiratory system and associated structures.

Figure 10.2 The child and adult airway.

Figure 10.3 The nasopharynx, the oropharynx and laryngopharynx and associated structures.

Figure 10.4 The trachea.

Figure 10.5 Alveoli.

Figure 10.6 The oxygen–haemoglobin dissociation curve.

Figure 10.7 Respiratory centre within the brain.
Source: Tortora and Derrickson (2006), Figure 23.24, p. 905. Reproduced with permission of John Wiley and Sons, Inc.

Figure 10.8 The mechanism of respiration. Adapted from Crawford (2011a,b) and Tortora and Derrickson (2006).

Figure 10.9 Chest movement with inspiration and expiration.

Figure 11.1 The endocrine system.

Figure 11.2 The endocrine glands and hormones of the head and neck.

Figure 11.3 The parathyroid glands.

Figure 11.4 The thymus gland.

Figure 11.5 The adrenal glands.

Figure 11.6 The gastrointestinal system and its hormones.

Figure 11.7 The reproductive system and its hormones.

Figure 12.1 The structures associated with the digestion of food.

Figure 12.2 The blood supply to the gastrointestinal system.

Figure 12.3 Innervation of the digestive tract.

Figure 12.4 The oral cavity.

Figure 12.5 Primary dentition, or ‘milk teeth’.

Figure 12.6 Secondary dentition, or permanent teeth.

Figure 12.7 Salivary gland positions in the mouth.

Figure 12.8 Diagram showing circular and longitudinal muscles in the digestive tract.

Figure 12.9 Peristalsis.

Figure 12.10 pH paper universal indicator colours.

Figure 12.11 An overview of the small intestine.

Figure 12.12 Structure of a villus of the small intestine.

Figure 12.13 Position of the liver in relation to the gastrointestinal tract.

Figure 12.14 Position of the gallbladder and pancreas.

Figure 12.15 The large intestine.

Figure 13.1 The renal system – anterior view.

Figure 13.2 Gross anatomy of the kidney.

Figure 13.3 Internal anatomy of the kidney.

Figure 13.4 The nephron.

Figure 13.5 Blood supply to and from the kidneys.

Figure 13.6 The bladder – cross-section.

Figure 13.7 Female and male urethra.

Figure 13.8 Bladder control sensory pathway.

Figure 14.1 Development of internal genitalia.

Figure 14.2 Development of external genitalia.

Figure 14.3 Male reproductive system.
Source: Tortora and Derrickson (2009), Figure 28.1, p. 1082. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.4 The Tanner scale for male genital growth.

Figure 14.5 Negative-feedback system associated with the control of testosterone in the blood.
Source: Tortora and Derrickson (2009), Figure 28.8, p. 1089. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.6 Male reproductive organs. (a) Posterior aspect of the longitudinal (frontal) section of the penis. (b) Transverse view of the penis with the dorsal aspect at the top.

Figure 14.7 Events in the transformation of a spermatid into a sperm cell.

Figure 14.8 Stages of spermatogenesis.
Source: Tortora and Derrickson (2009), Figure 28.6, p. 1088. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.9 Components of a sperm.
Source: Tortora and Derrickson (2009), Figure 28.6, p. 1088. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.10 The female reproductive system (sagittal section) and surrounding structures.
Source: Tortora and Derrickson (2009), Figure 28.11(a), p. 1096. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.11 The uterus and associated structures.
Source: Nair and Peate (2013), Figure 14.4, p. 404. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 14.12 The developmental sequences associated with maturation of an ovum.
Source: Tortora and Derrickson (2009), Figure 28.14(a)–(d), pp. 1099–1100. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.13 Oogenesis and follicular development.
Source: Tortora and Derrickson (2009), Table 28.1, p. 1102. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.14 The ovarian and uterine cycles.
Source: Tortora and Derrickson (2009), Figure 28.23, p. 1113. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.15 The female reproductive cycle: changes in anterior pituitary and ovarian hormones and their effect on the menstrual cycle.
Source: Tortora and Derrickson (2009), Figure 28.24, p. 1114. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.16 Anatomy of the vagina.

Figure 14.17 The female external genitalia (vulva).
Source: Nair and Peate (2013), Figure 14.2, p. 402. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 14.18 The breast.
Source: Tortora and Derrickson (2009), Figure 28.22, p. 1111. Reproduced with permission of John Wiley and Sons, Inc.

Figure 14.19 The Tanner scale for female breast growth.

Figure 15.1 Organization of the nervous system.

Figure 15.2 Motor neurone cell.
Source: Tortora and Derrickson (2009), Figure 12.2, p. 418. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.3 Neuroglia cell of the CNS.
Source: Tortora and Derrickson (2009), Figure 12.6, p. 422. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.4 Action potential.
Source: Tortora and Derrickson (2009), Figure 12.21, p. 437. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.5 Embryonic brain development.

Figure 15.6 Development of the brain and spinal cord.
Source: Tortora and Derrickson (2009), Figure 14.28, p. 538. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.7 Circle of Willis.
Source: Tortora and Derrickson (2009), Figure 21.19(c), p. 791. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.8 Cerebral ventricles (right lateral view).
Source: Tortora and Derrickson (2009), Figure 14.3, p. 499. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.9 Anterior view of frontal section through the skull showing the cranial meninges.
Source: Tortora and Derrickson (2009), Figure 14.2(a), p. 498. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.10 Structure of the brain.
Source: Tortora and Derrickson (2009), Figure 14.1, p. 497. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.11 Lateral view of the right cerebral hemisphere showing Brodmann's functional areas.
Source: Tortora and Derrickson (2009), Figure 14.15, p. 519. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.12 Anterior view of the spinal cord.
Source: Tortora and Derrickson (2009), Figure 13.1, p. 462. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.13 Functions of the cranial nerves.
Source: Peate and Nair (2011), Figure 6.10, p. 171. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 15.14 The spinal cord and spinal nerves.
Source: Tortora and Derrickson (2009), Figure 13.2, p. 463. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.15 The spinal nerves and their areas of innervation.
Source: Peate and Nair (2011), Figure 6.13, p. 175. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 15.16 A typical spinal nerve.
Source: Tortora and Derrickson (2009), Figure 13.14, p. 482. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.17 Sympathetic nervous system.
Source: Tortora and Derrickson (2009), Figure 15.2, p. 550. Reproduced with permission of John Wiley and Sons, Inc.

Figure 15.18 Parasympathetic nervous system.
Source: Tortora and Derrickson (2009), Figure 15.3, p. 551. Reproduced with permission of John Wiley and Sons, Inc.

Figure 16.1 Smooth muscle – cross-section.

Figure 16.2 Cardiac muscle.

Figure 16.3 The gross anatomy of striated skeletal muscle.

Figure 16.4 Micro-anatomy of skeletal muscle fibre.

Figure 16.5 Neuromuscular junction.

Figure 16.6 Origin and insertion.

Figure 16.7 Lateral view of the muscles of facial expression.

Figure 16.8 Anterior view of the muscles of facial expression.

Figure 16.9 Muscles of the neck.

Figure 16.10 The superficial muscles of the shoulder.

Figure 16.11 Rotator cuff muscles.

Figure 16.12 Anterior and posterior views of upper arm muscles.

Figure 16.13 Muscles of the forearm.

Figure 16.14 Muscles of breathing.

Figure 16.15 The abdominal muscles.

Figure 16.16 Muscles of the pelvis.

Figure 16.17 Muscles of the hip.

Figure 16.18 Anterior and posterior views of the muscles of the leg.

Figure 16.19 The muscles of the foot.

Figure 17.1 The axial and appendicular skeleton.
Source: Tortora and Derrickson (2009), Figure 7.1, p. 200. Reproduced with permission of John Wiley and Sons, Inc.

Figure 17.2 Bone formation.

Figure 17.3 Intramembranous ossification.
Source: Tortora and Derrickson (2009), Figure 6.5, p. 183. Reproduced with permission of John Wiley and Sons, Inc.

Figure 17.4 Ossification of bone.

Figure 17.5 Bone growth and remodelling.

Figure 17.6 Ossification of the wrist.
Adapted from Butler et al., (2012).

Figure 17.7 Haversian canal.

Figure 17.8 Common types of fractures.

Figure 17.9 Salter–Harris classification of epiphyseal fractures.

Figure 17.10 A long bone – femur.

Figure 17.11 The tarsal bones – short bone.

Figure 17.12 A flat bone – the sternum.

Figure 17.13 The vertebrae – an irregular bone.

Figure 17.14 The patella – a sesamoid bone.
Source: Peate and Nair (2011), Figure 8.10, p. 243. Reproduced with permission of John Wiley and Sons, Ltd.

Figure 18.1 Location and structures of tongue papillae and taste buds.
Source: Tortora and Derrickson (2009), Figure 17.3(a–c), p. 603. Reproduced with permission of John Wiley and Sons, Inc.

Figure 18.2 The anatomy of the ear.

Figure 18.3 Properties of sound waves with different pitch and volume.

Figure 18.4 Cochlear anatomy.

Figure 18.5 Structure of a crista ampullaris.
Source: Tortora and Derrickson (2009), Figure 17.25, p. 630. Reproduced with permission of John Wiley and Sons, Inc.

Figure 18.6 Anatomy of the eye.

Figure 18.7 Refraction of light in the eye.

Figure 18.8 Anatomy of the optic nerve.

Figure 18.9 Optic chiasma.

Figure 19.1 The cells of the epidermis.

Figure 19.2 The layers of the epidermis.

Figure 19.3 The structures of the dermis.

Figure 19.4 The nail.

Figure 19.5 The hair follicle.

Figure 19.6 Heat loss from a newborn baby. Adapted from Crawford and Hickson (2002).

Figure 19.7 Implication of cold stress on an infant. Adapted from Crawford and Hickson (2002).

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Library of Congress Cataloging-in-Publication Data

Fundamentals of children's anatomy and physiology: a textbook for nursing and healthcare students / edited by Ian Peate and Elizabeth Gormley-Fleming.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-62505-7 (pbk.)

I. Peate, Ian, editor. II. Gormley-Fleming, Elizabeth, editor.

[DNLM: 1. Anatomy. 2. Child. 3. Physiological Phenomena. QS 4]

QP34.5

612–dc23

2014038945

A catalogue record for this book is available from the British Library.

Contributors

Elizabeth Akers RN B. Nursing, BSc (Hons), Diploma in Tropical Nursing PG Cert (Teaching and Learning)

Practice Educator, Bear Ward, Cardiac Unit, Great Ormond Street Hospital NHS Foundation Trust, London

Born in central New South Wales, Elizabeth grew up in the great Australian outdoors. Elizabeth began her general nurse training at the University of Sydney in 1993 and completed a postgraduate year at Sydney Children's Hospital in 1996. On an adventurous whim Elizabeth accepted a post at Great Ormond Street Hospital in London and has since moved to the Bedfordshire countryside to raise her family. Elizabeth still works at Great Ormond Street Hospital in the cardiac unit, where she is one of a team of practice educators. Elizabeth's special interests are in simulation, general paediatrics and congenital heart disease.

Ann L. Bevan RN, RSCN, PhD

Senior Lecturer, School of Health and Social Care, Bournemouth University, Bournemouth, UK

Ann began her nursing career at Poole General Hospital before then moving on to various other positions and further education. She has worked in various places around the UK and in Hong Kong, before moving to Canada where she worked in clinical practice for 5 years before moving into education. Ann returned to her current post in 2010. Her key interests are child health, childhood nutrition and obesity, health promotion and action research. Ann's publications are growing, and she is a Board member and Treasurer of Phi Mu Honour Society for Nurses in England.

Mary Brady RN, RSCN, CHSM, BSc, PGCHE, MSc

Senior Lecturer, Faculty of Health, Social Care and Education, Kingston University, London, UK

After completing RN training, Mary undertook RSCN training. Afterwards, she worked on a general paediatric ward for infants, then moved to Birmingham Children's Hospital to work on a neonatal and infant surgical ward as a staff nurse and then sister. She completed the paediatric intensive care course at the Hospital for Sick Children (Great Ormond Street) and worked on the cardiac ICU. In 1991 she moved to a neonatal unit as a surgical sister. From 1995 to 2004 she was ward manager/senior sister on a general children's ward.

In 2004, Mary moved into nurse education, where she is currently Field lead for children's nursing. She teaches pre- and post-registration nurses, midwives and paramedics.

Mary is an external examiner at Huddersfield University.

Petra Brown RGN DPSN BSc (Hons) MA

Lecturer, School of Health and Social Care, Bournemouth University, Bournemouth, UK

Petra began her nursing a career in 1988 at Salisbury School of Nursing, becoming a staff nurse. She has worked in a variety of clinical areas, including recovery, intensive & coronary care and telephone triage. On completing her Critical Care degree, Petra started her career in nurse education as a Practice Educator for critical care, A&E and orthopaedics at Bournemouth and Christchurch NHS Hospital. On completing a Master's Degree in Health and Social Care Practice Education, she was appointed as a lecturer at Bournemouth University on the overseas and pre-registration nursing courses. Her key areas of interest are nursing practice, overseas nursing, nurse education, practice development, respiratory and critical care.

Mary L. Donnelly SRN, RSCN, DipEd, PG Cert Ed, BSc (Hons), MA

Senior Lecturer in Children's Health, Alternate Professional Lead and Programme Field Tutor for Children's Nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Mary began her nursing career in 1978 training to be a state registered nurse at Edgware General Hospital's School of Nursing. On completion of training she became a staff nurse in the Accident and Emergency department at Edgware General and later became a senior staff nurse on the children's ward at the same hospital. In 1986 she became an Industrial Nursing Officer, but returned to accident and emergency nursing in 1990. While working in the accident and emergency department at Barnet General Hospital, Mary studied for her second registration as a Registered Sick Children's Nurse, becoming an Accident and Emergency Sister and Paediatric Nurse Specialist for the same hospital. In 2001 she became a Nurse Facilitator for the North Central London Workforce Development Confederation and later went on to become the acting lead nurse for the cadet nursing scheme for the same NHS organization. Mary has worked as a lecturer in Child Health at the University of Hertfordshire since 2003 and is currently the Alternate Professional Leader and Programme Field Tutor for Children's Nursing at the same institution.

Elizabeth Gormley-Fleming RGN, RSCN, BSc (Hons), MA (Keele), PG Dip HE (Herts)

Associate Dean of School, Academic Quality Assurance, Children's Nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Liz commenced her nursing career in Ireland, where she qualified as an RGN and RSCN. After working in Our Lady's Hospital for Sick Children in Dublin, she moved to London to work at Northwest London NHS Trust initially in adult nursing, but then moved to Children's Services where she had a variety of roles from staff nurse to lead nurse. Liz also worked in Northern Ireland during the 1990s, where she worked in childrens' orthopaedics and as a school nurse. Liz has worked in education since 2001, initially as a clinical facilitator before moving into full-time HE in 2003. Her areas of interest are care of the acutely ill child, healthcare law and ethics, the use of technology in higher education and practice-based learning.

Debbie Martin MSc, BSc (Hons), EN(G), RSCN, PGDEd, DipON(Oxford)

Senior Lecturer in Children's Nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Debbie commenced her nursing career in 1979 at The Nuffield Orthopaedic Centre, Oxford; after completing a Diploma in Orthopaedic nursing she went on to Mount Vernon Hospital and became an Enrolled Nurse. She worked part time for a number of years, at Mount Vernon and St Albans Hospital whilst bringing up a family, then undertook further training to become a Registered Sick Children's Nurse. She worked as a Staff Nurse and a Junior Sister at Hemel Hempstead Hospital and then moved into a placement support and practice development role. She moved into nurse education at the University of Hertfordshire in 2006. Her key areas of interest are pre-registration nurse education, simulation in nurse education, adolescent health and care of siblings of children with long-term conditions.

Alison Mosenthal RGN, RSCN, Dip N (London), Diploma Nursing Education, MSc

Senior Lecturer in Children's Nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Alison began her nursing career at St Thomas' Hospital London before undertaking her RSCN training at Great Ormond Street in 1979. After qualifying she worked in the respiratory intensive care unit and then moved into nurse education in the School of Nursing at Great Ormond Street in 1983.

After a career break raising her family, Alison returned to clinical nursing working as a clinical nurse specialist in paediatric Immunology nursing at St Georges' Healthcare NHS Trust in 1996. She remains in clinical practice there, but returned to teaching in higher education at the University of Hertfordshire in 2010. She currently works there part time as a senior lecturer on the children's nursing course.

Joanne Outteridge RN (Child), ENB 415, BN (Hons), PG Dip Health Care Ethics, PG Dip HE, MSc

Jo began her nursing career as a children's nurse at the Evelina Children's Hospital, London, working in paediatric cardiology and then paediatric intensive care. She then moved to teaching children's pre-registration and respiratory nursing at City University, London, becoming a lecturer practitioner on the children's medical wards at the Royal London Hospital.

Ian Peate EN(G) RGN DipN (Lond) RNT BEd (Hons) MA (Lond) LLM

British Journal of Nursing

Senior Lecturer, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Journal of Neonatal Nursing

Senior Lecturer, Children's Nursing, School of Health and Social Work, University of Hertfordshire, Hatfield, UK

Peter Vickers Cert Ed, Dip CD, SRN, RSCN, BA, PhD, FHEA

Lisa Whiting DHRes, MSc, BA (Hons) RGN, RSCN, RNT, LTCL, FHEA

Lisa completed the 4-year RGN/RSCN programme at the Queen Elizabeth Medical Centre, Birmingham, in 1983. She gained a range of paediatric clinical experience, developing her career within the area of critical care nursing and becoming a ward sister on the children's cardiac intensive care unit at Guy's Hospital. Lisa has worked in education for a number of years, teaching students undertaking a range of children's nursing programmes. In addition, Lisa has studied academically, nurturing an interest in child health promotion; she has completed a Doctorate in Health Research that drew on an ethnographic approach to facilitate the emergence of assets that underpin children's wellbeing.