Saladin - Anatomy and Physiology The Unity of Form and Function 3e, Biologia, Biology
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Saladin: Anatomy &
Physiology: The Unity of
Form and Function, Third
Edition
Front Matter
Preface
© The McGraw−Hill
Companies, 2003
Preface
Thank you to the colleagues and students who have
made this textbook so successful and helped to ensure
its staying power in a very competitive textbook niche.
Several people have asked me, with this book doing so
well, why I don’t retire from the classroom. The answer
is that not only do I find classroom teaching the most ful-
filling aspect of my profession, but also that it is my stu-
dents who teach me how to write. I work continually at
finding more and more effective ways of getting con-
cepts across to them, at turning on the light of insight.
The best ideas for communicating difficult physiological
ideas often come to mind during my face-to-face inter-
actions with students, and many are the times that I have
dashed back from the lecture room to the drawing pad or
keyboard to sketch concepts for new illustrations or
write down new explanations. Grading exams and
homework assignments also continually gives me new
impressions of whether I have effectively taught an idea
through my writing. Thus, my students are my unwitting
writing teachers. This pertains also to the students in my
“extended classroom”—students worldwide who use
the book and write to ask my help in understanding dif-
ficult concepts.
What are the improvements in this edition? I con-
tinue to aim for ever-better clarity, brevity, currency, and
accuracy. Physiology, especially, is a complex subject to
explain to beginning students, and I am always working
in both the lecture room and textbook to find clearer ways
to explain it. Physiology also is a fast-growing field, and
it’s a challenge to keep a book up to date without it grow-
ing longer and longer. After all, our lecture periods and
semesters aren’t getting any longer! So, while updating
information, I have looked for ways to make my discus-
sions more concise in each edition. I also continue to cor-
rect errors as students and content experts have sent me
queries, corrections, and suggestions. Accuracy is, of
course, an advantage of a seasoned textbook over a new-
comer, and this book has gained a lot of seasoning and a
little spice from my extensive correspondence with stu-
dents and colleagues.
This preface describes the book’s intended audience,
how we determined what students and instructors want in
the ideal A&P textbook, what has changed in this edition
to best meet your needs, how this book differs from others,
and what supplements are available to round out the total
teaching package.
Audience
This book is meant especially for students who plan to
pursue such careers as nursing, therapy, health education,
medicine, and other health professions. It is designed for
a two-semester combined anatomy and physiology course
and assumes that the reader has taken no prior college
chemistry or biology courses. I also bear in mind that
many A&P students return to college after interruptions to
raise families or pursue other careers. For returning stu-
dents and those without college prerequisites, the early
chapters will serve as a refresher on the necessary points
of chemistry and cell biology.
Many A&P students also are still developing the
intellectual skills and study habits necessary for success
in a health science curriculum. There are many, too, for
whom English was not their original language. Therefore,
I endeavor to write in a style that is clear, concise, and
enjoyable to read, and to enliven the facts of science with
analogies, clinical remarks, historical notes, biographical
vignettes, and other seasoning that will make the book
enjoyable to students and instructors alike. Each chapter
is built around pedagogic strategies that will make the sub-
ject attainable for a wide range of students and instill the
study and thinking habits conducive to success in more
advanced courses.
How We Evaluated Your Needs
This book has evolved through extensive research on the
needs and likes of A&P students and instructors. In devel-
oping its three editions so far, we have collected evalua-
tive questionnaires from reviewers; commissioned
detailed reviews from instructors using this book and
those using competing books; held focus groups from
coast to coast in the United States, in which instructors
and students studied the book in advance, then met with
us to discuss it in depth for several hours, including how
it compared to other leading A&P textbooks; and created
panels of A&P instructors to thoroughly analyze the entire
book and its art program. These efforts have involved
many hundreds of faculty and students and generated
thousands of pages of reviews, all of which I have read
carefully in developing my revision plans. In a less formal
viii
Saladin: Anatomy &
Physiology: The Unity of
Form and Function, Third
Edition
Front Matter
Preface
© The McGraw−Hill
Companies, 2003
Preface
ix
way, the book has improved because of the many e-mails I
receive from instructors and students worldwide who not
only tell me what they like about it, but also raise sugges-
tions for correction or improvement. I’ve responded gen-
erously to these e-mails because I learn a great deal look-
ing up answers to readers’ questions, finding sources to
substantiate the book’s content, and sometimes finding
that I need to update, clarify, or correct a point.
illustrative concepts not found in other books. Profes-
sional medical illustrators and graphic artists have ren-
dered these, as well as the classic themes of A&P, in a vivid
and captivating style that has contributed a lot to a stu-
dent’s desire to learn.
As the book has evolved through these three edi-
tions, I have used larger figures and brighter colors;
adopted simpler, uncluttered labeling; and continued to
incorporate innovative illustrative concepts. A good illus-
tration conveys much more information than several times
as much space filled with verbiage, and I have cut down
on the word count of the book to allow space for larger and
more informative graphics.
The illustration program is more than line art. I con-
tinue to incorporate better histological photography and
cadaver dissections, including many especially clear and
skillful dissections commissioned specifically for this book.
Several of my students have modeled for photo-
graphs in this book. As much as possible with the volun-
teers who came forth, I have represented an ethnic variety
of subjects.
How We’ve Met Your Needs
Our research has consistently revealed that the three qual-
ities instructors value most in a textbook are, in descend-
ing order of importance, writing style, illustration quality,
and teaching supplements. I have focused my attention
especially on the first two of these and on pedagogic fea-
tures, while McGraw-Hill Higher Education has continu-
ally engaged other authors and software developers to pro-
duce a more diverse package of superb supplements for
students and instructors.
Writing Style
Students benefit most from a book they enjoy reading, a
book that goes beyond presenting information to also tell
an interesting story and engage the reader with a some-
what conversational tone. That was my guiding principle
in finding the right voice for the first edition, and it
remains so in this one. I try to steer a middle course,
avoiding rigid formality on one hand or a chatty conde-
scending tone on the other. I feel I have succeeded when
students describe the tone as friendly, engaging, collo-
quial, almost as if the author is talking to them, but not
talking down to them.
In devising ways to make the writing more concise
without losing the qualities that make it interesting and
enjoyable, I have been guided by reviewers who identified
areas in need of less detail and by students who cited cer-
tain areas as especially engrossing and pleasurable to read.
In this edition, I somewhat reduced the number of bold-
faced terms and the amount of vocabulary, and fine-tuned
such mechanics as sentence length, paragraph breaks, and
topic and transitional sentences for improved flow. In
such difficult topics as action potentials, blood clotting,
the countercurrent multiplier, or aerobic respiration, I
think this book will compare favorably in a side-by-side
reading of competing textbooks.
Supplements
The third most highly rated quality is the package of learn-
ing supplements for the student and teaching aids for the
instructor. Instructors have rated overhead transparencies
the most important of all supplements, and we now include
transparencies of every item of line art in the book, and
some of the photographs and tables. Included are unlabeled
duplicates of many anatomical figures, useful for testing or
labeling to fit one’s individual teaching approach. A full set
of both labeled and unlabeled illustrations is also available
in the Instructor’s Presentation CD-ROM.
Students have expressed growing enthusiasm and
appreciation for the Online Learning Center and the
Essential Study Partner. We have continued to enrich
these media with an abundance of learning aids and
resources. These and other student and instructor supple-
ments are listed and described on page xiii.
What Sets This Book Apart?
Those who have not used or reviewed previous editions
will want to know how this book differs from others.
Illustrations
When I was a child, it was the art and photography in biol-
ogy books that most strongly inspired me to want to learn
about the subject. So it comes as no surprise that students
and instructors rate the visual appeal of this book as sec-
ond only to writing style in importance. I developed many
Organization
The sequence of chapters and placement of some topics in
this book differ from others. While I felt it was risky to
depart from tradition in my first edition, reviewer com-
ments have overwhelmingly supported my intuition that
these represent a more logical way of presenting the
Saladin: Anatomy &
Physiology: The Unity of
Form and Function, Third
Edition
Front Matter
Preface
© The McGraw−Hill
Companies, 2003
x
Preface
human A&P. Indeed, some have written that they are
changing their teaching approach because of this book.
opening page of each chapter. These fall into three cate-
gories: 101 clinical applications, 13 on medical history,
and 9 on evolutionary medicine. For a quick survey of
their subject matter, see the lists under these three phrases
in the index.
Heredity
I treat the most basic concepts of heredity in chapter 4 rather
than waiting, as most books do, until the last chapter. Stu-
dents would be ill-prepared to understand color blindness,
blood types, hemophilia, sex determination, and other topics
if they didn’t already know about such concepts as dominant
and recessive alleles, sex chromosomes, and sex linkage.
Clinical Applications
It is our primary task in A&P to teach the basic biology of
the human body, not pathology. Yet students want to
know the relevance of this biology—how it relates to
their career aims. Furthermore, disease often gives us our
most revealing window on the importance of normal
structure and function. What could better serve than cys-
tic fibrosis, for example, to drive home the importance of
membrane ion pumps? What better than brittle bone dis-
ease to teach the importance of collagen in the osseous
tissue? The great majority of Insight sidebars therefore
deal with the clinical relevance of the basic biology. Clin-
ical content has also been enhanced by the addition of a
table for each organ system that describes common
pathologies and page-references others.
Muscle Anatomy and Physiology
I treat gross anatomy of the muscular system (chapter 10)
immediately after the skeletal system and joints in order to
tie it closely to the structures on which the muscles act
and to relate muscle actions to the terminology of joint
movements. This is followed by muscle physiology and
then neurophysiology so that these two topics can be
closely integrated in their discussions of synapses, neuro-
transmitters, and membrane potentials.
Nervous System Chapters
Many instructors cite the nervous system as the most dif-
ficult one for students to understand, and in many
courses, it is presented in a hurry before the clock runs out
on the first semester. Other A&P textbooks devote six
chapters or more to this system. It is overwhelming to both
the instructor and student to cover this much material at
the end of the course. I present this system in five chap-
ters, and notwithstanding my assignment of a separate
chapter to the autonomic nervous system in this edition,
this is still the most concise treatment of this system
among the similar two-semester textbooks.
Medical History
I found long ago that students especially enjoyed lectures in
which I remarked on the personal dramas that enliven the
history of medicine. Thus, I incorporated that approach into
my writing as well, emulating something that is standard
fare in introductory biology textbooks but has been largely
absent from A&P textbooks. Reviews have shown that stu-
dents elsewhere, like my own, especially like these stories.
I have composed 13 historical and biographical vignettes to
have an especially poignant or inspiring quality, give stu-
dents a more humanistic perspective on the field they’ve
chosen to study, and, I hope, to cultivate an appropriately
thoughtful attitude toward the discipline. Historical
remarks are also scattered through the general text.
Profiles of Marie Curie (p. 58), Rosalind Franklin
(p. 132), and Charles Drew (p. 694) tell of the struggles and
unkind ironies of their scientific careers. Some of my
favorite historical sidebars are the accounts of William Beau-
mont’s digestive experiments on “the man with a hole in his
stomach” (p. 977); Crawford Long’s pioneering surgical use
of ether, until then known mainly as a party drug (p. 628);
the radical alteration of Phineas Gage’s personality by his
brain injury (p. 538); and the testy relationship between the
men who shared a Nobel Prize for the discovery of insulin,
Frederick Banting and J. J. R. MacLeod (p. 671).
Urinary System
Most textbooks place the urinary system near the end
because of its anatomical association with the reproductive
system. I feel that its intimate physiological ties with the
circulatory and respiratory systems are much more impor-
tant than this anatomical issue. The respiratory and uri-
nary systems collaborate to regulate the pH of the body flu-
ids; the kidneys have more impact than any other organ on
blood volume and pressure; and the principles of capillary
fluid exchange should be fresh in the mind of a student
studying glomerular filtration and tubular reabsorption.
Except for an unavoidable detour to discuss the lymphatic
and immune systems, I treat the respiratory and urinary
systems as soon as possible after the circulatory system.
Evolutionary Medicine
The human body can never be fully appreciated without a
sense of how and why it came to be as it is. Medical liter-
ature since the mid-1990s has shown increasing interest in
“evolutionary medicine,” but most A&P textbooks con-
tinue to disregard it. Chapter 1 briefly introduces the con-
“Insight” Sidebars
Each chapter has from two to six special topic sidebars
called Insights, listed by title and page number on the
Saladin: Anatomy &
Physiology: The Unity of
Form and Function, Third
Edition
Front Matter
Preface
© The McGraw−Hill
Companies, 2003
Preface
xi
cept of natural selection and how certain human adapta-
tions relate to our biological past. Later chapters have nine
Evolutionary Medicine insights and shorter evolutionary
remarks in the main body of text. Students will find novel
and intriguing ways of looking at such topics as mito-
chondria (p. 124), hair (p. 204), skeletal anatomy (p. 286),
body odors (p. 595), the taste for sweets (p. 990), the
nephron loop (p. 897), lactose intolerance (p. 970),
menopause (p. 1060), and senescence (p. 1114).
at the end of the chapter, 10 “True/False” questions in the
chapter review that require the student to analyze why the
false statements are untrue, and usually 5 questions per
chapter in the figure legends, prompting the student to ana-
lyze or extrapolate from information in the illustrations. A
great number and variety of additional questions are avail-
able to students at the Online Learning Center.
System Interrelationships
Most instructors would probably agree on the need to
emphasize the interrelationships among organ systems
and to discourage the idea that a system can be put out of
one’s mind after a test is over. This book reinforces the
interdependence of the organ systems in three ways.
1. Beginning with chapter 3 (p. 93), each chapter has
a “Brushing Up” box that lists concepts from
earlier chapters that one should understand before
moving on. This may also be useful to students
who are returning to college and need to freshen
up concepts studied years before, and to
instructors who teach the systems in a different
order than the book does. It also reinforces the
continuity between A&P I and II.
2. For each organ system, there is a “Connective
Issues” feature (p. 212, for example) that
summarizes ways in which that system influences
all of the others of the body, and how it is
influenced by them in turn.
3. Chapter 29 includes a section, “Senescence of the
Organ Systems,” which can serve as a “capstone
lesson” that compellingly shows how the age-
related degeneration of each system influences, and
is influenced by, the others. Senescence is an
increasingly important topic for health-care
providers as the population increases in average
age. This section should sensitize readers not only
to the issues of gerontology, but also to measures
they can take at a young age to ensure a better
quality of life later on. For instructors who prefer to
treat senescence of each organ system separately
throughout the course, earlier chapters cite the
relevant pages of this senescence discussion.
Pedagogy
Several features of this book are designed to facilitate the
student’s learning.
Learning Objectives
I divide each chapter into typically five or six segments of
just a few pages each, with a list of learning objectives at
the beginning and a list of “Before You Go On” content
review questions at the end of each one. This enables stu-
dents to set tangible goals for short study periods and to
assess their progress before moving on.
Vocabulary Aids
A&P students must assimilate a large working vocabulary.
This is far easier and more meaningful if they can pro-
nounce words correctly and if they understand the roots
that compose them. Chapter 1 now has a section, “The
Language of Medicine,” which I hope will help get stu-
dents into the habit of breaking new words into familiar
roots, and help them appreciate the importance of preci-
sion in spelling and word use. Pronunciation guides are
given parenthetically when new words are introduced,
using a “pro-NUN-see-AY-shun” format that is easy for
students to interpret. New terms are accompanied by foot-
notes that identify their roots and origins, and a lexicon of
about 400 most commonly used roots and affixes appears
in appendix C (p. A-7).
Self-Testing Questions
Each chapter has about 75 to 90 self-testing questions in
various formats and three levels of difficulty: recall,
description, and analysis or application. The
ability to
recall
terms and facts is tested by 20 multiple choice and
sentence completion questions in the chapter review. The
ability to describe
concepts is tested by the “Before You Go
On” questions at the ends of the chapter subdivisions,
totaling about 20 to 30 such questions per chapter. The
ability to analyze and apply
ideas and to relate concepts in
different chapters to each other is tested by an average of 5
“Think About It” questions at intervals throughout each
chapter, 5 “Testing Your Comprehension” essay questions
What’s New?
I’ve been cautious about reorganizing the book and tam-
pering with a structure that has been responsible for its
success. Nevertheless, the voices of many reviewers have
convinced me that a few changes were in order.
Changes in Chapter Sequence
I made two changes in chapter sequencing and numbering:
Saladin: Anatomy &
Physiology: The Unity of
Form and Function, Third
Edition
Front Matter
Preface
© The McGraw−Hill
Companies, 2003
xii
Preface
Nervous System Chapters
The most frequent request has been to give the autonomic
nervous system a chapter of its own, with slightly deeper
coverage. I have done so at chapter 15. Another common
request I’ve accommodated has been to discuss the spinal
cord and spinal nerves together in one chapter (now chap-
ter 13) and the brain and cranial nerves together in another
(now chapter 14).
Content Changes
I have strengthened the coverage of the following topics
(indicating chapter numbers in parentheses): mitochon-
drial diseases (3), autoimmune diseases (5), the stages of
hair growth (6), biomechanics of bone tissue (7), the enteric
nervous system (15), receptive fields of sensory neurons
(16), hormone-transport proteins (17), the blood-thymus
barrier (21), clonal deletion and anergy (21), renal autoreg-
ulation (23), lipostats and leptin (26), and the trisomies (29).
I have updated information on the following, drawing
on research and review literature as recent as April 2002,
even as the book was in production: genetic translation in
the nucleus (4), signal peptides (4), stem cell research (5),
hair analysis (6), osteoporosis treatments (7), knee surgery
(9), muscle–connective tissue relationships (11), mitosis in
cardiac muscle (11), astrocyte functions (12), surgical treat-
ment of parkinsonism (12), amyotrophic lateral sclerosis
(13), memory consolidation (14), functional MRI (14), the
sensory role of filiform papillae (16), a new class of retinal
photoreceptors (16), the history of anesthesia (16), the rela-
tionship of growth hormone to somatomedins (17), cyto-
toxic T cell activation (21), asthma (21), neuroimmunology
(21), atrial natriuretic peptide (23), hunger and body
weight homeostasis (26), heritability of alcoholism (26),
the functions of relaxin (28), contraceptive options (28),
the fate of sperm mitochondria (29), Werner syndrome (29),
telomeres (29), and theories of aging (29).
Chemistry
To compensate for the added nervous system chapter with-
out making the book longer, and because many reviewers
felt that the book could do without two full chapters of
chemistry, I condensed the coverage of chemistry by about
25% and combined the two former chemistry chapters into
one (now chapter 2). This results in a change of chapter
numbers from 3 through 15, but from chapter 16 to the end,
the numbers are the same as in the previous editions.
Changes in Chapter Organization
In three cases, I felt that a subject could be presented more
effectively by rearrangements and content substitutions
within a chapter. Other chapters continue to be organized
as they were in the second edition.
Chapter 1, Major Themes of Anatomy
and Physiology
Here I replaced the section on human taxonomic classifi-
cation with sections on anatomical and physiological
variability. This gives the chapter a less zoological and
more clinical flavor. Also, I feel it is important at the out-
set of such a course to instill a sense of the familiar roots
of biomedical terms, the importance of precision in
spelling, and other aspects of vocabulary. Thus I moved
the former appendix B, which introduced students to
medical etymology, to chapter 1 (“The Language of Med-
icine,” p. 19).
Issues of Terminology
In 1999, the
Terminologia Anatomica
(TA) replaced the
Nomina Anatomica
as the international standard for
anatomical terminology. I have updated the terminology
in this edition accordingly, except in cases where TA ter-
minology is, as yet, so unfamiliar that it may be more a
hindrance than a help for an introductory anatomy course.
For example, I use the unofficial
femur
rather than the offi-
cial
os femoris
or
femoral bone.
The TA no longer recognizes eponyms, and I have
avoided using them when possible and practical (using
tactile disc
instead of
Merkel disc,
for example). I do intro-
duce common eponyms parenthetically when a term is
first used. Some eponyms are, of course, unavoidable
(Alzheimer disease, Golgi complex)
and in some cases it
still seems preferable to use the eponyms because of famil-
iarity and correlation with other sources that students will
read (for example,
Schwann cell
rather than
neurilemmo-
cyte
).
Chapter 17, The Endocrine System
As many reviewers desired, I have separated endocrine
pathology from normal physiology and placed the pathol-
ogy at the end of the chapter.
Chapter 21, The Lymphatic and
Immune Systems
I have found it more effective to present cellular immunity
before humoral immunity, since humoral immunity
depends on some concepts such as helper T cells usually
introduced in the context of cellular immunity.
I follow the recommendation of the American Med-
ical Association
Manual of Style
(ninth edition, 1998) to
delete the possessive forms of nearly all eponyms. There
are people who take offense at the possessive form
Down’s
syndrome
and yet may be equally insistent that
Alzheimer’s disease
be in the possessive. The AMA has
grappled with such inconsistencies for years, and I accept
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