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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Wiley Series on Cognitive Dynamic Systems
- Sprache: Englisch
Anatomy and Physiology for Nursing and Healthcare Students at a Glance The market-leading at a Glance series is popular among healthcare students and newly qualified practitioners for its concise, simple approach and excellent illustrations. Each bite-sized chapter is covered in a double-page spread with clear, easy-to-follow diagrams, supported by succinct explanatory text. Covering a wide range of topics, books in the at a Glance series are ideal as introductory texts for teaching, learning and revision, and are useful throughout university and beyond. Everything you need to know about anatomy and physiology ... at a Glance! An ideal introduction and revision guide for anatomy and physiology As part of the popular At a Glance series, Anatomy & Physiology for Nursing & Healthcare Students provides a wonderful introduction to the topic and is written with the student nurse in mind. This is also a useful reference guide for any healthcare professional looking for a quick refresher on the human body. The book strikes a balance between being succinct without being superficial, with concise writing that provides an overview of anatomy and physiology. Helping nurses develop practical skills and deliver increasingly complex care for patients through the study of how the body functions, readers will also find: * A user-friendly approach that includes bite-size pieces of information and full-colour diagrams to help students retain, recall, and apply facts to their practice * Clinical practice points that aim to encourage readers to relate to the theoretical concepts in practice * New to the second edition: a chapter on anatomical terms and emphasising the importance of the correct anatomical terminology in communication between healthcare professionals * Includes access to a companion website with self-assessment questions for each chapter This quick and easy-to-digest introduction to anatomy and physiology is the perfect textbook for nursing students in all fields of practice, allied healthcare students including paramedics and physiotherapists, and newly qualified nurses and nursing associates. It is also an ideal reference book for anyone looking for an overview of the human body. The book is also available in a range of digital formats which allows for easy access on the go. For more information on the complete range of Wiley nursing and health publishing, please visit: www.wiley.com To receive automatic updates on Wiley books and journals, join our email list. Sign up today at www.wiley.com/email All content reviewed by students for students Wiley nursing books are designed exactly for their intended audience. All of our books are developed in collaboration with students. This means that our books are always published with you, the student, in mind. If you would like to be one of our student reviewers, go to www.reviewnursingbooks.com to find out more. This new edition is also available as an e-book. For more details, please see www.wiley.com/buy/9781119757207
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Table of Contents
Cover
Title Page
Copyright Page
Preface
Abbreviations
Acknowledgements
How to use your revision guide and the companion website
Features contained within your revision guide
Part 1: Foundations
1 Anatomical terms
Anatomical position
Anatomical terms
Directional terms
Planes
Body cavities
2 Genetics and genomics
DNA and RNA
Mitosis, meiosis and fertilisation
Mitosis
Meiosis
Fertilisation
3 Homeostasis
Homeostasis
Feedback mechanisms
Negative feedback
Positive feedback
4 Fluid compartments
Body water
Location of body fluids
Maintaining fluid balance
Body fluid movement
5 Cells and organelles
Components of a cell
6 Transport systems
Simple diffusion
Facilitated diffusion
Osmosis
Endocytosis and exocytosis
7 Blood
Functions
Blood components
Development of blood cells
8 Inflammation and immunity
Immunity
Inflammation
9 Tissues
Epithelial tissue
Nervous tissue
Connective tissue
Muscle tissue
Part 2: The nervous system
10 The brain and nerves
The brain
The meninges
The cerebrospinal fluid
The neuron
Cranial nerves
11 The structures of the brain
Cerebrum
Diencephalon
Brainstem
Cerebellum
Limbic system
Ventricles of the brain
Cerebrospinal fluid
12 The spinal cord
Spinal cord sections
Functions of the spinal cord
Reflex actions
Spinal nerves
13 The blood supply
Circle of Willis
The blood–brain barrier
14 The autonomic nervous system
Sympathetic nervous system
Parasympathetic nervous system
Autonomic control by the CNS
Autonomic reflexes
15 The peripheral nervous system
Peripheral nervous system connections
Sensory division
Motor division
Part 3: The heart and vascular system
16 The heart
Walls of the heart
Chambers of the heart
Valves of the heart
Blood vessels of the heart
17 Blood flow through the heart
Blood flow
Pulmonary circulation
Systemic circulation
Coronary circulation
Coronary arteries
Coronary veins
18 The conducting system
Cardiac conduction
Sinoatrial node
Atrioventricular node
Bundle of His
Left and right bundle branches
Purkinje fibres
The cardiac cycle
19 Nerve supply to the heart
The autonomic nervous system
Chemical regulation
Baroreceptors
Other factors in heart regulation
20 The structure of the blood vessels
The blood vessels
Structure of the blood vessels
The arteries
The veins
The capillaries
21 The blood pressure
What is blood pressure?
Physiological factors
The control of blood pressure
Taking a blood pressure measurement
22 The lymphatic circulation
Functions of the lymphatic system
The lymphatic system
Lymph
Lymph nodes
Lymphatic organs
Part 4: The respiratory system
23 The respiratory tract
Upper respiratory tract
Lower respiratory tract
Blood supply
24 Pulmonary ventilation
Breathing
Inspiration
Exhalation
Factors affecting pulmonary ventilation
Lung volumes
25 Control of breathing
Medullary rhythmic area
Pneumotaxic area
Apneustic area
Central chemoreceptors
Peripheral chemoreceptors
Inflation reflex
Other influences on respiration
26 Gas exchange
External respiration
Exchange of gases in the lungs
Fick’s Law
Internal respiration
Factors affecting pulmonary and systemic gas exchange
Transport of gases
Part 5: The gastrointestinal tract
27 The upper gastrointestinal tract
The mouth (the oral cavity)
Oesophagus
Stomach
28 The lower gastrointestinal tract
The small intestine
The large intestine (the colon)
29 The liver, gall bladder and biliary tree
The liver
The gall bladder
30 The pancreas and spleen
The pancreas
The spleen
31 Digestion
Mechanical digestion
Chemical digestion
Digestion and absorption
Part 6: The urinary system
32 The kidney (microscopic)
Nephrons
Bowman’s capsule
Glomerulus
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting ducts
33 The kidney (macroscopic)
The kidney
Renal cortex
Renal medulla
Renal pelvis
Blood supply
Nerve supply
34 The ureters, bladder and urethra
The ureters
The urinary bladder
The urethra
35 The formation of urine
Filtration
Selective reabsorption
Secretion
Hormonal control
Aldosterone
Part 7: The male reproductive system
36 The external male genitalia
The testes
Spermatogenesis
The penis
The epididymis
Vas deferens, ejaculatory ducts and spermatic cord
37 The prostate gland
Zones of the prostate gland
Surfaces of the prostate gland
Function of the prostate gland
Some structures around the prostate gland
Prostate specific antigen
38 Spermatogenesis
Male sex hormones
Part 8: The female reproductive system
39 The female internal reproductive organs
Internal female reproductive organs
Female sex hormones
The uterus
The fallopian tubes
The vagina
The cervix
40 The external female genitalia
Mons veneris
Labia majora
Labia minora
Clitoris
Urethra
Hymen
Blood supply
Lymphatic drainage
Nerve supply
41 The female breast
The female breast
Breast development
Hormones and the breast
42 The menstrual cycle
The reproductive cycle
The pituitary gland
The follicular phase
The ovulatory phase
The luteal phase
The menstrual cycle
Part 9: The endocrine system
43 The endocrine system
The endocrine glands
The pituitary gland and the hypothalamus
The pineal gland
The anterior pituitary lobe
The posterior pituitary lobe
44 The thyroid and adrenal glands
The thyroid gland
Parathyroid glands
The adrenal glands
45 The pancreas and gonads
The pancreas
The gonads
Other endocrine glands
Part 10: The musculoskeletal system
46 Bone structure
Bone
Ossification
The skeleton
47 Bone types
The skeleton
Skeletal divisions
Bone types
48 Joints
Joints
Movements
Fibrous joints
Cartilaginous joints
Synovial joints
Fixed joints
49 Muscles
Muscle tissue
Properties of muscle tissue
Part 11: The skin
50 The skin
The layers of the skin
51 The skin appendages
The dermal appendages
52 Epithelialisation
Wounds
How wounds heal
Types of wound healing
Wound closure
53 Granulation
Granulation tissue
Tissue repair
Overgranulation
Part 12: The senses
54 Sight
Vision
The orbit
Eyelids, lashes, eyebrows
The lacrimal apparatus
The sclera
The cornea
The aqueous humour
The iris
The lens and ciliary muscle
The retina
Visual system pathways to the brain
The visual cortex
55 Hearing
The ear
The outer (external) ear
The middle ear
The inner ear
56 Olfaction
Physiology of olfaction
Olfactory nerve and cribriform plate
Olfactory bulb
Olfactory tract
57 Gustation
The tongue
Anatomy and physiology
Taste bud anatomy
Appendix 1: Normal physiological values
Full blood count
Coagulation
Haematinics
Biochemistry
Endocrinology
Other biochemistry tests
Tumour markers
Immunology
Lumbar puncture results
Appendix 2: Prefixes and suffixes
Appendix 3: Glossary
Further reading
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1
The body cavities.
Chapter 2
Table 2.1
Types of RNA.
Chapter 5
Table 5.1
Common elements in the body.
Chapter 8
Table 8.1
Types of antibodies.
Chapter 39
Table 39.1
The layers of the uterus.
Chapter 43
Table 43.1
Hormones released by the hypothalamus and anterior pituitary gla
...
Chapter 44
Table 44.1
Some effects associated with abnormal secretion of thyroid hormo
...
Chapter 45
Table 45.1
Other endocrine glands.
Chapter 54
Table 54.1
Structures of the eye.
List of Illustrations
Chapter 1
Figure 1.1
The standard anatomical position.
Figure 1.2
Anatomical terms.
Figure 1.3
Anatomical planes.
Figure 1.4
Body cavities.
Chapter 2
Figure 2.1
DNA and RNA.
Figure 2.2
Mitosis.
Figure 2.3
Meiosis.
Figure 2.4
Fertilisation.
Chapter 3
Figure 3.1
Components of a negative feedback system.
Figure 3.2
Negative feedback – raised blood pressure.
Figure 3.3
Negative feedback – raised temperature.
Figure 3.4
Positive feedback of childbirth.
Chapter 4
Figure 4.1
Body water content.
Figure 4.2
Fluid compartments.
Chapter 5
Figure 5.1
Structures located within body cells.
Figure 5.2
Mitochondrion.
Figure 5.3
The fluid mosaic arrangement.
Chapter 6
Figure 6.1
Simple diffusion.
Figure 6.2
Channel‐mediated facilitated diffusion of potassium ions (K+) thr
...
Figure 6.3
Osmosis. Water molecules move through the selectively permeable m
...
Figure 6.4
Tonicity and the red blood cell.
Chapter 7
Figure 7.1
Centrifuged blood.
Figure 7.2
Three principal formed components: red blood cells, white blood c
...
Figure 7.3
Compoments of blood.
Figure 7.4
Haemopoiesis.
Chapter 8
Figure 8.1
Types of acquired immunity.
Figure 8.2
The cells of the immune system.
Chapter 9
Figure 9.1
Levels of organisation.
Figure 9.2
Types of cells.
Figure 9.3
Human body tissues.
Chapter 10
Figure 10.1
The brain.
Figure 10.2
The meninges.
Figure 10.3
The neuron.
Figure 10.4
The cranial nerves.
Chapter 11
Figure 11.1
The cerebrum.
Figure 11.2
The cerebellum.
Figure 11.3
The limbic system.
Chapter 12
Figure 12.1
Spinal cord and spinal nerves.
Figure 12.2
The meninges.
Chapter 13
Figure 13.1
The circle of Willis.
Figure 13.2
The blood–brain barrier.
Chapter 14
Figure 14.1
The sympathetic and parasympathetic nervous systems.
Chapter 15
Figure 15.1
The somatic nervous system.
Figure 15.2
The motor pathway.
Chapter 16
Figure 16.1
The location of the heart.
Figure 16.2
The walls of the heart.
Figure 16.3
Cells of the myocardium.
Figure 16.4
Myocardial cells.
Chapter 17
Figure 17.1
Blood flow through the heart.
Figure 17.2
The blood vessels of the heart.
Figure 17.3
The coronary veins.
Chapter 18
Figure 18.1
The conducting system of the heart.
Figure 18.2
The cardiac cycle.
Chapter 20
Figure 20.1
The blood vessels.
Figure 20.2
Layers of the blood vessels.
Figure 20.3
Comparison of an artery, vein and capillary.
Figure 20.4
Capillary network.
Chapter 21
Figure 21.1
The baroreceptors.
Figure 21.2
Blood pressure measurement.
Chapter 22
Figure 22.1
The lymphatic system and organs.
Figure 22.2
The lymphatic capillaries.
Figure 22.3
Lymph node.
Chapter 23
Figure 23.1
The respiratory organs.
Figure 23.2
Detailed structures of the respiratory tract.
Figure 23.3
The lower respiratory tract.
Figure 23.4
Bronchial tree.
Chapter 24
Figure 24.1
Boyle’s Law.
Figure 24.2
Inspiration and expiration.
Chapter 25
Figure 25.1
The respiratory centre.
Figure 25.2
Peripheral chemoreceptors.
Chapter 26
Figure 26.1
External respiration.
Figure 26.2
Gas exchange in the lungs.
Figure 26.3
Internal respiration.
Chapter 27
Figure 27.1
The upper and lower gastrointestinal tract.
Figure 27.2
The tongue.
Figure 27.3
Swallowing action.
Figure 27.4
The stomach.
Chapter 28
Figure 28.1
The small intestine.
Figure 28.2
The large intestine.
Chapter 29
Figure 29.1
The liver, gall bladder and pancreas.
Figure 29.2
Liver lobules.
Figure 29.3
Bile production and secretion.
Chapter 30
Figure 30.1
The pancreas.
Chapter 31
Figure 31.1
Digestion and absorption.
Chapter 32
Figure 32.1
A nephron.
Figure 32.2
Bowman’s capsule.
Chapter 33
Figure 33.1
External layers of the kidney.
Figure 33.2
Blood flow through the kidney.
Chapter 34
Figure 34.1
Blood supply to the ureter.
Figure 34.2
The urinary bladder.
Figure 34.3
The male urethra.
Figure 34.4
The female urethra.
Chapter 35
Figure 35.1
Renal filtration.
Figure 35.2
Renin‐angiotensin pathway.
Chapter 36
Figure 36.1
The left testis and epididymis.
Figure 36.2
Sagittal view of the penis and male pelvis.
Figure 36.3
The anatomy of the penis.
Chapter 37
Figure 37.1
The prostate gland.
Chapter 38
Figure 38.1
Spermatogenesis.
Figure 38.2
Primary and secondary sex characteristics.
Chapter 39
Figure 39.1
The female reproductive organs.
Chapter 40
Figure 40.1
The external female genitalia.
Chapter 41
Figure 41.1
The breast.
Figure 41.2
The breast and surrounding structures.
Figure 41.3
Lobules and ducts.
Figure 41.4
The axillary lymph nodes.
Figure 41.5
Breast lymph.
Chapter 42
Figure 42.1
Hormonal regulation of the changes in the ovary and uterus.
Figure 42.2
Changes in the concentration of anterior pituitary and ovarian h
...
Chapter 43
Figure 43.1
The major endocrine glands.
Figure 43.2
The pituitary gland and surrounding structures.
Chapter 44
Figure 44.1
The thyroid and parathyroid glands.
Figure 44.2
Control of thyroid hormone production – negative feedback.
Chapter 45
Figure 45.1
The pancreas.
Figure 45.2
Insulin and glucagon effects on blood glucose.
Chapter 46
Figure 46.1
Bone remodelling.
Figure 46.2
Bone growth.
Figure 46.3
Osteon, Haversian canal.
Chapter 47
Figure 47.1
The skeleton: axial and appendicular.
Figure 47.2
Compact bone (long bone).
Figure 47.3
Short bone.
Figure 47.4
Flat bone.
Figure 47.5
Irregular bone.
Figure 47.6
Sesamoid bone.
Chapter 48
Figure 48.1
Joint types.
Chapter 49
Figure 49.1
Muscle tissues.
Chapter 50
Figure 50.1
The skin and associated structures.
Figure 50.2
Skin types.
Figure 50.3
The layers of the epidermis.
Chapter 51
Figure 51.1
The hair and associated glands.
Figure 51.2
The nails.
Chapter 52
Figure 52.1
Epidermal and deep wound healing.
Chapter 53
Figure 53.1
Summary of wound healing events.
Chapter 54
Figure 54.1
The eye.
Figure 54.2
The lacrimal apparatus.
Chapter 55
Figure 55.1
The ear.
Figure 55.2
The outer ear.
Figure 55.3
The middle ear.
Figure 55.4
The inner ear.
Chapter 56
Figure 56.1
Pathway of smell.
Figure 56.2
Olfactory epithelium and olfactory receptor cells.
Figure 56.3
The olfactory bulb (nerve).
Chapter 57
Figure 57.1
The tongue.
Figure 57.2
Taste.
Guide
Cover Page
Title Page
Copyright Page
Preface
Abbreviations
Acknowledgements
How to use your revision guide and the companion website
Table of Contents
Begin Reading
Appendix 1: Normal physiological values
Appendix 2: Prefixes and suffixes
Appendix 3: Glossary
Further reading
Index
WILEY END USER LICENSE AGREEMENT
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Anatomy and Physiology for Nursing and Healthcare Students at a Glance
Second Edition
Ian Peate, OBE FRCN
University of Roehampton, London;
Visiting Professor
St Georges and Kingston University, London;
Visiting Professor Northumbria University, Newcastle upon Tyne; Visiting Senior Clinical Fellow University of Hertfordshire, Hatfield, UK
Series Editor: Ian Peate
This edition first published 2022© 2022 John Wiley & Sons Ltd
Edition HistoryJohn Wiley & Sons Ltd (1e, 2015)
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Ian Peate to be identified as the authors of this work has been asserted in accordance with law.
Registered OfficesJohn Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USAJohn Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Office9600 Garsington Road, Oxford, OX4 2DQ, UK
For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com.
Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content that appears in standard print versions of this book may not be available in other formats.
Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Library of Congress Cataloging‐in‐Publication Data applied for:
Names: Peate, Ian, author.Title: Anatomy and physiology for nursing and healthcare students at a glance / Ian Peate.Other titles: Anatomy and physiology for nurses at a glance | At a glance series (Oxford, England)Description: 2nd edition. | Hoboken, NJ : Wiley-Blackwell, 2022. | Series: At a glance series | Preceded by: Anatomy and physiology for nurses at a glance / Ian Peate, Muralitharan Nair. 2015. | Includes bibliographical references and index.Identifiers: LCCN 2022007589 (print) | LCCN 2022007590 (ebook) | ISBN 9781119757207 (paperback) | ISBN 9781119757214 (adobe pdf) | ISBN 9781119757221 (epub)Subjects: MESH: Anatomy | Physiological Phenomena | Handbook | Nurses InstructionClassification: LCC QP40 (print) | LCC QP40 (ebook) | NLM QS 39 | DDC 612.0076–dc23/eng/20220222LC record available at https://lccn.loc.gov/2022007589LC ebook record available at https://lccn.loc.gov/2022007590
Cover Design: WileyCover Images: © SEBASTIAN KAULITZKI/Getty Images, PIXOLOGICSTUDIO/Getty Images
Preface
I am delighted to have been asked to provide a second edition of Anatomy and Physiology for Nursing and Healthcare Students at a Glance. This popular revision aid has retained the user‐friendly approach that includes bite‐sized pieces of information and full‐colour diagrams that help students retain, recall and apply facts to their practice.
All health and care providers aim to offer care that is safe and effective. In order to care effectively for people (sick or well), it is essential to have an understanding of and insight into anatomy and physiology.
The human body is composed of organic and inorganic molecules organised at a variety of structural levels; despite this, an individual should be seen and treated in a holistic manner. If the healthcare professional is to provide appropriate and timely care, it is essential that they are able to recognise illness, take prompt action to deliver effective treatment and refer appropriately, ensuring that the person they offer care and support to is at the centre of all that they do.
Healthcare professionals are required to demonstrate a sound knowledge of anatomy and physiology with the intention of providing safe and effective nursing care. This is often assessed as a part of a programme of study using a number of assessment techniques. The overall aim of this concise text is to provide an overview of anatomy and physiology and the related biological sciences that can help to develop your practical skills and improve your knowledge with the aim of you becoming a caring, knowledgeable and compassionate provider of care. It is anticipated that you will be able to deliver increasingly complex care for the people you care for when you understand how the body functions.
As you begin to appreciate how people respond or adapt to pathophysiological changes and stressors, you will be able to understand that people (regardless of their age) all have unique biological needs. The integration and application of evidence‐based theory to practice is a key component of effective and safe healthcare. However, this goal cannot be achieved without an understanding of anatomy and physiology.
An additional chapter has been introduced, Anatomical Terms, emphasising the importance of understanding and using the correct anatomical terminology when making a description of body parts as a shared method of communicating between health and care staff. This new edition also includes clinical practice points which aim to encourage readers to relate the theoretical concepts described to practice.
Anatomy is associated with the function of a living organism and as such it is almost always inseparable from physiology. Physiology is the science dealing with the study of the function of cells, tissues, organs and organisms; it is the study of life.
Ian PeateLondon
Abbreviations
ACTH
Adrenocorticotrophic hormone
ADH
Antidiuretic hormone
ANP
Atrial natriuretic peptide
ANS
Autonomic nervous system
ATP
Adenosine triphosphate
AV
Atrioventricular
BBB
Blood–brain barrier
BP
Blood pressure
Ca
2+
Calcium
CCK
Cholecystokinin
Cl
Chloride
CNS
Central nervous system
CRH
Corticotrophin‐releasing hormone
CSF
Cerebrospinal fluid
CO
2
Carbon dioxide
CRC
Cardioregulatory centre
CSF
Cerebrospinal fluid
DNA
Deoxyribonucleic acid
EPO
Erythropoietin
FSH
Follicle‐stimulating hormone
GH
Growth hormone
GHRIF
Growth hormone release‐inhibiting factor
H
+
Hydrogen
H
2
O
Water
Hb
Haemoglobin
HCG
Human chorionic gonadotrophin
HCL
Hydrochloric acid
HR
Heart rate
K
+
Potassium
kPa
Kilopascal
Mg
2+
Magnesium
mmHg
Millimetres of mercury
mRNA
Messenger ribonucleic acid
Na
+
Sodium
NH
3
Ammonia
O
2
Oxygen
PCA
Posterior cerebral artery
PCO
2
Partial pressure of carbon dioxide
PCT
Proximal convoluted tubule
pH
A measure of the acidity or basicity of an aqueous solution
PNS
Parasympathetic nervous system
PO
2
Partial pressure of oxygen
PRH
Prolactin‐releasing hormone
RBC
Red blood cell
RER
Rough endoplasmic reticulum
RNA
Ribonucleic acid
rRNA
Ribosomal ribonucleic acid
SA
Sinoatrial
SER
Smooth endoplasmic reticulum
SNS
Sympathetic nervous system
tRNA
Transfer ribonucleic acid
TSH
Thyroid‐stimulating hormone
WBC
White blood cell
Acknowledgements
Ian would like to thank his partner Jussi Lahtinen and also Mrs Frances Cohen for all their support and encouragement.
How to use your revision guide and the companion website
Features contained within your revision guide
Each topic is presented in a double‐page spread with clear, easy‐to‐follow diagrams supported by succinct explanatory text.
Part 1Foundations
Chapters
1
Anatomical terms
2
Genetics and genomics
3
Homeostasis
4
Fluid compartments
5
Cells and organelles
6
Transport systems
7
Blood
8
Inflammation and immunity
9
Tissues
1Anatomical terms
Figure 1.1The standard anatomical position.
Figure 1.2Anatomical terms.
Source: Tortora GJ, Derrickson B. (2017) Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley
Figure 1.3Anatomical planes.
Source: Tortora GJ, Derrickson B. (2017) Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley
Figure 1.4Body cavities.
Source: Tortora GJ, Derrickson B. (2017) Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley, with permission from John Wiley & Sons.
Table 1.1The body cavities.
Cavity
Content
Dorsal
Cranial cavity: holds the brain Spinal cavity: includes spinal column and spinal cord
Ventral
Thoracic cavity: surrounded by the ribs and chest muscles, superior to the diaphragm and abdominopelvic cavity. Further divided into the pleural cavities (left and right) which contain the lungs, bronchi and the mediastinum which contains the heart, pericardial membranes, large vessels of the heart, trachea, upper oesophagus, thymus, lymph nodes and other blood vessels and nerves Abdominopelvic cavity: divided into the abdominal cavity and pelvic cavity. The abdominal cavity: is between the diaphragm and the pelvis, lined with a membrane, contains the stomach, lower part of the oesophagus, small and large intestines (apart from sigmoid and rectum), spleen, liver, gallbladder, pancreas and adrenal glands, kidneys and ureters. The pelvic cavity: contains the urinary bladder, some reproductive organs and the rectum
Anatomical position
Those terms that are used to describe locations and positions reference a person in what is known as the anatomical position. The international standard anatomical position is standing upright as seen in Figure 1.1; whenever referring to anatomical terms, always apply them to the person standing in the anatomical position. By using this as a standard posture for anatomical descriptions, confusion can be avoided even when in reality the person is in some other position.
The position is defined as if the body is standing erect with hips and knees extended, head forward facing, eyes open looking directly forwards with the mouth closed. The arms are by the sides (shoulders adducted), the palms are facing forward (elbows extended and wrists supinated), and the feet together. In this position, the radius and ulna are parallel.
Anatomical terms
It is important to understand and use anatomical terminology when making a description of body parts so there is a shared method of communicating (a common language) with nurses, doctors and other healthcare staff. This is done in order to accurately describe anatomical locations irrespective of their language. Knowing about anatomical terms makes things safer and clearer and will save time.
Anatomical terms (using a specific vocabulary) describe the directions within the body and also the body’s reference planes, cavities and regions (Figure 1.2). There are a number of occasions when a nurse or other healthcare worker is required to record information in nursing or medical notes with the intention of communicating with others or telling others the exact body part or location. Standard terms for describing human anatomy including the body and its organs are required to do this.
Directional terms
Directional terms describe the positions of structures relative to other structures or locations in the body.
When referring to left and right, reference is being made to the left and right side of the person standing in the anatomical position, not to the left and right side of the observer.
Anterior (also called ventral) refers to the front of the body and posterior (dorsal is also used) to the back of the body. The nipples, for example, are on the anterior (ventral) surface of the body, the buttocks are superior (dorsal).
Superior means above, towards the head, and inferior means below, towards the feet. The umbilicus is superior to the genitalia but inferior to the head.
Proximal and distal are only used to describe two points on the same arm or leg. Proximal means close to where the arm or leg is inserted into the body. Distal means further away from where the arm or leg is inserted into the body. The knee is proximal to the ankle as the knee is closer to where the leg inserts into the body. With regard to the arm, the wrist is distal to the elbow as the wrist is further away from where the arm inserts into the body.
Medial refers to any point that is closer to the midline of the body and lateral means any point further away from the midline. The midline is an imaginary line that separates the body in half vertically. The inner thigh is medial and the outer thigh is lateral.
Planes
To describe the anatomical positions of the internal structures, planes or sections are used (Figure 1.3). There are four planes.
Sagittal
Frontal
Transverse
Oblique
The sagittal, vertical (top to bottom) plane divides the body into left and right sides. It is known as a midsagittal plane when it divides the body down the middle into equal left and right sides. If the divide does not pass exactly midline, this is known as parasagittal. The frontal plane divides the body into anterior (ventral) and posterior (dorsal) portions. The transverse plane divides the body into superior and inferior portions. The oblique plane is a slanted plane (at an angle) passing through the body.
Body cavities
These areas contain internal organs. The two main cavities are the dorsal and ventral cavities (Figure 1.4). The dorsal cavity (sometimes called caudal) is on the posterior of the body, containing the cranial cavity and spinal cavity. The ventral cavity is on the anterior of the body, divided into the thoracic cavity and abdominopelvic cavity; the diaphragm divides the ventral cavity into two subcavities: thoracic and abdominal (Table 1.1).
2Genetics and genomics
Figure 2.1DNA and RNA.
Table 2.1Types of RNA.
Type of RNA
Description
Messenger RNA (mRNA)
Copies portions of genetic code, a process known as transcription, and transports these copies to ribosomes, the cellular factories that facilitate the production of proteins from this code
Transfer RNA (tRNA)
Responsible for bringing amino acids, basic protein building blocks, to these protein factories, in response to the coded instructions introduced by the mRNA. This protein‐building process is called translation
Ribosomal RNA (rRNA)
The protein builder of the cell, without which protein production would not occur
Figure 2.2Mitosis.
Figure 2.3Meiosis.
Figure 2.4Fertilisation.
Genetics is the study of the way particular features or diseases are inherited through genes passed down from one generation to the next. The idea of having a single gene for this or a single gene for that (determining fate) is not a good way of describing the complexity of genes. There are groups of genes that work together, influenced by a variety of environmental and other factors. The genome can be seen as the body’s instruction manual, with a copy of it in almost every healthy cell in the body. The study of the genome and the technologies that are required to analyse and interpret it is known as genomics.
DNA and RNA
Both deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) are made of nucleotides (bases) which are the building blocks, responsible for the storage and reading of genetic information that underpins all life. DNA encodes all genetic information, also acting as a biological store allowing the blueprint of life to be passed between generations. RNA reads and then decodes what is stored. This is a multistep process with specialised RNAs for each step (Table 2.1).
DNA and RNA are nucleic acids, known as linear polymers, consisting of sugars, phosphates and bases, but there are differences between the two. The differences permit the two molecules to work together, fulfilling essential roles. See Figure 2.1 for the differences. The complementary base pairs in DNA are adenine (‘A’), thymine (‘T’), guanine (‘G’) and cytosine (‘C’) and RNA shares adenine (‘A’), guanine (‘G’) and cytosine (‘C’) with DNA, but contains uracil (‘U’) instead of thymine (Figure 2.1).
Molecules in DNA have an even and uniform shape while in RNA they are uneven and diverse shapes. DNA molecules are made up of millions of nucleotides and RNA molecules are usually smaller, composed of hundreds to a few thousand nucleotides.
Mitosis, meiosis and fertilisation
The human cell usually has 46 chromosomes: 44 autosomes, which are paired, and two sex chromosomes, usually specifying whether someone is male (usually XY) or female (usually XX). Autosomes, known as homologous chromosomes, have all of the same genes arranged in the same order, However, there are small differences in the DNA letters of the genes.
Mitosis occurs when cells divide to make more cells or reproductive cells (meiosis), and when reproductive cells join to make a new individual (fertilisation).
Mitosis
Prior to a cell dividing to make two cells, all of its chromosomes are copied, known as sister chromatids. Until cell division, the copies stay connected with each other by their middles (centromeres.) Upon cell division, the copies are pulled apart, each new cell getting one identical copy of each chromosome. Every cell has an identical set of chromosomes (see Figure 2.2).
Meiosis
When egg and sperm cells form, they go through a type of cell division called meiosis. Meiosis reduces the number of chromosomes by half as well as creating genetic diversity. The cell copies each chromosome, unlike in mitosis, homologous chromosome pairs align, exchanging pieces (recombination). Recombination increases genetic diversity by adding pieces of slightly different chromosomes together. The recombined homologous chromosomes are divided into two daughter cells. Then the sister chromatids are pulled apart into a total of four reproductive cells. Each of these cells has one copy each of 23 chromosomes; all possess a unique combination of gene variations (Figure 2.3).
Fertilisation
Egg and sperm cells have 23 chromosomes each, half as many chromosomes as regular cells. Through the process of fertilisation, egg and sperm join, making a cell with 46 chromosomes (23 pairs), a zygote. For each chromosomal pair, one homologous chromosome came from each parent. Genes are arranged in the same order but there are small variations in the DNA letters of those genes (Figure 2.4).
Clinical practice point
Nurses and other healthcare professionals are ideally placed to offer and promote genetic and genomic healthcare as they highlight health promotion, prevention, screening, patient, family and community relationships.
A genetic disorder is a disease caused by a change in the DNA sequence away from the normal sequence. Genetic disorders can be caused by a mutation in one gene, by mutations in multiple genes, by a combination of gene mutations and environmental factors, or damage to chromosomes.
3Homeostasis
Figure 3.1Components of a negative feedback system.
Figure 3.2Negative feedback – raised blood pressure.
Figure 3.3Negative feedback – raised temperature.
Figure 3.4Positive feedback of childbirth.
Homeostasis
Homeostasis is an important physiological concept and can be defined as the ability of the body or a cell to seek and maintain a condition of equilibrium within its internal environment when dealing with external changes. It is a state of equilibrium for the body. Homeostasis allows the organs of the body to function effectively in a broad range of conditions.
All the organs and organ systems of the human body work together in harmony and are closely regulated by the nervous and endocrine systems. The nervous system controls almost all body activities and the endocrine system secretes hormones that regulate these activities. Working together, the organ systems supply body cells with all the substances needed and also eliminate waste. They also keep temperature, pH, blood glucose and other conditions at just the right levels required to support life processes.
Temperature at 36.5 °C
Blood glucose – 4–8 mmol/L
pH of the blood – 7.4
Feedback mechanisms
There are a variety of feedback mechanisms used by the body to regulate internal systems. There are three fundamental elements associated with the feedback system: a receptor, a control centre and an effector (Figure 3.1). The effector may be a muscle, organs or another structure that receives messages indicating a reaction is required.
Receptor
The receptor senses changes in the internal environment, relaying information to the control centre. Specific nerve endings in the skin, for example, sense a change in temperature, detecting changes such as a sudden increase or fall in body temperature.
Control centre
The brain is the control centre, receiving information from the receptor and interpreting the information, and then sending information to the effector. The output could be nerve impulses or hormones or other chemical signals.
Effector
An effector is a body system, for example, the skin, blood vessels or the blood, that receives the information from the control centre, producing a response to the condition. For example, in the regulation of body temperature by our skin (if it drops below normal), the hypothalamus acts as the control centre, which receives input from the skin. The output from the control centre goes to the skeletal muscles via nerves to initiate shivering and this raises body temperature.
Negative feedback
Most body systems work on negative feedback. Negative feedback ensures that, in any control system, changes are reversed and then returned back to the set level. An example might be, if the blood pressure increases, then receptors in the carotid arteries detect this change in blood pressure and relay a message to the brain. The brain will cause the heart to beat more slowly and, by doing this, work towards decreasing the blood pressure. Decreasing heart rate has a negative effect on blood pressure (Figure 3.2). Another example of negative feedback is regulation of body temperature at a constant 37 °C. If we get too hot, blood vessels in the skin vasodilate and heat is lost and we cool down. If we get too cold, blood vessels in the skin vasoconstrict, we lose less heat and the body warms up. The negative feedback system therefore ensures that homeostasis is maintained (Figure 3.3).
Positive feedback
This is the mechanism used by the body to enhance an output needed to maintain homeostasis. Positive feedback mechanisms push levels out of normal ranges. While this process can be beneficial, it is rarely used by the body because of the risk of the increased stimuli becoming out of control.
An example of positive feedback is the release of oxytocin (a hormone) to increase and keep the contractions of childbirth happening as long as needed for the child’s birth. Contractions of the uterus are stimulated by oxytocin, produced in the pituitary gland in the brain, and the secretion of it is increased by positive feedback, increasing the strength of the contractions (Figure 3.4).
Another example of positive feedback occurs in lactation, during which the mother produces milk for her child. During pregnancy, levels of prolactin (a hormone) increase. Prolactin normally stimulates milk production but during pregnancy, progesterone inhibits milk production. At birth, when the placenta is released from the uterus, levels of progesterone drop and as a result, milk production flows. As the infant feeds, its suckling stimulates the breast, promoting further release of prolactin, producing even more. This positive feedback ensures the infant has sufficient milk during feeding. When the baby is weaned and is no longer breast feeding, stimulation stops, with prolactin in the mother’s blood returning to pre‐breastfeeding levels.
Clinical practice point
Respiratory system: a high concentration of carbon dioxide in the blood triggers faster breathing. The lungs exhale more frequently, which removes carbon dioxide from the body faster.
Excretory system: a low level of water in the blood triggers retention of water by the kidneys. The kidneys produce more concentrated urine, therefore less water is lost from the body.
Endocrine system: a high concentration of glucose in the blood triggers secretion of insulin by the pancreas. Insulin, a hormone, helps cells absorb glucose from the blood.
4Fluid compartments
Figure 4.1Body water content.
Figure 4.2Fluid compartments.
Source: Tortora GJ, Derrickson B. (2017) Tortora’s Principles of Anatomy and Physiology, 15th edn. Hoboken: Wiley, with permission from John Wiley & Sons.
The ability to maintain an adequate fluid balance is essential to health. Inadequate fluid intake or excessive fluid loss can lead to dehydration, which may impact negatively on renal and cardiac performance and electrolyte function. Regulating the volume and composition of body fluids, controlling how they are distributed throughout the body and balancing body fluid are critical when maintaining homeostasis and health.
Body water
A body fluid is a substance, usually a liquid, produced by the body that comprises water and dissolved solutes. Body fluids are dilute water solutions. Humans are predominantly made up of water, which ranges from around 75% of body mass in infants to approximately 50–60% in adult men and women and in old age as low as 45%. Body water varies with the amount of adipose tissue that the body stores. As the amount of adipose tissue increases, percentage of body water falls. Women tend to store more adipose tissue than men.
The brain and kidneys have the highest proportions of water, composed of 80–85% of their masses. The teeth, in contrast, have the lowest proportion of water at 8–10% (Figure 4.1).
Location of body fluids
Body fluids are present in two main ‘compartments’: inside cells and outside cells (Figure 4.2). Around two‐thirds of body fluid is intracellular fluid (ICF) or cytosol, the fluid which is located within cells. The other one‐third is extracellular fluid (ECF), outside cells, and includes all other body fluids. Approximately 80% of the ECF is interstitial fluid, which fills the microscopic spaces between tissue cells; 20% of the ECF is blood plasma (the liquid component of blood). Other extracellular fluids include interstitial fluid, which includes the lymph in lymphatic vessels; cerebrospinal fluid in the nervous system; synovial fluid in joints; aqueous humor and vitreous body in the eyes; endolymph and perilymph in the ears and pleural, pericardial and peritoneal fluids located between serous membranes.
Intracellular fluid
Around two‐thirds of the body’s fluid is intracellular in the adult, contained within more than 100 trillion cells; this amounts to approximately 28 litres for an average 70 kg male. These vast numbers of cells are not physically united; the ICF compartment is a virtual compartment. These are small discontinuous collections of fluid but from a physiological perspective, intracellular fluid is considered as if it were one single compartment.
Extracellular fluid
Extracellular fluid is located outside cells, surrounding them. Effective functioning of body cells depends on the precise regulation of the composition of their surrounding fluid. As the ECF surrounds the cells of the body, it serves as the body’s internal environment. The space that surrounds the entire body is the external environment.
Extracellular fluid declines as we age and is more readily lost from the body than the ICF. ECF is usually subdivided into a number of smaller compartments that are located in the intravascular and interstitial compartments or spaces. The intravascular compartment comprises the fluid within the blood vessels (the plasma volume). In an average adult blood volume amounts to 5–6 litres, approximately 3 litres of which is plasma. The interstitial fluid is the fluid in the ‘gaps’ between the cells and outside the blood vessels; this includes lymph fluid, sometimes called the ‘third space’. Transcellular fluid is fluid contained within particular cavities of the body and digestive secretions that are separated by a layer of epithelium from the interstitial compartment. Transcellular fluid is akin to interstitial fluid and often this is considered to be a part of interstitial volume. The transcellular fluid amounts to around 1 litre.
