Cover
Title Page
Contributors
1. About the editors
2. About the contributors
Acknowledgements
Preface
1. Anatomy and physiology
2. References
Prefixes, suffixes
How to use your textbook
1. Features contained within your textbook
About the companion websites
Chapter 1: Basic scientific principles of physiology
1. Introduction
2. Levels of organisation
3. Characteristics of life
4. Bodily requirements
5. Atoms
6. Elements
7. Compounds
8. Chemical equations/chemical reactions
9. Acids and bases (pH)
10. Blood and pH values
11. Homeostasis
12. Organic and inorganic substances
13. Units of measurement
14. Conclusion
15. Glossary
16. References
17. Activities
Chapter 2: Cells, cellular compartments, transport systems, fluid movement between compartments
1. Introduction
2. Cell membrane
3. Functions of the cell membrane
4. Cellular fluid compartments
5. Effects of water deficiency
6. Variation in body fluid content
7. Transport systems
8. Electrolytes
9. Hormones that regulate fluid and electrolytes
10. Conclusion
11. Glossary
12. References
13. Further reading
14. Activities
Chapter 3: Genetics
1. Anatomical map
2. Introduction
3. The double helix
4. Chromosomes
5. From DNA to proteins
6. The transference of genes
7. Mendelian genetics
8. Spontaneous mutation
9. Conclusion
10. Glossary
11. References
12. Further reading
13. Activities
Chapter 4: Tissue
1. Introduction
2. Epithelial tissue
3. Connective tissue
4. Membranes
5. Muscle tissue
6. Nervous tissue
7. Tissue repair
8. Conclusion
9. Glossary
10. References
11. Activities
Chapter 5: The skeletal system
1. Body map
2. Introduction
3. The axial and appendicular skeleton
4. Bone and its functions
5. Bone formation and growth (ossification)
6. Embryonic formation
7. Bone fractures
8. Bone structure and blood supply (histology)
9. Organisation of bone based on shape
10. Joints
11. Conclusion
12. Glossary
13. References
14. Further reading
15. Activities
Chapter 6: The muscular system
1. Body map
2. Introduction
3. Types of muscle tissue
4. Functions of the muscular system
5. Composition of skeletal muscle tissue
6. Gross anatomy of skeletal muscles
7. Microanatomy of skeletal muscle fibre
8. Types of muscle fibres
9. Blood supply
10. Skeletal muscle contraction and relaxation
11. Energy sources for muscle contraction
12. Aerobic respiration
13. Oxygen debt
14. Muscle fatigue
15. Organisation of the skeletal muscular system
16. Skeletal muscle movement
17. The effects of ageing
18. Conclusion
19. Glossary
20. References
21. Further reading
22. Activities
Chapter 7: Circulatory system
1. Body map
2. Introduction
3. Components of blood
4. Properties of blood
5. Plasma
6. Functions of blood
7. Formation of blood cells
8. Red blood cells
9. White blood cells
10. Platelets
11. Haemostasis
12. Coagulation
13. Blood groups
14. Blood vessels
15. Blood pressure
16. Lymphatic system
17. Lymphatic organs
18. Functions of the lymphatic system
19. Conclusion
20. Glossary
21. References
22. Further reading
23. Activities
Chapter 8: The cardiac system
1. Body map
2. Introduction
3. Size and location of the heart
4. The structures of the heart
5. The blood supply to the heart
6. Blood flow through the heart
7. The electrical pathways of the heart
8. The cardiac cycle
9. Factors affecting cardiac output
10. Regulation of stroke volume
11. Regulation of heart rate
12. Conclusion
13. Glossary
14. References
15. Further reading
16. Activities
Chapter 9: The digestive system
1. Body map
2. Introduction
3. The activity of the digestive system
4. The organisation of the digestive system
5. The digestive system organs
6. The structure of the digestive system
7. The pancreas
8. The liver and production of bile
9. The gallbladder
10. The large intestine
11. Digestive tract hormones
12. Nutrition, chemical digestion and metabolism
13. Conclusion
14. Glossary
15. References
16. Further reading
17. Activities
Chapter 10: The renal system
1. Body map
2. Introduction
3. Renal system
4. Kidneys: external structures
5. Kidneys: internal structures
6. Functions of the kidney
7. Blood supply of the kidney
8. Urine formation
9. Ureters
10. Urinary bladder
11. Urethra
12. Micturition
13. Conclusion
14. Glossary
15. References
16. Further reading
17. Activities
Chapter 11: The respiratory system
1. Body map
2. Introduction
3. Organisation of the respiratory system
4. The upper respiratory tract
5. The lower respiratory tract
6. Blood supply
7. Respiration
8. Pulmonary ventilation
9. Work of breathing
10. Volumes and capacities
11. Control of breathing
12. External respiration
13. Ventilation and perfusion
14. Transport of gases
15. Acid–base balance
16. Internal respiration
17. Conclusion
18. Glossary
19. References
20. Further reading
21. Activities
Chapter 12: The reproductive systems
1. Body map
2. Introduction
3. The male reproductive system
4. The female reproductive system
5. Conclusion
6. Glossary
7. References
8. Further reading
9. Activities
Chapter 13: The nervous system
1. Body map
2. Introduction
3. Organisation of the nervous system
4. Sensory division of the peripheral nervous system
5. Central nervous system
6. Motor division of the peripheral nervous system
7. Neurotransmitters
8. Neuroglia
9. The meninges
10. Cerebrospinal fluid
11. The brain
12. The peripheral nervous system
13. Cranial nerves
14. The spinal cord
15. The autonomic nervous system
16. Conclusion
17. Glossary
18. References
19. Further reading
20. Activities
Chapter 14: The senses
1. Introduction
2. The chemical senses
3. The senses of equilibrium and hearing
4. The sense of sight
5. Conclusion
6. Glossary
7. References
8. Further reading
9. Activities
Chapter 15: The endocrine system
1. Body map
2. Introduction
3. The endocrine organs
4. Hormones
5. The physiology of the endocrine organs
6. The thyroid gland
7. The parathyroid glands
8. The adrenal glands
9. Mineralocorticoids
10. Glucocorticoids
11. Pancreas
12. Insulin
13. Glucagon
14. Somatostatin
15. Conclusion
16. Glossary
17. References
18. Further reading
19. Activities
Chapter 16: The immune system
1. Body map
2. Introduction
3. Blood cell development
4. Organs of the immune system
5. The lymphatic system
6. Lymphoid tissue
7. Types of immunity
8. The acquired immune system
9. Immunoglobulins (antibodies)
10. Primary and secondary response to infection
11. Immunisations
12. Conclusion
13. Glossary
14. References
15. Further reading
16. Activities
Chapter 17: The skin
1. Body map
2. Introduction
3. The structure of skin
4. The epidermis
5. The dermis
6. The accessory skin structures
7. The functions of the skin
8. Conclusion
9. Glossary
10. References
11. Further reading
12. Activities
Normal values
Answers
1. Chapter 1
2. Chapter 2
3. Chapter 3
4. Chapter 4
5. Chapter 5
6. Chapter 6
7. Chapter 7
8. Chapter 8
9. Chapter 9
10. Chapter 10
11. Chapter 11
12. Chapter 12
13. Chapter 13
14. Chapter 14
15. Chapter 15
16. Chapter 16
17. Chapter 17
Index
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List of Tables

Chapter 01
1. Table 1.1 The fundamental SI units
2. Table 1.2 Other common SI units
3. Table 1.3 Multiples of SI units
4. Table 1.4 Measures of weight
5. Table 1.5 Measures of volume
6. Table 1.6 Measures of length
7. Table 1.7 Measures of energy
Chapter 02
1. Table 2.1 Cellular compartments and their functions
2. Table 2.2 Principal electrolytes and their functions
Chapter 04
1. Table 4.1 The major primary blast cells and their connective tissue type
2. Table 4.2 Types of connective tissue proper, their main constituents, functions and locations
Chapter 05
1. Table 5.1 The bones of the axial skeleton
2. Table 5.2 The bones of the appendicular skeleton
3. Table 5.3 Bone formation throughout a person’s life
4. Table 5.4 Some factors that impact on bone structure
5. Table 5.5 Six types of joint
Chapter 06
1. Table 6.1 Different types of muscle tissue
2. Table 6.2 Cellular components of a muscle fibre
3. Table 6.3 Muscle names
4. Table 6.4 Muscles of the head and neck
5. Table 6.5 Muscles of the upper limbs (shoulder, arm and hand)
6. Table 6.6 Muscles of the trunk (thorax and abdomen)
7. Table 6.7 Muscles of the lower limbs (hip, pelvis/thigh and leg)
8. Table 6.8 Types of muscle movement
Chapter 07
1. Table 7.1 Compositions of plasma and their functions
2. Table 7.2 Blood clotting factors
3. Table 7.3 Blood groups
4. Table 7.4 Differences between arteries and veins
Chapter 08
1. Table 8.1 Names of the coronary arteries, their major branches and the areas of the heart they supply
Chapter 09
1. Table 9.1 Summary of the role of the digestive system hormones
2. Table 9.2 Vitamins summary
3. Table 9.3 Minerals summary
Chapter 10
1. Table 10.1 Summary of the functions of the kidneys
2. Table 10.2 Summary of filtration, reabsorption and excretion in the nephron and collecting ducts
3. Table 10.3 Solutes in the urine
4. Table 10.4 Colours of urine
Chapter 11
1. Table 11.1 Summary of important gas laws
2. Table 11.2 The proportion of gases that constitute the atmosphere (partial pressures are expressed as P_gas)
3. Table 11.3 Important lung volumes
4. Table 11.4 Definitions of important gas transport terminology
5. Table 11.5 The major types of hypoxia and their causes
Chapter 12
1. Table 12.1 The layers of the uterus
Chapter 13
1. Table 13.1 The cranial nerves
2. Table 13.2 Effects of the parasympathetic and sympathetic divisions of the autonomic nervous system
Chapter 15
1. Table 15.1 Nervous system versus endocrine system
2. Table 15.2 Hormones released by the hypothalamus and the anterior pituitary gland
Chapter 17
1. Table 17.1 The layers of the epidermis

List of Illustrations

Chapter 01
1. Figure 1.1 Levels of organisation of the body.
2. Figure 1.2 The atom.
3. Figure 1.3 Schematic diagram of an atom.
4. Figure 1.4 The carbon atom.
5. Figure 1.5 (a–d) Ionic bonding of a sodium and a chlorine atom to form a sodium chloride molecule.
6. Figure 1.6 (a–e) Covalent bond.
7. Figure 1.7 Hydrogen bonds and water.
8. Figure 1.8 Pictorial depiction of the chemical equation (reaction) producing water.
9. Figure 1.9 The pH scale.
10. Figure 1.10 Simplified diagram of a pH scale.
Chapter 02
1. Figure 2.1 Examples of some cells of the human body.
2. Figure 2.2 Structure of a cell.
3. Figure 2.3 Cell membrane.
4. Figure 2.4 Selective transport system.
5. Figure 2.5 Action of transmembrane proteins.
6. Figure 2.6 Fluid compartments.
7. Figure 2.7 Capillary hydrostatic and osmotic pressures.
8. Figure 2.8 Simple diffusion.
9. Figure 2.9 Facilitated diffusion.
10. Figure 2.10 (a–c) Effect of solute concentration on a red blood cell.
11. Figure 2.11 Active transport system.
12. Figure 2.12 Pinocytosis, phagocytosis and receptor-mediated endocytosis.
13. Figure 2.13 Exocytosis.
14. Figure 2.14 Electrolytes of intracellular and extracellular compartments.
15. Figure 2.15 Crystals in the joint cavity.
16. Figure 2.16 Crystals in the tissue.
Chapter 03
1. Figure 3.1 (a–c) The cell nucleus.
2. Figure 3.2 A pictorial representation of a portion of the double helix.
3. Figure 3.3 DNA from double helix to chromosome.
4. Figure 3.4 Male human chromosomes.
5. Figure 3.5 The separation of DNA.
6. Figure 3.6 (a, b) The mRNA becomes associated with a small ribosomal subunit.
7. Figure 3.7 Summary of the movement of the ribosome along mRNA.
8. Figure 3.8 Brief summary of protein synthesis.
9. Figure 3.9 The cell cycle.
10. Figure 3.10 (a–f) Mitosis.
11. Figure 3.11 Gene crossover.
12. Figure 3.12 Genetic inheritance.
13. Figure 3.13 X-linked inheritance.
Chapter 04
1. Figure 4.1 Epithelial tissue is classified by shape and depth.
2. Figure 4.2 (a–c) Simple squamous epithelium forms the endothelial layer of blood vessels.
3. Figure 4.3 Simple cuboid epithelium forms part of the secretory portion of the pancreas.
4. Figure 4.4 Ciliated simple columnar epithelium lines the Fallopian tubes.
5. Figure 4.5 Non-ciliated columnar epithelium lines the digestive tract.
6. Figure 4.6 Pseudostratified ciliated columnar epithelium lines the trachea.
7. Figure 4.7 Non-keratinised stratified squamous epithelial tissue lines the vagina.
8. Figure 4.8 Cuboidal epithelial tissue is found in the oesophagus.
9. Figure 4.9 Transitional epithelium lines the bladder and allows for distension.
10. Figure 4.10 Exocrine glands classified by shape, with examples of location.
11. Figure 4.11 Connective tissue reinforces epithelial tissue.
12. Figure 4.12 Constituents of connective tissue.
13. Figure 4.13 Where cartilage is found within the body.
14. Figure 4.14 Synovial membranes fill joint cavities.
15. Figure 4.15 The major muscle types with examples of their location: (a) skeletal muscle; (b) cardiac muscle; (c) smooth muscle.
16. Figure 4.16 An example of nervous tissue.
Chapter 05
1. Figure 5.1 The human skeleton (a) anterior view, (b) posterior view. Axial skeleton blue and appendicular skeleton white.
2. Figure 5.2 Intramembranous ossification.
3. Figure 5.3 Endochondral ossification of the tibia.
4. Figure 5.4 The stages a broken bone goes through for repair to occur.
5. Figure 5.5 The Haversian system in compact bones and trabeculae in spongy bone.
6. Figure 5.6 A long bone – the femur.
7. Figure 5.7 The tarsal bones – short bones.
8. Figure 5.8 A flat bone – the sternum.
9. Figure 5.9 (a, b) The vertebrae – an irregular bone.
10. Figure 5.10 The patella – a sesamoid bone.
Chapter 06
1. Figure 6.1 Gross anatomy of a skeletal muscle.
2. Figure 6.2 Diagram showing a skeletal muscle fibre.
3. Figure 6.3 Motor unit.
4. Figure 6.4 Summary of muscle contraction and relaxation.
5. Figure 6.5 (a–c) Sources of ATP for muscle energy.
6. Figure 6.6 (a, b) Head and neck muscles.
7. Figure 6.7 (a–g) Muscles of the upper limbs (shoulder, arm and hand).
8. Figure 6.8 Trunk (thorax and abdomen).
9. Figure 6.9 (a–f) Muscles of the lower limbs (hip, pelvis/thigh and leg).
10. Figure 6.10 Anterior view of the major muscles of the body.
11. Figure 6.11 Posterior view of the major muscles of the body.
Chapter 07
1. Figure 7.1 Components of blood.
2. Figure 7.2 Cells of the blood.
3. Figure 7.3 Formed elements of blood.
4. Figure 7.4 Red blood cells.
5. Figure 7.5 Haemoglobin molecule.
6. Figure 7.6 Negative feedback for erythropoiesis.
7. Figure 7.7 Destruction of the red blood cell.
8. Figure 7.8 Neutrophil.
9. Figure 7.9 Eosinophil.
10. Figure 7.10 Basophil.
11. Figure 7.11 Monocytes.
12. Figure 7.12 Lymphocyte.
13. Figure 7.13 ABO blood groups.
14. Figure 7.14 Blood vessels.
15. Figure 7.15 (a–e) Layers of a blood vessel.
16. Figure 7.16 Artery and vein.
17. Figure 7.17 Capillary.
18. Figure 7.18 Lymphatic system.
19. Figure 7.19 Lymphatic capillaries.
20. Figure 7.20 Lymphatic circulation.
21. Figure 7.21 A lymph node.
Chapter 08
1. Figure 8.1 Location of the heart.
2. Figure 8.2 Heart wall.
3. Figure 8.3 Cardiac muscle cells (cardiac myocytes).
4. Figure 8.4 Cardiac action potential.
5. Figure 8.5 The chambers of the heart.
6. Figure 8.6 Coronary arteries.
7. Figure 8.7 Cardiac catheterisation.
8. Figure 8.8 Percutaneous coronary intervention
9. Figure 8.9 A simplified diagram of the flow of blood though the heart.
10. Figure 8.10 Anatomical view of the blood flow through the heart.
11. Figure 8.11 Conduction system of the heart.
12. Figure 8.12 Normal electrical conduction.
13. Figure 8.13 Pacemaker.
14. Figure 8.14 Chest lead placement for a 12‐lead ECG.
15. Figure 8.15 The cardiac cycle.
16. Figure 8.16 Normal ECG of one cycle of the heart.
17. Figure 8.17 Baroreceptor reflex.
Chapter 09
1. Figure 9.1 The digestive system.
2. Figure 9.2 The oral cavity.
3. Figure 9.3 (a, b) Teeth.
4. Figure 9.4 Salivary glands.
5. Figure 9.5 (a, b) Swallowing.
6. Figure 9.6 Peristalsis in the oesophagus.
7. Figure 9.7 Structure of the digestive tract.
8. Figure 9.8 The stomach.
9. Figure 9.9 Gastric glands and cells.
10. Figure 9.10 Phases of gastric juice secretion.
11. Figure 9.11 The small intestine.
12. Figure 9.12 The cells within the villi of the small intestine.
13. Figure 9.13 The liver, gallbladder and pancreas.
14. Figure 9.14 Liver lobule.
15. Figure 9.15 The large intestine.
16. Figure 9.16 The food pyramid.
Chapter 10
1. Figure 10.1 Organs of the renal system.
2. Figure 10.2 External layers of the kidney.
3. Figure 10.3 (a, b) Internal structures showing blood vessels.
4. Figure 10.4 Internal structures.
5. Figure 10.5 Obstructive kidney.
6. Figure 10.6 Nephron.
7. Figure 10.7 Bowman’s capsule.
8. Figure 10.8 Peritoneal dialysis.
9. Figure 10.9 Nephron with capillaries.
10. Figure 10.10 Common iliac vessels and ureter.
11. Figure 10.11 Layers of the urinary bladder.
12. Figure 10.12 Male urethra.
13. Figure 10.13 Location of female urethra.
Chapter 11
1. Figure 11.1 Major structures of the upper and lower respiratory tract.
2. Figure 11.2 Structures of the upper respiratory tract.
3. Figure 11.3 Gross anatomy of the lower respiratory tract.
4. Figure 11.4 Anatomy of the larynx.
5. Figure 11.5 The bronchial tree.
6. Figure 11.6 Microscopic anatomy of a lobule.
7. Figure 11.7 The flow of blood between the lungs, the heart and the body.
8. Figure 11.8 Boyle’s law: the volume of a gas varies inversely with its pressure.
9. Figure 11.9 The muscles involved in pulmonary ventilation.
10. Figure 11.10 Movements of inspiration and expiration.
11. Figure 11.11 Diagrammatic description of the major lung volumes and capacities.
12. Figure 11.12 The respiratory centres of the brainstem.
13. Figure 11.13 External respiration: exchange of oxygen and carbon dioxide within the lungs.
14. Figure 11.14 The oxyhaemoglobin dissociation curve: (a) at normal body temperature, arterial carbon dioxide levels and normal arterial blood pH; (b) with high or low arterial blood pH; (c) with high or low arterial carbon dioxide levels.
15. Figure 11.15 (a, b) External and internal respiration: oxygen and carbon dioxide follow their pressure gradients (Hb: haemoglobin).
Chapter 12
1. Figure 12.1 The male reproductive system.
2. Figure 12.2 A testicle demonstrating seminiferous tubules.
3. Figure 12.3 Stages of spermatogenesis.
4. Figure 12.4 Components of a sperm.
5. Figure 12.5 Negative feedback system associated with the control of testosterone in the blood.
6. Figure 12.6 The scrotum and testes.
7. Figure 12.7 The anatomy of the penis.
8. Figure 12.8 The female reproductive system.
9. Figure 12.9 (a–f) The developmental sequences associated with maturation of an ovum.
10. Figure 12.10 Oogenesis.
11. Figure 12.11 The ovarian and uterine cycles.
12. Figure 12.12 An IUD device in situ.
13. Figure 12.13 The uterus and associated structures.
14. Figure 12.14 The breast.
Chapter 13
1. Figure 13.1 Organisation of the nervous system.
2. Figure 13.2 Motor neurone.
3. Figure 13.3 Action potential.
4. Figure 13.4 Neuroglia.
5. Figure 13.5 The meninges.
6. Figure 13.6 The ventricles (right lateral view of the brain).
7. Figure 13.7 Circle of Willis.
8. Figure 13.8 The structures of the brain.
9. Figure 13.9 Right cerebral hemisphere.
10. Figure 13.10 Functions of cranial nerves.
11. Figure 13.11 The spinal cord.
12. Figure 13.12 The spinal cord and spinal nerves.
13. Figure 13.13 The spinal nerves and their areas of innervations.
14. Figure 13.14 A typical spinal nerve (CNS: central nervous system).
15. Figure 13.15 Sympathetic nervous system.
16. Figure 13.16 Parasympathetic nervous system.
Chapter 14
1. Figure 14.1 (a, b) Gross and microscopic anatomy of olfaction.
2. Figure 14.2 Olfactory pathway.
3. Figure 14.3 Tongue and the location of the papillae.
4. Figure 14.4 Cross-section of part of the tongue and microscopic view of a taste bud.
5. Figure 14.5 Structure of the ear.
6. Figure 14.6 Inner ear.
7. Figure 14.7 (a, b) Ampulla at rest and in response to movement.
8. Figure 14.8 Hair cells and otolith.
9. Figure 14.9 Action of gravity on the otolith.
10. Figure 14.10 Cross-section of the cochlea (highlighted section is shown in detail in Figure 14.12).
11. Figure 14.11 Cochlea showing the continuous nature of the vestibular and tympanic ducts.
12. Figure 14.12 Organ of Corti.
13. Figure 14.13 Accessory structures of the eye.
14. Figure 14.14 Anatomy of the eye.
15. Figure 14.15 Cross-section of the retina.
16. Figure 14.16 Refraction of light passing from air (less dense) to water (dense).
17. Figure 14.17 Focal length.
18. Figure 14.18 Accommodation to (a) far and (b) near objects.
19. Figure 14.19 (a) Myopic eye uncorrected and (b) corrected by a concave lens.
20. Figure 14.20 (a) Hyperopic eye uncorrected and (b) corrected by a convex lens.
21. Figure 14.21 Snellen chart.
Chapter 15
1. Figure 15.1 Location of the endocrine organs.
2. Figure 15.2 Transportation of hormones in the blood.
3. Figure 15.3 Endocrine, paracrine and autocrine.
4. Figure 15.4 Target cell and non-target cell.
5. Figure 15.5 The negative feedback system.
6. Figure 15.6 The hypothalamus and pituitary gland.
7. Figure 15.7 (a, b) Position of the thyroid gland and parathyroid glands.
8. Figure 15.8 Negative feedback control of thyroid hormone production.
9. Figure 15.9 Position of the adrenal glands.
10. Figure 15.10 Cross-section of an adrenal gland.
11. Figure 15.11 Cross-section of the adrenal cortex.
12. Figure 15.12 Control of aldosterone secretion.
13. Figure 15.13 Response of the endocrine system to stress.
14. Figure 15.14 Effects of insulin and glucagon on blood glucose concentrations.
Chapter 16
1. Figure 16.1 The development of blood cells.
2. Figure 16.2 Position of the thymus within the body.
3. Figure 16.3 Principal components of the lymphatic system.
4. Figure 16.4 Structure of a lymph node.
5. Figure 16.5 Phagocytosis (stage 1).
6. Figure 16.6 Phagocytosis (stage 2).
7. Figure 16.7 Phagocytosis (stage 3).
8. Figure 16.8 Phagocytes migrate from blood to the site of tissue injury.
9. Figure 16.9 Development and types of T-cell lymphocytes.
10. Figure 16.10 Cellular and humoral immune responses.
11. Figure 16.11 (a–c) Process of teaching T-cells and B-cells to recognise pathogens (infectious organisms).
12. Figure 16.12 (a, b) Model of an antibody (IgG).
13. Figure 16.13 Model of an antigen showing the epitopes (receptors).
14. Figure 16.14 Antibody responses to an infection.
Chapter 17
1. Figure 17.1 (a–d) The types of cells in the epidermis.
2. Figure 17.2 A microscopic perspective of the skin with the various strata.
3. Figure 17.3 Three layers of skin: the epidermis, the dermis and subcutaneous layer.
4. Figure 17.4 A pilosebaceous unit.
5. Figure 17.5 A sweat gland.
6. Figure 17.6 The nail.

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Contributors

About the editors

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

Editor-in-Chief of the British Journal of Nursing
Head of School, School of Health Studies, Gibraltar
Ian began his nursing career in 1981 at Central Middlesex Hospital, becoming an enrolled nurse working in an intensive care unit. He later undertook 3 years’ student nurse training at Central Middlesex and Northwick Park Hospitals, becoming a staff nurse and then a charge nurse. He has worked in nurse education since 1989. His key areas of interest are nursing practice and theory, men’s health, sexual health and HIV. Ian has published widely. He is Visiting Professor, Kingston University London and St George’s, University of London.

Muralitharan Nair SRN, RMN, DipN (Lond) RNT, Cert Ed, BSc (Hons) MSc (Surrey), Cert in Counselling, FHEA
Muralitharan commenced his nursing a career in 1971 at Edgware General Hospital, becoming a staff nurse. In 1975 he commenced his mental health nurse training at Springfield Hospital and worked as a staff nurse for approximately 1 year. He worked at St Mary’s Hospital Paddington and Northwick Park Hospital, returning to Edgware General Hospital to take up the post of senior staff nurse and then charge nurse. He has worked in nurse education since 1989. His key interests include physiology, diabetes, surgical nursing and nurse education. Muralitharan has published widely in journals and co-edited a number of textbooks. He has now retired from being a full-time lecturer but is working as a nursing consultant.

About the contributors

Carl Clare RN DipN, BSc (Hons), MSc (Lond), PGDE (Lond)
Carl began his nursing a career in 1990 as a nursing auxiliary. He later undertook 3 years’ student nurse training at Selly Oak Hospital (Birmingham), moving to The Royal Devon and Exeter Hospitals, then Northwick Park Hospital, and finally The Royal Brompton and Harefield NHS Trust as a Resuscitation Officer and Honorary Teaching Fellow of Imperial College (London). He has worked in nurse education since 2001. His key areas of interest are physiology, sociology, cardiac care and resuscitation. Carl has previously published work in cardiac care, resuscitation and pathophysiology.

Louise McErlean RGN, BSc(Hons), MA (Herts)
Louise began her nursing career in 1986 at the Victoria Infirmary in Glasgow, becoming a registered general nurse. She later completed the intensive care course for registered general nurses while working in Belfast as a staff nurse. She then worked as a junior sister at the Royal Free Hospital and has worked in nurse education since 2005. Her key areas of interest are pre-registration nurse education and intensive care nursing.

Janet G Migliozzi RN, BSc (Hons), MSc (Lon), PGDE, FHEA
Janet is a senior lecturer in the School of Health & Social Work, University of Hertfordshire. Janet commenced her nursing career in London and worked at a variety of hospitals across London, predominantly in vascular, orthopaedic and high-dependency surgery before specialising in infection prevention and control. Janet has worked in higher education since 1999, and her key interests include medical microbiology and microbial resistance, healthcare-associated infection, patient safety, infection prevention strategies/education of healthcare professionals at both a UK and European level and the use of clinical simulation to minimise healthcare risk. Janet has previously published work in minimising healthcare-associated risk and pathophysiology. Janet is a member of the European Nurses Association and is also the research and development lead for the East of England branch of the Infection Prevention Society.

Peter S Vickers Cert Ed, DipCD, SRN, RSCN, BA, PhD, FHEA
Following a career in teaching, Peter commenced nursing in 1980, working at the York District Hospital and the Hospitals for Sick Children, Great Ormond Street, London, becoming the Clinical Nurse Specialist in Paediatric Immunology. Following a degree in Biosciences and Health Studies, in 1999, he was awarded his doctorate following research into the long-term development of children with severe combined immunodeficiency in the UK and Germany. He worked in nurse education for several years and has written books on children’s responses to early hospitalisation and on research methodology; he has also written chapters for nursing bioscience and pathophysiology books, and presented papers at international conferences. His areas of interest are immunology and immunology nursing, infectious diseases, genetics and research. Now retired, he remains active in writing and was President of INGID (the international organisation for nurses working within the field of primary immunodeficiencies) from 2012 to 2014.

Anthony Wheeldon MSc (Lond), PGDE, BSc(Hons), DipHE, RN
Anthony began his nursing career at Barnet College of Nursing and Midwifery. After qualification in 1995 he worked as a staff nurse and senior staff nurse in the Respiratory Directorate at the Royal Brompton and Harefield NHS Trust in London. In 2000 he started teaching on post-registration cardio-respiratory courses before moving into full-time nurse education at Thames Valley University in 2002. Anthony has a wide range of nursing interests, including cardio-respiratory nursing, anatomy and physiology, respiratory assessment, nurse education, and the application of bioscience in nursing practice. In 2006 Anthony joined the University of Hertfordshire, where he has taught on both pre- and post-registration nursing courses. He is currently an associate subject lead for adult nursing.

Preface

We were delighted when we were asked to write a second edition of the popular Fundamentals of Anatomy and Physiology for Student Nurses. The first edition has been a very popular choice not only with student nurses but also with students in other healthcare professions and this has been reflected in the title of this second edition. The second edition of Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students retains all of the attributes in the popular first edition as well as a whole range of new features in this book and also through the companion websites.

Those contributing to the text are all dedicated to the provision of high-quality, safe and effective care. The authors are all experienced academics working in higher education, with many years of clinical experience, knowledge and skills, teaching a variety of multidisciplinary student groups at various academic levels. We are confident that after you have gained a sound understanding of anatomy and physiology you will be able to understand better the needs of the people you have the privilege to care for. High-quality, safe and effective care for all is something all of us should strive to provide; however, this will be a challenge if we do not fully appreciate the person in a holistic manner. Those who provide care have to take into consideration the anatomical and physiological elements, but they must also consider the psychosocial aspects of the person and their family, addressing the needs of the whole being, the whole person. This text has been devised in such a way as to encourage learning and understanding. We hope you enjoy reading it, and more importantly that you are hungry to learn more, that you will be tempted to delve deeper as you grow and develop into becoming a provider of healthcare that is world class, safe and effective.

The companion to this book, Fundamentals of Applied Pathophysiology: An Essential Guide for Nursing and Healthcare Students (Nair and Peate, 2013), also in its second edition, will help in your development and understanding. Within your programme of study which is related to the provision of care it is important that you are confident and competent with regards to pathophysiology and anatomy and physiology. It is not enough that you remember all of the facts (and there are many of these) that are linked with anatomy and physiology; you also have to relate these to those you care for. Some of those people may be vulnerable and at risk of harm, and it is your responsibility to ensure that you are knowledgeable and that you understand the complexities of care. This new edition of Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students will help you.

It is a requirement of several programmes of study that lead to registration with a professional body that you demonstrate competence in a number of spheres, and this will include anatomy and physiology – for example, see The Standards for Pre-Registration Nursing Education (Nursing and Midwifery Council, 2010).

The human body is as beautiful on the inside as it is on the outside; when working in harmony the mind and body is an astonishing mechanism that has the capacity to perform a range of amazing things. Healthcare students practise and study in a number of healthcare settings, in the hospital and the primary-care setting and in the person’s own home where they are destined to meet and care for patients with a range of altered anatomical and physiological problems. Employing a fundamental approach with a sound anatomical and physiological understanding will provide healthcare students with an essential basis on which to provide care.

Anatomy and physiology

Anatomy can be defined simply as the science related to the study of the structure of biological organisms; there are dictionaries that use such a definition. Fundamentals of Anatomy and Physiology for Nursing and Healthcare Students focuses on human anatomy, and the definition of anatomy for the purposes of this text is that it is a study of the structure and function of the human body. This allows for reference to function and also structure; in all biological organisms structure and function are closely interconnected. The human body can only operate through interrelated systems.

The term anatomy is Greek in origin and means ‘to cut up’ or ‘to dissect’. The first scientifically based anatomical studies (credited to Vesalius, the 16th-century Flemish anatomist, doctor and artist) were based on observations of cadavers (dead bodies). Contemporary approaches to human anatomy differ, however, as they include other ways of observation; for example, with the aid of a microscope and other complex and technologically advanced imaging tools. Subdivisions are now associated within the broader field of anatomy, with the word anatomy often preceded with an adjective identifying the method of observation; for example, gross anatomy (the study of body parts that are visible to the naked eye, such as the heart or the bones) or microanatomy (where body parts such as cells or tissues are only visible with the use of a microscope).

Living systems can be defined from a number of perspectives:

At the very smallest level, the chemical level, atoms, molecules and the chemical bonds connecting atoms provide the structure upon which living activity is based.
The smallest unit of life is the cell. Specialised bodies – organelles – within the cell perform particular cellular functions. Cells may be specialised; for example, bone cells and muscle cells.
Tissue is a group of cells that are similar and they perform a common function. Muscle tissue, for example, is made up of muscle cells.
Organs are groups of different types of tissues working together to carry out a specific activity. The stomach, for example, is an organ made up of muscle, nerve and tissues.
A system is two or more organs that work together to carry out a specific activity. The digestive system, for example, comprises the coordinated activities of a number of organs, including the stomach, intestines, pancreas and liver.
Another system that possesses the characteristics of living things is an organism; this has the ability to obtain and process energy, the capacity to react to changes in the environment and the ability to reproduce.

As anatomy is associated with the function of a living organism it is almost always inseparable from physiology. Physiology can be described as the science dealing with the study of the function of cells, tissues, organs and organisms. Physiology is concerned with how an organism carries out its many activities, considering how it moves, how it is nourished, how it adapts to changing environments – human and animal, hostile and friendly. It is in essence the study of life.

Physiology is the foundation upon which we build our knowledge of what life is; it can help us to decide how to treat disease as well as help us to adapt and manage changes imposed on our bodies by new and changing surroundings – internal and external. Studying physiology will help you understand disease (pathophysiology) arising from this; physiologists working with others are able to develop new ways for treating diseases.

Just as there are a number of branches of anatomical study, so too are there a number of physiological branches that can be studied; for example, endocrinology, neurology and cardiology.

There are 17 chapters. The text is not intended to be read from cover to cover, but you may find reading chapters one to four first will help you come to terms with some of the more complex concepts; we would encourage you to dip in and out of the book. The chapters use simple and generously sized full-colour artwork in order to assist you in your understanding and appreciation of the complexities associated with the human body from an anatomical and physiological perspective. There are many features contained within each chapter that can help you to build upon and develop your knowledge base; we would encourage you to get the most out of this book.

The text takes the reader from the microscopic to macroscopic level in the study of anatomy and physiology. The contents demonstrate the movement from cells and tissues through to systems. This approach to teaching is a tried-and-tested approach, especially when helping learners understand a topic area that can sometimes be seen as complex.

This book has been written with these key principles in mind, to help inform your practice as well as your academic work. This second edition retains the features that have helped students bring to life the fascinating subject of human anatomy and physiology; there is also a range of new features provided to further enhance the student experience.

Each chapter begins with several questions that are posed to test your current knowledge; this allows you to pre-test. Learning outcomes are provided. These will cover the content within the chapter, but only you can do the learning; these outcomes are what are expected of you after reading and absorbing the information. This is a minimum of what you can learn; do not be constrained by the learning outcomes, they are only provided to guide you. Where appropriate an anatomical map is provided; this is related to the chapter you are reading, allowing you to ‘situate or visualise’ the anatomy being discussed.

Another feature in most of the chapters that is provided to help you consider people you care for, to help you make clinical links, is the ‘Clinical considerations’ box. These boxes demonstrate the application to your learning, citing specific care issues that you may come across when working with people in care settings.

A new addition is the feature called ‘Medicines management’. In this feature the contributors discuss the administration of medicines, medicine management issues. This addition can help you appreciate the importance of understanding anatomy and physiology with the intention of administering medicines safely and effectively.

In most chapters there is a series of snapshots. This new addition relates the theory to practice, introducing you to the issues being discussed in a practical way.

At the end of the chapter you are provided with a bank of multiple choice questions. Some of the answers to the questions are not found in the text; in this case you are encouraged to seek out the answers and in so doing develop your learning further.

Other features provided will help you measure the learning that has taken place; for example, true or false, label the diagram, find out more, crosswords or word searches. These are meant to be fun, but they also aim to pull together the content of the chapter.

The feature ‘Conditions’ at the end of the chapter provides you with a list of conditions that are associated with the topics discussed in the chapter. You are encouraged to take some time to write notes about each of the conditions listed; this will help you relate theory to practice. You can make your notes taken from other textbooks or other resources – for example, the people you work with in a care area – or you may make the notes as a result of people you have cared for. It is important, however, that if you are making notes about people you have cared for you must ensure that you adhere to the rules of confidentiality.

At the end of every chapter a glossary of terms is provided. We present this to facilitate the learning of difficult words or phrases; understanding these words and phrases is important to your success as a healthcare student. When you have mastered the words your medical vocabulary will have grown and you will be in a better position to develop it further.

We have, in this new edition, included a list of prefixes and suffixes as well a table of normal values.

A myriad of features have been compiled to help your learning with two companion websites. The features include an interactive glossary and a series of case studies with the intention of bringing alive the subject matter. The electronic resources associated with this book are designed to help enhance your learning; they are varied and informative and are visually stimulating.

The advantages of these resources are that they can be used in your own place at your own pace. The aim is to encourage further learning and to build upon what you know already. There are also links to other resources via the further reading section at the end of the chapters.

Using the electronic resources alongside the book, as well as the human resources you will meet in practice, will enhance the quality of your learning. The electronic resources available cannot replace the more conventional face-to-face learning with other students, lecturers, registered practitioners and patients; they complement it.

We have enjoyed writing this second edition and we sincerely hope you enjoy reading it. We wish you much success with your studies, whether they are in the classroom or in the many care areas that you might find yourself working.

References

Nair, M. and Peate, I. (2013) Fundamentals of Applied Pathophysiology: An Essential Guide for Nursing and Healthcare Students, 2nd edn. Oxford: John Wiley & Sons, Ltd.
Nursing and Midwifery Council (2010) Standards for Pre-Registration Nursing Education. http://standards.nmc-uk.org/PublishedDocuments/Standards%20for%20pre-registration%20nursing%20education%2016082010.pdf (accessed 7 November 2015).

For Nursing and Healthcare Students

About the editors

About the contributors

Anatomy and physiology

References