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Celk are *rated

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* i *,1* ii ' *

.-

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from their environment by a plasma membrane (and wmetmes a cell m i O . Tha function d the plasma membrane Is to wntml the pasage of m o t ~ u l u and out of the cell Into mereare~baJccstqwkrofcdlr@iawZesandw~ P m k a w n l k (bactrria) are relativrly small and lack a nucleus, whqqpwkaryotlc e l k (fungi. adnul. and plant cells) are larger and+ a well-&fined d e w *par& from the nMplsrm by a double membrane RNCtUIe Thb chapter will revlew the major rtrunursl components of prokatybtlc and cukaryotlc cells, the propertiesof the plasma membrane that rvnwndsall <ens, and the mechanlrmr for tranrponkng molecules across the plasma membrane.

1

STRUCTURAL FEATURESOJ PRCW&YOTKCEUS
Pmkaryot~ cells GaaCWla) am retuvaly mall (7-10 jun long) and mdst of a plasma membrane that rurrqnds a gmple Internal cytoplasmic

compartment cMlf.lnfng ONXUN+ arhl sU df the emymcr and small malecules q u i d for sell n i ts n m !& y n uhd reproduelon. Tha plasma m&ne s m l l y surrounded by a I@ I proUKNH cell wall, In m n t r m with eukmyotk rell% prokalper do @ c0afiln sUWlulsr membran, boundargsnelkr.
A

t.ll W.The thkk rlg~d muhKa that wrmundslk plasma membrane
may ranse immfc(vnn from 15, to 100 prohlos, wd ndlypaccharldr The ce wh& lktypkally a pobxhwide w m thwe monaMdrsMr and is mually membrare.

B P l m mcmbmna. The p l m a membrane wmrols the movement of mWerlak h and out of celk An murally m n g membranes conrlR of an amphipathub~byer composed of liplh and membrane pmtehl
C. Nud.oid. ThcDNA of ptak#ak calk Is found in a @on of the cytoaol

known M thb nwleoid. This region Is equiwlent to the nucleus In eukaryotic cells, but a IS not separated from the cytoplasm by a membrane.

I

D. Cytaplrm. The total internal compartment of prokaryotic cells , s

d.fkwd a the cytoplasm s
E.

CThe omer surfaceof bacteria are coated w ~ t h flagella, whlQ are thread-llkestructuresthatallow the bacteria m mow raptdly

mr

Eukaryotk cslts errmnsldwobly l h r r r than pmkaryotr and have rubcellular coaylammentr that are deflnad by rrstworks of tnternsl membrqne drurtun. The linear dlmemionr of eukaryotic celk generally Ol wThe ranges from T -m . Nuchue of a typicplwkaryotk call is rhown In Flgure 1-1.

the cell from io mrrrnHulw eiwbmmem and is primarily wlmmed with wntmrlhql the n r of W ( e r into and om of the cell

ti

--qz&n. In euluryotes, an u a ihcludln~thb k , plasma
c&~U~M% CIolBi

g g

n*rdmarymm ugh

NOTE

r ac d rr n *( o l t

a ~ d
c r ~

m e t c r y v.nclsr. T b ends

--svrarh

T o% & the I u m of any of the w! ? &
olgalleller OI

r ~ m , d ~ ~ ~ h M n o n c h O i o n M t h c ~ ~ .the cnVt o I I

~ i r c g t r ~ m m e w m d e ~ f

, *t&mmnbranoasyrram
dm$4arInthhbodi.
$ . ~ ~ o t *

sndttandrnawawno)*ilhb~&ld~ttK~di%&r~ellulu u w l ~ T h f l c ~ * h v m - c e F * l the Subarllirk* Orsenellas .
P q r n ~ ~ ~

Inmkwho@b~koRbU,*adlntc*
f E kv.rying~bml"W&?-cgem a d

o. # w " s . r c r ~ l l l , e t w p w r ~ , o&. m& Muup " m .
1. I k l * d u - r o n * m o f . - - ~

ravpmalet.aar~tfl-.*rtsun*q(opkmr udtbnudwpkmi;Ruaw.r~(smeti~Whthe rrtoahra 1. %T--hthc-Ufthrklgh-ntof ~ k 7Jt ' S and-

r ~m-~s*ulbrt.llr*udtbiah.m be ! w & p t r i ~ t I w s4 #uc&e. w w b r m of d ~ . ~ Y MU e v t e ~ e s l tNC d i w w d in d W l

*h r i l u k r

Wm.sr8rnellcr

rndmmrn
z pubrnrr
2 pa#J*<

- y" k' *

P

.rrlRlpMp.thfq haviW pofsr h.M graupr that Intarad wlth ffia a q u d FnvfMnnient.Ihe hYa~ph6bir Ulb I m c t with one ~tofwmlfrkwbottk.bneyn:Th.~.cidrofW

1

NBDE

1: ANATOMICW E N C E S
I

s Hm&Mpkk are t k ~ 4 u l l d l n bhks of all btologic . g
mmbranes, c

membrane I*&

~ ~ c 50 and 80% )M the total m ~ Th. p ~ h ~ I l p l CuMl in a n h 1 plasma ds frletpbmw.a mrlLt&c phosphWJdy1~hel)nh pkorphatldy~sth.m~smlne, phaphatidyk~ea.~ d y l i n l s ~ t aand l,

ryjwowdin @bob W W . 12 Qd.naol k a maiormnpownt of p l a n s m e m B r ~ u ~ makmg u p b t w w n $5 and 25% of the toM lipid. ~ C h o l m e r ois l ahnyrhtheunesMi%dfonh c. ~ l p i l & b make up the remainder of the plasma membrane ~kirl~thou$h~~nijds~&~kthm to%ofthe + a dtipM ih t h r 6 +&puy, ap very I m v a n t m
d k c l l and & ~ ' h t & O r n

*ms+m p m M m ion ask of membrane

BquKad reglorn of other N m b n 6 e as(lkd.
~hthrh&~~ntes~cthlrtmntbtfgty~chainsof Wrligidcc4nwwnD.
1 $trunun.The bitaym conrlas of two leaflets held together by h@ophaW interadnrnr betyan the fa* d d s In each leaflet

GYwmlmm
pa*n

F @ m 1-2

m-e#
UpiBbRqsr..ma~ny*mrtwO*d

2 ~ ~ ~ I u M d ~ n t a r a s a I l a y n r - w

ucarldetaketlm~~.
a. Bboapbow

u m y The chMkwcoa@inlng lipids m m.

LduqrhlfWd@!s snd+fWmfi 8rp w*iched m the on$er lrr&t wkr~9arormro-sonWnlaa phwhaliptdr f ~ b w h p i W o r 1 ~ c pboOphltidyt9thnoamingam found LRd

I

The curbhydrate portions of born IN NursHELL --a&dj#ddacfaund on* tnerior o ~ h . ~ ~ * ~ ~ ( u n m o f i alln3embranecaix++bm ~ ~ m ~ @ ~ atgdredtol@orpmbdnsand~ m k ~ . ~ m m c m ~ O f m e c a l l L h l h rsypun*trq. Proteins are not randomly tnrertcd o n aumbruaYlnrZ~WbwhmW N-tmBinusWtade the cell. w h i i a@rs fmw d r i rlon me'Cytca6lh .da of the -am ~ t n t ~ 0 e ~ ~ p t D w n a r e a I w a y r h M 6 d b r m e - w i m a m

priadYhrfheamr*.flb

b CwImWWW,

*

"a

,

3.

I*dny;th,fhtLtlt ott)UIX(JnTa IlwtbrIMl is hflusnced by the

e rL&di& k &muweed by the fact that n

a.&

*

the pmpomon of ewer umumted fatty xi&o $-mt.cham fatty r ad3
4. MoUltpr Pharphdlpidr mow laterally W i n the membrane at very

high r a w . S m integral membRmprc?eim un also move laterally o within the plane ofthe membram uhtreb$tAsmoment of &hen i m5trimd by lnteracflonwlth Oblrr*parim &er in the cyMrol w i wkkletimcell.

TRANSPORTACROSS THE P W M A MEMBRANE
Thc plasm membrane k a selective barrisr that ~ m t a h l dirtincl tnternal r
and external environments by contmllingttn pasage of moleculer mto and out of the cell. S c u nurhanlrmr are used for the tnnrpwt of molecule wrl acnmthemnnbrane A Ovnorir Water m w n wosa,cell membran from a cwnpartmentwith a lower rolute concentration to a wmmrtmem with a hisher solute CMuqntrabon. The n w v l r p ~ l of watw requires no expenditure of t uar@(*o&*pnvlmkddlnd~hetorcsthllt~~ldb.r.9~1& to preventthe mwMnenr of wawbs8uaen campartm.
B Passive tmUpwt. The mWMefit of molecules srmrr a membr.de fmm a regton of higher conCMWnCMWn~i n ef af ccmentratlon b to a m o termed 'psslve transpm' b.uuse It requhr no external rsum of ehngy. ?here are oM d plahe tranrpoMlmptc Murion and

I

fscilltateddiffusion.
IN A NUTSHELL
1. Slmpk diffusion. 5maII uncharged mo)eruler such as oxygen and carbar dloniida can pa%thmugh the llpkl b~layer bydlffwion

arrurkM lrnotsa&i& Faah'tated a a n y M w u e s s W R b n d n p ~ ~ t h e ~ m a n d 5 o l r snnabkand mmpefmW t n h # W

from a region of hagher concentratron to a region of lower concentration, ions can move thrwgh open lonlelective proteln channck vta simpte dtffiuon.
2. F+dllt.t.d diffusion. $onn n o l ~ ~ haw m ~ i wry low permeability

I

i

beawe of their s l n or polar nature, and they require pmteln

~ntontorrMaregionofhishnrenmatiDRma~of
loner concentratton. The carrier-mediated movement down a EOncsntntian gradtent rr tenmd 'fsriilUted difhnlon.' U1 of the twyart proteinr are Integral membrane 6 f W s that span the Inemham multtple timn. For example. the g l u ~ a a tnnsporters mnain 12 m d u ~ n n i n damaln p
C naivr Wawwt The mvamnt o f m o h k

uma a membranefrom a requires region of kn* anxmntrstlon to a region of high both a u k promn and ttn nymdlture of energy.The hydmlyvr of n ATP by an ATPase K dlrectb FMlpled to this transport and the free energy rehared i n hyddysk is uaed to mow lorn up an el&~cal or called 'actwe transport' and it a otelnr in &ive tnnrpwt are the Od and K* Into the d : + - ~ T P u n

~~

KPBLC6( MWKAL

NOTE

~

d

b

r

e

~ ' 7~r -

e

#

k ~ o l t h m ~ ~ b , . l p h C ~ y d g v m n ~ ~ ~ . I p h a

1

ru(unlicont.lns a molecqle of G& Ru sponhi-nnptor complex
rnpWlm~of&ndGCJP')or&on~.mdthkdilorbln ar+sw troni 6, barnma: T ~ C and alpha-GW M t l v a m a n lnol(utv-pmc.k,nr(,*ad**).trcyda..Thbtnmc*a

I

, Es -k

brr Wen divIdsd Inl. three

m--*

I

2. ~ . I r * o c l d . . t r T h k p m ~ a r u & k n ~ n o v v o ~ r . ~dallulu~&snditnfmro~uptokeofndeaJcsthnus in we not lmdvrd nd It k rmt a -tratlng

~~

pms&

3. ~ T M 4 p r % & S k l a M n ? 4 ' & l n M W r g . a n d k c a r m d

mbnaaophspcrm8-b

8. ~ ~ o f m r r o ~ o u t o f t h e c e ~ k i c h ~ m nsDcytoslr There am w t y w of e x q w k , mpu!ated exayloair and ~ w u t t i o n i n b o t h ~ ~ 6 e m 0 l t c u k s t h n ~ ~ into 5mvWy VIIMCS.
1. Il.put.W mmytnsh The secretion of hormones requires a signal

kfontnc eaCTetoiy vifA hrsc with ttw pram0 mcmkane. me nsMIlsncashdWlthd.BHrr 2. SomSWb s u d a a %ntwy &cler thai a n not cwted with dathln are tontmwusly fusing wish the flasma mrmbrane. There cryvain msintaane protains mmbtane l~pids ndplpma and

wins.

NBDE

SCIENCES

1
/

RNA mklet.a n fwnd in the n u c h . he rynthesk and aaembly of riboranar oeam in a regton of the nucleusknown ar the nucleolus

I I

/

/

I

\

\

\

'rc

FrgureZ 1 Funmons of the nucleus
B Stmcbne. The malor murtural features of the nucleus are the nuclear

enva!upe, the nuclear lamma, the nl~lear pores, and the nwleolw
1 Nuclwr envelope. The periphery of tha nuclew s defined by a . doubk mrnrbrane known as tho W a f rtlv+. Each of the nuclear membranes I composed of a dirttnct llpid bllayer that Is s a p p m x ~ m l 6 nm tho& Thus, the nuclear envelope i MOT y s than t plasma mcmbrana The outer nuclesr nnm(uam s rontlnunn b with the ~~r reikuium. It is araoclaMwith nbwnn?~h t ta ars sNvely synth&zims pmn The inner nucher rnwnbrane is r ra

coated with a nurkwrk of fbwr pmterm k n o w as the nuclear l w n a The d w b k membrane structure contarnix paer w dIan& through which most mMmmOlecula must pa to enter w t w e the nudeus.

t h r typer of OM4 am dlreimed in tha flm ah.pta of b60kEuIar ~ !Jfdogy. The m mmmon typa ia% DM4 a d.mc WatrorrCrick d! o+ hew with maja en* mm+x 9@ 1 t h e a m ar rtar for
DNA-protehrkrmsc1olk

2. Histinu prDt41nr. The hfsones are paitively charged proterns e n n w with lWne and argdne reridus T h y have no e n aaMty but em i r d v e d in OtU &aging. Thws am fiLe type. of hlstoner: H1. )LZA HZB. H . atrdalW% hhlstom are mwl~fied 3 porttrsrmPtionaliV hy photphwTlation,-on, and -n. The hlstanes s t impocFln* in t o r m ( ~ n v o type, of StrtKturdr In dKaMDn nud*aaama and s*n&dmms.

3. ~ p M * n r T h e s w m e . i r n r o b a d i n n a r l a u f u n n k n r r u c h as rkpllkatlo~ a mpt OM4 mplir. and r k n i tw e of dmmtin f m o n am h w n as the mnh* W I n a TAsar we &ic or
nutralpmtaim.

6 U .

I ~ ~ O W Ilr Ic W k , -go d ~ S ordtrlCbd-unl-.maag.51n

throwh

.aacohd.nat(arof~.nrha*skl~S.CllPr~ofthe mdrr(ronraend=lewdt~rc,the~~snSKeher~mto W IIIEh W i n m u nOwmffdyIRW base WR qf W The , iaap+ are the bwlnniop of tha knob-like t b i a n ~ n g rcelled ChrMwawes that ara obrwrvpD@ under the msrro$rogr In early smphase as mrtwls begis. The rhromomefes further cm&nra, as slwm m F W2.2. to ~ fgrm thp&?mwme
C lLRgOfdlltMB(I*CkrOmahY~aM&.)yo(tE~lnUJ.u~~~nbe tided tnto m m*lor*PaS W d M1 WstlltC d CoWmsatlon: e

hwoammmand e

w k w .

I R~tctschromatinn htghly eondenled (3s-nm lolenold fheir or hipher m s Of ~ n s a t ! u nni traw-lly e .~ ih WY% 2. ~ k a m a c ~ ( a n n c f W n d b t h p 0 t e n t t a l l y -ptMlalty m v e h of chmmam

C. Funetlon. Mc rib~somes =sthe cellular machlused for protein rynth&sls.They can e m eather as hn ps&amws ln the WwlaSm a a5

mmbram-asoclmd dm-. whkh a n anshad t o the rwgh endoplnmrnticu(um Psbenw0 cm~s arlngb ix+ZNR that k beiw of trenrlated by m r a l rlbororner at the same time, all mavlng on the mRNA from the 5' MKl towardthe 3' end (Ftgure 3-1) The two nbaomal subunit6 anoclate on the m N . wsth the mall subunit bind~ng RA ftrat. Subsequent blnd~ng the large wbuntt ts necessary before proteln of r y n k can begln lnd~vidual h m e S are spaced approximately 80 r nuclcotidar apart along the mRNA molecule Each rtbosome Is ~ndependmtly synthauzmga rlnglepobptlde

ore than 50% of the tetal membrane I" eukaryOt1~ ir made up of cells sndDplmic retkulum. T k w sra tvvo types' rough e n d o p l m reticulum and smwth smloplasmk tefkulum.
A Rough ~

~ ntirulvm (RER). The R R Is a rlngle llpld btlayer i Er r o n t i n w wRh the outer &r membrane R k wganized into rtacks of I#n)rRstwned saa called dsmn.r, which are studded wlth ribmanes on its rytoplarmlc 9 t h . g~vimg the organelle 1 rough % W r q n e c Th Intend space oi the dsternae k loMrm the lummal

t(AIDU\N MEW

uoadaw aplued uowluSOw leu61r pue 'ralalwed uotaly6oaa~ 1su6rr 'ropladed leu6D SsllnbJ u3u aqa q w r w o s ~ q l l j o o l l ~ ~ w u su (8 dqs) u a w h l u utaio~d 'alunqnr aqa $0 Su~pu!q 6ulMollo4 as1lj Sulpu~q alunqns leuumgl llw a41 qaw VNUWaqa 10 PU? ,5 aqa a u m w e (v daas) s+qunanr ~eUc5CqlJ 0% ayl $0 Uo1aqwsre-aql'aluori(lad a a ~ )uo rv16aqs~saqatlr(r ulaaold IIV (z-Ea~n61d)* . w k vloltud L s ,(rlla teune a ~ w ~ 'w 3 uopnar 4% pauwap 6 d reaaotd p rlraqauQ aqa ut pen&e+ a e aeqa qla3 ul auau)wd Pan q 131 wnlnnaa wwreldopua q6nor aqa Kq pazmqauAs are ' w u d l pue 'rnae~sdle16109 aqb 'aue~qwawewreld aql 'uola€u2as lo$ p a u l w a* EW wlaamd rapqdadnfod $0u o w $ ~ p o u leuolaelsuenm pue 'rulaaold auelqww $0 uolle~o(rue1a 'SlreqauL ulmodd 131 aqa q 1 pqalam me rumpun$aalql .]la>aqa jo lled aslel e f l a w

I
demned for
RE& XR

m n l n nuclwtrd. wquences

cod^^

for approxkndsly 30

C W
I

~ . m h m . u Q h t h c ~ p p t Y b ~ b v

mmbrane orbrrecnaxlfmnwcen

mmfmahmoaulaumonm~

m e p D ~ r D r u ( ~ ~ B n c s n t l ( n , * ~ # ~

ef *

W m

i*tagaRS9-rma

warn that

2 tamtwkaesat wWw3ms. Several ~~r

czcur a& the w &(SCtkratad in tho m%s i i m RZR :e&mne fernone tho r1OMd w t i d e wd irdtgradCd by

.

L

~ n ~ w h c ~ c - l v l d&d &to the RER protclra are +-ryniherbw3-zwQ'h;ar+pr*lmw -hrihshrns,0fmeeadOpllrrnk&,~01~lll~~1
w ~ ~ d g r ~ s ~ C o C m a r ~ I s Gobi -ma and hpuma.Hawmr, am.pmrinr are d&nd tok(noertedordnW.dinthohs.RYmnOnofad,

n

1

l

r

l r n i d e r h ~ * & ~ ~ tups af nretlna #at are m m

Plusel~honrcandmtOaE

rnWnneoefizvvhrchcanbehrnnful uWmMdbyapharefl

p b # w w . me feCdM m w of enzymn vwlar r j f l i~l~ liM between diifersnt lyrar?ny. All of th. lymsomal nayFlKS am adel hdrdprC u(th oeWfiral .Qhnyirt a p sf ~ 0 : I m R e b 0 Th. H 5 nur qifor on &We MvtronmMt pmmmts ihk d.rr of etwwes

C- F .

The ma@$ f w B t t 0 ~sf Lwwme& IT ~ t . r ~ - ( - i a I t D b D D a d may C. +ith.r extracelJular s IntlJutluu. T l u c*gclditlon of r nmieuak SUE^ m wm8twm or qguuUn. is known as

d

luautal.kretjkawb-.

r. --mprrp-rn*e(tbyw
mctisl Wumeion 96 ih. P ( Mnrbrqae, -king m
~ ~ ~ ~ H I

In an
a

h

a.
rwzgnizn

h

~ Q I I~*W I C I teH an arid.lyd~rprndou.rthn plmrns

m~

-*tudclsoTaaaM(l$arsmItreeD~~~ t h e r e e e p t w r f o ~ a t e I n r p d . l ~

pmwki ~ ~ ~ ~ m F f u w t o r a n d i D l g a r d t o e n t tbodlai&wk&,

nKpmxbmaarca h c t n ~ g m w o f a n J 1 , wlth a sinale m b r a n r 2d a dlaarebr W wrgrr from .p~~oxhaLsly n 0.1s ta 05 lurr h a y commn a numhsr of on ha tr&r hydrogw, awm f r m ergonu m t r o ( m e . h m h o acids, ~ r longdUh faW y r i d s ) to molrrdpr oxygen with th. format~on hydrqrn peroxide. of

1

I

1. Th# eetw membune IS It canburs an abundance of pwh. an ~msOrai mernkane w e n that fomn manneb m the outer membrane thmugh whtch mokuies of
h

rmrnwmanpass
2.

the mamx i h &
sp"rfhm,

t F d u d of AlP k,

releasngenwforATP

mall ions &a+, Kt, H? and mpll nwkcukr W , P ADP, &wateI. The bnwnneabtllty IS likely related t o the high content of the ilpid card~olrplnThe Inner m b r a n e has numerous infofdlngr, called r i m that greatly inoame the total surface area. The e n m fw .Ictmn MnrPmf and exldcUre phosph~rylatipn +re ,imbedded ~n the Inner mmbmw T ~ nuE of mitochondne and the wmber of costae per nalahondrlwr ue @reimiw@ the m e t a b ~ k to &lty of the cdb m whahKh t h e y wde. & lcutDplei wdiar tlrwe and kMmy I tubule wlid both r@quueiarpa ianrntr of ATP f ~Uwir normal r function There cell types therefore have an abundance of mhhmdthwith a luge nu-of d d y p&d o ~ M e

mt Inner m e m m t5 ~mpermeable m to & l

1 I
.

3 7h.Mww&#mm rOlnprtmadir the space betwaenthe inner and o u t n ~ , ~ m n t d n r e m p e s & u r A;TPtophesphonlate e other nudRldikrtucatlne and admyfshktnare)
4
I

htatprotenrs demned for the m ~ r are corn&& w tranrlated h c W bvt mnwn Ntwm~nal a m m o d o d mat dfrectthern ~

the region enclosed by the Inner membrane. whlch contams renralc@feRMt Caqonenk. a Dehydra$enasw oxldtw msny of the substxtratsr +n the cell (pyrwete, amino DWds fatw BEdJ, generang NAD5l Md FADHl tOr a bv the eW~ontranswrt n and enerw I. W P ~ ~ O ~ M . IC and the enzyme b ~owble-strenrld m h r am* d rnachlnery neceswy fw i t s roplrcat~on and axpression are all h a t e d ~nthe mahlx The human mitoch0ndri.l nuefeoUde sequence encoder a few ~f Iko mttochondr~ill .prMelns Mjtwhnndnal DNA Is alwayr Inhnited f mthe mether, W m n g r M the maternal tram mi^ of d w e f maasolsm. c RNA, pmtelns, and ribaomer a l k mhcbmdr~a caw out to proteln syntheer However, most mltochondrtal proteins are rynthes~zed the cytoplssm and are transferred lnto the ~n mnwhondna
S

-

B Mbckndrial funcwn. The majar f w a o n of the mltwhondrm a to syWhsW A P (Fwure 3-5). Cellular o W l 0 n cf slucov stet5 In the T ~ytoplwn, where !t id ronvwted to wrwate by gl~c~iya~s, yleldong 2

molecules o'f ATP per gbcwe ryruvate IS transported lnto the mktOchondr+al matrix, when pyrwate dohydrogenase or~dlzer to fi ~KoA.~@%trateforthcTCA~le.

at the p b ends of the microtvbulq whtch arc ortented toward the partphew of tlm cell
D )nwuRMnawxhtd with mi-la

There are three mqor t p of ye

movement that involw m~crotubules
1 C ml h -

movement dunng meloslr and mumk d e w & on !he

actlnty of miaohrbuk Mlvctvbule arwmbly Is an mpmant event

~n rp~ndlefDrmatlon 2 I n u a p l l u l a W and q a & h ban-

requrrer m~ornubules.

3 Ghaty mDMnnnt is produced by the dLa beating In Slhapd warn and Is Important #n clearlng mucus from the rerplratory t r s d Movement is produced by the axoneme, a complex structure composed of m k m t ~ a n a veriety of ather poWn that allow d thr beatmg acrion to~cw. Smture of the axomme u shown b Ths n
Fewrl-1 a In axoneme, there are two central mlumubuleswrrounded a

crrcle of nine pertpheral mcrotubule doublets The wnpheral 'doubw are fured so that thy share s common Wxtk wall nx) form two subtubufa (A and 6) Subtubule A rr a complete ndcrotubule. Msubklbule 8 o onfy spstlal rvbtubule r
E. D I ~ R Iassoctated whh mlrmtubula% Two d,rcare states rnvolw

m&lkuGionol maroWnlek C b & k k - A ~ M rylldrm and branchlertahk.
1 Ch&Q~k-Higahi ryndrone k ct!arsnwksd by a defsu in the sbibty of mlutdubuler to polymerlzewrthin leukocytes. Thk leadsto a delay thue prevsntmg I n the fuwn of phsgrxomeswlth lyroro-,

fIWqwtwr of banem.
2 Aodhct& s caused by ~mmotlle cllla ~nthe rwirmory epithet14 reSnMng tn the Inabltwoicllla to remove $"haled bacteria.

WERMEDWE F I H E N T Z

$mZ @m%+
mere

--,

h * mmpohnts sf t$ e

qtorkeleton, with a dmmeteer of 10 nm, are

r o p l l k e fllamentr functbon prlmarlly ~n structural roles Intermediate ftlam+mn s n classiffed tnto three types kerattn filaments, Vlmentinmntalnlng filaments, and neur.filamem These tough and durable filamenn nre fowmt predominantly In those parts of the cell that are wbjected .to mechanical stress when they fundm to msmtnain cell shape ad the m i n q M wgmdtbvmhin the all

t
KAPLMl M E W

NOTE

Keraun flanmnlr form the tonofilamene that mnnectdesnwmes m eprlbelml

celk

I N A NUTSHELL

MmfiIdmntr are doubk-stranded helms of p&mIzedacM

IN A NUrSHElL

~.Tharyt&OfthcptMsir&idedintwdiunt.unl&

SWW%w k h aund the mttrc lengthd the ma& f8rr.

Myofibersmlarge-malac& mwafewofamp d ~ n w l o r nw m of ~ d ~ ~m~2hrCfila~theeanlhe avm@!%elements ~ri!amenrr we the thm Iacbn) and aKt 6 n p ) fibmentr thatspdemt onemu&dmgcwmrdm,

hWsnu s c d e d to & Z Ilne +nP emmi mwwd the r centn ob&glr&pap, w&em t)wy *e# v!. with my~sln
Nunurn composed of 6 tIgW chains Each myosin

f l b w talb d % h fwqchqn am RUfthd mfo a double heliwl nrwcture. fo&iqce&m ylhtro m j m h nmkcu@ lmergct to form htamentr. T e globular heeds d the q m t n molecule b contain ATPa* m i v i t y as well a rite5 for brndlng t o adln s
ihmt5.

r ~ a d ~ o m i n o r u t l a ~ ~ u b l i o n o t ~ c
.ndnryehwntar.
~ ~ a R b m s l # O ~ r ~ c Qh.s~eiUler&&oftba%murdwtes ~ b

Usbn, i s,

mthandrqatrrwaeg, kpr(~mk& ~ l o p ~ h L t f a r a d W i n W M o l ~ & ~ l p w n a M ~ i n ~ n x g l -wth ~ w I I M I I s M ~ o ~ ~ *~B~Mprapvy7--

*

.

_

NBDE 1: ANATOMIC SCIENCES
I

C Admny&

krM& in *dcW mw&. R relaxed muxle, the acttn filamQnfr extend approxtmately halfway over the myolin fxlament (Figure 42). During CarVactim the actln filaments slide toward each other and pa* the myosin fikments, wuhng in the rhorten~ng the of sarcomere, the inyofibril, and the l q t h of ttw mwle mir Is k n ar ~WM~ofN*lqantuabo. There B no change In the lengm &ol&~qma;st #larame. fie mwunent of myosin along the actln f i l a m k lTP dependent The myosin head bin& A P which e T, hydrolyzed to AW and Pi by-n ATPaw ADP and 4 remadn bound to the AP s t .The m T m ie hs)ld nrar&ta.n ad* thtn filament, and as ~tmakes contact with the thtn flbmenr, It undergoes a conformationalchanp( .ad relearar ADP ad 4 A ncond molecule of A P bgnds to the myDsin head, callslng it to be r e l e d from the t h ~ n T filament. Hydrolysis of A P n r u l b in the myoran head rcsumlng Its T anginal conforniath. ?Re myortn head a then ready fot anothw cyde

.

D TmpMlin and MponryoWl m rtuacb COmraRion. Centrol of muscle . contr8ction Is vtovbdhd by troponin, tropomyosn, and a change in mntraclular caiom wxmtratioris mn the BIchnn c w ~ ~ n t r n i o n e n low (lo-' M), tmIand troponln T arm strongly bound to tropwnyom, h d n g t br the actk, amwe 60 mot it b W the myom l o ~ a n d ~ ~ ~ , blnd~ng @n bcUn momwnen, Trapanin C i s either loosely stte tho R d C MRdr t noponIn, + o associated w ~ t h ttopfmyosin or n bound to tmpmin I and tropmin T . Whchshfftrtc$xmyown akbwrng When u b u m mKgRmNmr mcwsa qbwe lff7M tn the call, tmponin C b~ndrxalclum and w**rgaer a change in sonfarmatton, forcing lnanarthmurde. 1nvearedCa2' tropmln I and tropcnln T to nrwe The movament e x p s the myaain bYKk myown l&t cham brim wfmh binding r on the amn. pennrttlnp intwactlon Mween the two b m e n ~ m e ~ ~ w l s filaments to occur. This. however, does not nectrurcly result in I&td!au~j, therebyacbviD A m -wand fnranrnstiaflng mntranfon Contractton u result only rf A P a p n t n T mnm'llon E CMbol d IWemWm&durn omnb.t[onr.Small membranous fokk known as T-tubulw exunij from the u~catnnma wrmund each and myoRbrililtheZflne.n*T~Inactarammmunka6wrryltemforthe dep&arkstion o+the plasma membrane that ww When a nervous *fmufatlan signals the n k d e to contract. Depolqrknbm of the d * n m a rekyed to the-k s 4tlrulura (UU, a sheath of flanaMd~thlemMlhthc~wdstofesBmewnMia
whereas those in the @sol ate klY (lo-' I).de+&riratlm, the Upon caktum &IS me frm 1 ~ to ' than 10--5 M duma m a d o n . The Inweas8 Is due pl&b t o tke momwant of calcium ions through @ n*s.dm11143 themahgnsne of the Pnoplaanic nbculum The in haMh in d u i n omamra(ion murr nM ind nHevar the inh~brtm DY of m w i n bnding t o anin Once the Rnnutetion of the nerve ceases, ubrn k pumped back mto ttm wwplwnir rethhnn by the action of a S R s p ~ d i A m The cabum a bound in the SR by cakqwsterfn, an c a c t d ~ c p w W ~ a hwh hmnutyof aspartate and glutamae revdues Wh

-

a trix

has rpclal~zed junct~onal complexesthat allow cells to bmd t o

nebhbonng cells or to the extrxellular matnx, whnch provides a
structural framework for the awoatlon o cellr Thls chapter wlll f

w the baric structure of the dlfferent type5 of cell ~unctlonr

QUJUNCllONS
Cell lunctlmr anchor cells to each other. seal boundar~es between cells, and form channels fw dlrect tranrpon and comrnuntcatlon between cellr Each of the three typer of junchonal nrmplem has a character#rt~ l t r a r t r ~ r e u (ngure 5 1) deslgned t o perform a rpcc~ficfunnton A W r i n g IvnrUom are p w n t In all cell types, but are m o d numerous In tlrsuer that are subject t o enreme mechanical stress, wrch as the eplthelaal cells of skin, InWlne, and uterus These lunctlonr couple nclghborjngcells t o one another through bnterantonrt h a t are mediated by the cytoakeleton Amhorlng juncttmr ere found tnbath vertebratm and ~nvenebrater and are Important ~nboth adherbon and cellular movement There are fwo major type of anchoring junctlonr, bared on the type of rytoskeletal element jnvolved adherens iunctionl and d.unwwrw Adherenr juncttonr mnnect groups of actln fllamcmr In adjacent cellr, whereas desmorornn connect lntermedlate fllammtr of

'

1

+$gumst,w

w

1 Idh.rmr i u n ~ l n clo COUP& ECL 0th- d s or with . a~ with BynpaMnt of the s Wl ) r m-nK M lu s ju;Ubl@ mmpkra a

~ o f m r , n u ] c f ~ ~ ' I n ( a a H d u ~ P 0and t - l rm linke m M (nb) /\r shown

nalghlmrlngcell or with mC c X W i ~ a b t 1 ntaWn

C CHp W ,also kwwn as m
1 Structure Ths b y $trw

-t

.-c

lent of 'gap junctlanl a the ~.r)smambrane protennr of idjaceni ceib intera;utwIfh one another to form a w m n u w r daannel thiu Ir epan m tha m m k of both calk AHhwgh connexonr of neighboring celk are ro dtreet contact, the

a hollmr BaUndu made up of ~~s

U i i i5

4

B l m a membrann of the twa cek are separated by a dlght gap of
2 4 nm 2

FuMtfon. Gap Junctmns
bll coupling vla gap junctlonr provider a m e h a n ~ m o r M i n a t l i ? @ t h s R l v W df- 1 f h Mr Cells be CWSW ad bothkribtnlol)) ek@IcaJly. G*,jUNtionr n nQ Gap a MomkMa in nnvs and brain cellr. muscle, mmth murrlr, and liver nlb ul W L gap luna*nr sst vp dirat ebmricai connections that fras the two calk into a sin& oWriol unR Thk communkation IS maimainadby the c o m e m i o n of ca2* and CAMP lweb ~ n m v e a s e h t h e ~ c ~ ~ + ~ & r w c ~ pimwklllty of gsp junwherraran inwearc In CAMPincrease rhcabdiiofthecelbto~wta.
fgs $JmnSnan(n d

m y

lnowsd ,"rn&h,Isr Cd. ~111 gap </me luncbonr M m 5 me deaLh ofooe cell b n kW m mpkd n e g h m !

the & I larnlm The mw fwutbn of dlagan sto e orgmlxethe ritraLelWr matm rich In

.aal prDLin dhrt wmh im tka rrearalluh

1WG ?bqrrs OQ~-bbrWmlifCbr glkP * b . u l W i ~ md

~ w k * r e r s d u q r @ $ ~ ~ ~ ~Thr.nraJM w n ~ ~ a d

tuMa9A t ~ p r o v ~ ~ , ' ~ ~ snd ta large B ~ * o c
amri4*p.&.ll.

""

and fhe MrNdlukr mtrix.FI&wrcflnIs h n d ur revaral locatwm a wl&am(ibmudlar~tobetr~ndentlyprWmton~.

cBU M ~ V F b.

~ . R a a l R h r m % m % ~ M o o d ~ s
heelms

s

c E m W x flLronacrm a hlonk lrrrclrrbla a d asbrlhs ralb WtWI the matrk L.nclatrthL.RUTsr~*,ihrw-~it~
cantM~rnatrof~armglslna.U~M-)t L l ~ t q e p i W Y ~ & d C ~ o f a c ~ i e x c . wtrphrwaecha~wranpalinihshyrcofrhoaTf*chdkrr~

hsldwathwtydixiffidebmdLblMrimhsrmamro*rUl~iMIll adnraMr, caeh Mndhig a dlHpnlrt motelm sUd.1 as rirnegen IV, tlmmm wwete, etc. tam% tncdharwmmtadmcnt o r d s to cdnwmw t!%Ln.

NBDE

1:

~ N A T O M I CSCIENCES
1

cnW mmkm, Enzymes that prcvpnt additional rpemmozoafrom
pcneVning the

cxxytv membrane are released from grenules tn the
pcllucida,

cgsmita
2

mna A.aiw, Cortical granule mqmes alhr tha EMs
~ . H n r l o n s ~ I s

t

U

~

chninwb of nwlollr F I M I ~ the sperm and egg cell membranes of
a b induces tha rwmptlon of metwh In the cxxytv
1 T h e e Mw completesthe bswcd me lot^ dwnon w h ~ h result$In

w M ~ s c a l l a d ~ d . R n ~ ~ a s w e l l ~ t h r ~ ~ U b

FUSION OF THE MALE AND FEMALE PROYUUEl
A wmpdtlon of the ponud.i. The famate pronucleus contains and the male pmnuckur mmpinr &u r -2 22 + X u+xrhm-

.
1

figure €-I

WEmCon

B .

tomutlen. Fusion of the pmnuclel to pmduce the ygote Is

c m * i W the bqlbniw o? embrysnx dtveb#mmt and entail5 the
follovnng

a renor- the diploid number of c h r o m c ~ m n (

w

t

e

L Itdetermiitherex~ftheembfy.3 P n r X - b E a r i R s r p a r m ~ o n XX (female) indavldual, while a Y-beanng sperm produces an XY (male) mdivldual

$.

a

a s e n s of rrpld rrdtatlFd ~ v called-. m

I

_

I d . _ l *

w& s &ractenrsd by the atlon of the hlanoe/rf. and the BMntr that occur dunng

pactlon. the loorely wqwued ULItDrws flatten and are
By the 3rd o 4th day, the cnnmacted embryo <Wins I€-32 r Is rlferrtd to as the rnorula

-

-

-

-

wnte umne N O ~s ma h m o m Anamnra m,the s p m p r ~ d u c f amf~tute.wemmmMiyured

Lnwmas th? blastocek

C

(Flsure 7-1) The zygote, now tree of a b!astocpl and cons* of two cell groups.

L zona pelluada, a
he

Iha embryoMa bnner e l l mas) pproiecu into the wvny
an$ryoMMgim&tothempmpw

NBDE 1 ANATOMICSCIENCES
I

2 The WphobIart (outer cell m a ) forms an outer epnhellalI rwmunds the embryoblat and blartocele The tmphoblast to the fetal partton of the placenta

Fqm 7-1 &stoo/statSdap

IMPLANTAliON
A Noml 1 Implantat,on beglnr by the end of the first week when t k trophoblart cells over the anbryaMart pole Invade the endom&$ eplthelrum of the uterlns body Aher the ombryoblan IS embedded wlthm the endometrial aroma, the surface k repaired by a blWd clot wh& s later replaced by epithelial wergrowth
2 When the embryo ~rnplantr, the trophoblart producer human

CI I A LNC L

CORRELATE

dwrbnic gonadov@n (M6). Ths is a hormone that matnta~ns the

lheluerwreofhCGrnunne&-mts a mmm~fyuredmethodbrpwplancy

corpus luteum and Its pmaenerone secretron until the placenta
begins to produce8% own progesterone

B Abmmal
1 T b hmtocystmay Implant In an abnwmal site m the ufms near the

Internalol orawtx. 2 Implantation outstdo the uterus a referred to as an ertoplc CI I A LNC L CORRELATE

Due to the narrowness of the utenne lube. @@PIC N b i p s m a ~ l e that s pwsstbg.ondthefifrh week wn WNE the be

p g. ea Ectopic sites af tmplantat~on occur tn the utertne tube (tuba1 pregnancy), on the surface of the ovary. or In the abdomen. n where they often are found a the rectoutenne (Douglas') pouch
C Rorrt.rathnotthevophob*rt
1 The nophbtast prollfsratesand d~ffennttater two cell layers Into

a The CyMtmphoblast e the nngle-celledlayer adjacent to the .

mbrynblaR b The rynntiotmphoblan 1 a thick outer layer that lacks tell s boundartas and grow ! t the endomemal rtroma "o

hsure8.1 BbVxptai 10 d a ~
" ) , " a

0. trt.E+lhcmml

I~S&IV' Jrl iiltZW-%amS 1 The trophobialtend extrasrabryonlc romat#cmewderm Im

rimlation

'"*,-

5

-.

w *

c o m p e the chorion allowr b1wd to f 2. Tmphab*Ltrr w o u ~d rr19ternal b M , from rlnuroidr (enlarged, congested cap~llaries the endomstul of tnto me iacunar or intervillous oaces that haw formed ~n embryonic ryncytiotrophoblart When th~s occurs, the prmH uteroplacemal clrmbt~on erteblished. is

C C h ~ u v i *
1 The expanded extraembryonc coelom forms the chormn~c . ravlty

day 13
2. The bllamlnar embiyo, amntw, 8& yolksc

am sv&mnM in cavlty by the connecting stalk, wh~cha a condenratton emapmbryonc mewdwmthat later develop Into the umbllml co
r y (definitive) YOU( ~s( pinched off b K

3 At thlr tune, the W

the primaiyyolkrac(Flgura8-2)
r- mrrwm c = w r . n p w r m

W
, l
I

- - -;6 &wW6~,rd Wl@
"1Y.lCd-Ip*?r,

. , a L+

z-,

,-

---,
rt

i A< *

vfit * ,LC

&- *r .

. .-r

.-

\inom*s~t;iZ rrn
6w1F&@~a-3iv7kh+
F

kj[%*

-. -

NBDE
contact with the extraembryonic merodarm that coven the yolk and amnlon
2 Ecmdam(ll and endodermal Iayen fure at the cephalic and ends of thr embnonic dkctu form the ~ h a n n m a l and rnmbwws, + ~ e l ~ mgure 9-1) MlgraUngmerodermalmils not -t ae these weas but pa%on either side to surround tlu W a l te th8 bMopheryngealmembrane, the meMderm form I u r d i i k p 4 m , which will give rim to the heart

. --

G

~

v

s

FORMAnON OF NOTOCHORD
bay 16. & a t this Om, cells of the prlmlwe streak mlgrate rosually form the tube-like notochordal prDce%

I

d

Q n W day 16,

tke allanton fnmr aa a divertWtum of thr w t e r h r wall of the yolk sac, which e m * tnto th@connecting Salk Both thr allamDir and the yolk sac an nrponsiblr for early blood formatton, whuh

took place MambryonKally

TROWO%WTDEYEMPMENT
The chorbn M e r a t ~ a t s M form rhoMnk viiii durlng the thtrd week of r devalopnent Figure S2)

1

A Rimmy d a n formed .*am& of cytotrophobiancells migrate into l

the Irregularprocessesofthe syncytiallayer.

a

r .
_
NBDE 1. ANATOMIC SCIENCES
6

figure lC- i Neual tube dedopment (crmr s e ~ ~ )
4

.

Modmrul-.
MenowryzCwn

Rain nd &n.l d me &ghalk end of the newal tube . dilates to fwm the fedwtnn, mmbtah, and Mndbraln Th mrd n farmed horn t h remrmler of the tubs Neural u form tba dona1 mot 9 umg gsnglla of the urnm ewnamu m l l a menmnm WMann cells. adrenal medull and the m d a n q m

Em*andgxmla.rt-

. . .

csl9cnatgqdm

Yos*w@acfnaneInwm Autoronicm

P, I -

appear m the ~9phallc region ofthe emhryo

Vhwann&& AdrMalmeduNa

1, T k rmc p l m v u t r to form the Imc verrde, which g m rhm n w us to the organs of h r w q and equiltbnw
2 The Csns placode lmarjtnates to form the lens vencle, whlh f o m the

lanrdurhpthsmna*ofC Other Modemml dalvatmr ~ncludeskm,

ham nalls. subcutancovl gndZ munrneryglands peuitary g l W , and t& mnnel

MESENCHYMAL DERNAmrsS
By day 17. the orrglnally dlffure tntraamblyon~c mesoderm becoms. dlffwewiated Into thne dintnn reglons hrud.1 m e s d ~ m forms tlwe dumns on enher side of the embryonc rnldl~wThis regm b contigww h a f l y Ilmhthe (ntemadba nmrodmn, whl*, m turn, n aomiguour with ma krrnlm a o ~ m (rigurn $0.2)

A. P.rulrlmaod.rm
1 On day .

2 ,the pareual maoderm asrue bqins dlv~rion,"to 0 vgmemal block or rorniOl.the Rrrt pslr of uvnlter a f q ~ a rn t k i catwid wgum. suhaeqwnt WIN appear m a m nI awu~lcs, ap+vonnwteiy three pa d tmtd 4 2 4 HISare wesent b the anl w y
ofthefiw3week.

A

wd*.

W"l*&-M&the-~to

W a n d farm

a W W k a rnultofthehea44eId.(hebrammnra~ . cranial t o m u &&ec ? gn i and septum tranrvanum, nh
sac becomes ~nmrpanted into the embryo as the fo CaVfYWl+SiutOthEmkleutviathsa&~~inte

k b~rdnal m o r l y by the buccophacyngeal a
buCcwbarghp8.l m e d a m ruptures otthccnd af ME thl W + ta wUbli%h communkatzon betwan me amnbtk cavl Md the pmrkbegutFigure 103). b. nil f l 4 a qwll of ths tall ford, the pmxinul pan o f t od s aNantois 6 mn&.a~ into t doaca. rhe distal pan of h atlanmk mi I ths InllMlng silt whlch ?a% at the e lm n ofmefDurthweef&theyo&ucrta~mfamth+umt,U~

byth4&asaIpktewhMts&iwma

th. c w l membrane ot fhir rtage. Tlns nwmbRno form the +r of the postodeurn a daprauion of MBCI .Ood9on.*h!h divldes Into the urogenital and anal membranes (Frgure

I

yollr***-Lmg-dllfVhkhevcmud

t umb~lrclll h cord.
E

W1.r .nkdmd d.rlunh.Sthclude the L.pnhofia1 i r n i q W i M W pelt und the i ~ u ~ m b q o n l c pwti01~ the all of vltelltne duu. DMlvaUrw also-inc$dr t epl$beltdllini b rewiretory tract, urlnary bladder, urethra, tyrnpanl eunvhian tub, as well as the p.nnchyma of tha thyma thymus, liuw, and p a n a m .

mn 1 1 4
2. llllqRtllinnekm

Feglmern&MPdtdopmt

a. * . g a - F o t . a g 8 s n & ~ d i m W F a r w a l l . , ~ l l . n d e ~ s r c h m p e u e ~ t f m t t t ~ & l t u p * ~ b exmion cf wntayonlcw e imud(ng C C ~ ~ U ~ S , PCM. UIK

.. tr. ,

WINbrq, W l S r Antibe+ tranaWrrion la whrch the fstr. w l r paternal Ue r antlbndtar rxura. Uw f e u otnpinr p i v e ~nsnunlty age some ruh s dlphtherla w but

8.

raniair fluid. The *mniotc cw IS filled with fluid d M fro1 a memm~l Mwd and, m laa pmgnmq. fetal unne Amntctlc fI rapidly tumd ovar via the placental membrane Reginnlng in t h
m,3,th,it**lwal~~ndtahrmldtothearm(nibnMtM

tract
C

The m n b t k fluid cumins fetal m h wMch may h pled by saniocsntnk. Karyohlping of thsrc raH1 .Uowr ~ ~ l ~ Cell aritufe may~ ured to diagnae h t bs e s Hmrrilfmbmwka

mnlotil D. U m W d . AI the embor I mdevelops, it bulges into d . ty nd I curhroned by tb amniotk fturd ~ r a M of the ambryo I r h aparrrion sfthe emn&U cavity and the oblrteration ofthe Wme onk coebm. As 8 re*dt the amnm md ham f , k ma ww

rM~nd~~chManr~~m~theumbli~caicord.
1 Tka u .

n W d cord initgthlc.m%atm gha v i t e h -1% a1 11 raph. mnnnim of tbe & u h c cavity, momnchy hr b ~ &k IwMJ, is rirh inglpwsam~~~~plycam M and d !
u&t
W b W a V 1.uuX and the int.rtPMlloopr (whtch cannot bs acco dated by tbe abdnninal uvity end are mruded in a phpL

u m M M M.

NBDE 1 : ANATOMIC SCIENCES
f
The d~aphragm e c e b innervation fmm the t h i i r and Rfh oniul sagof the rp~nal cord With the 1 of the flm lumbar vertsbra, ttfe diaphragm to the 1 n n bmgShemRg p f p i Q mvrarlar ehnmntr of the dbaphr wad by intermdal nwva. HMNevw, the bulk of bbaphr msiwr la motor ruppiy via t &rank mews. h
A. In-m.

l

a

P.rfunliv&tomal -Is, The thoracK and par~toneal cavities ere i t~ally contlnwur vla plnd pencardiqwrmeal unalr on erther a& the forwut.
~ l and 5

no B PlwmpIurdirlnmmbwWs. L u g buds gmw I t the a

body wail 6 spirt mto two componentr:the thoraclc wall a

roperlcardial membrane {a thin layer of mroderm tha

mnnm cardinal vein and the phnn~c nerve) Rlght and I
csMIal~~fweRthePkdIIIlRtSdMdethethaai~ -dial caw and two pteural revMs.

1 Thepkuropenurdralmembranesfanathe adult M x ~ ~ ~ p r r l u d i ~ ~

MESENTERIES
The lateral folding of the embryonic k causes the lateral edger of th@ Intraembryonlccwlorn to fuse In the rndmo. which pertltwns the @& toned caWfy Intb two hklvar Sptwhnlc mesoderm encloser the primttEn gut and Is wnpended from the M y wall as a doublclayered met% bran* the d d mnantery The& nmmteq h f a d fromthen*r~ derm ofthe repturn vanwenurn and tiiw ewenthfor bnly a rhwt d i m &wUa?& tewin@theleitandcightnigmbofthepritoneal w t y M h r * A Dmaol nmnntay extpndt tmm the lornr end of the esophagus to the reglen of the hindgut. R w e s as a wthwsy for blood mrafr.

mrvcr, and lymphn~o supplyingthe lntstlnal tract. 1 DON1mC1001bMum is the mwntery of the stomach regton
a wring the fourth mek. c W appear in the mnanteryd o ~ l to

the stomach. TheZe clefts fuse to form the omMt.1 bum Ucsa pernow1 ra3 behmd the stomach b Dunng the fifth mek, the rpleen develop ktween the layen d dond mamfar). khtnd the math. he s p b n matma~nr csn ~rwthe~l~wdl~nthcrrgl~nofthekhkuln (lienorenal i~gwnent) and to the stomach vla dorsal mesentery derfvatlver (gaNolmnal tigamcm)

L
KAPLAN M

PHARYNGEALARCHES
The mewnchyne con of the pharyngeal a g w rlra m the m ~nofthef&esndnsdLEad,dhMIbownerannlnarveanb mPMM+T.

,3

RmmnbRtlut hcnrmr "pha-I' and ?na&Wman t same thng b KwmayseemCCRm 'hxhh/"ured msomerw*lvW

A H n t pluryng.sl(eIn) a& 1MIaamww a Musks of marttcatum. ternpalls marmer, and pterygd

b Anteraw htiyofthe drgatrtm c Mylohyoidwr d. Tewrtympani
2. Y.*W compwmt The -"chyme

dtvidn into a domi maxi process and a 'nntfcl mandibular m e s s .

a

b.

glvarrlrcmtksmandibkrtsdomi (Meckel'r artilagef hcomes &fed to form the malkvr
IMYI

% Wrulnrvr-Qfthefint-I mmllary and madibuhr divlriom of the trige

nave W.
serondPhaW%Fl(hyoicR1. M w ) . t u n

a. M u v k of h a i eylreufon. orMwlsrls orb end occuli, p wmcutmls buccmnor. ~ceipttofmntalk b SWlw . c Stybhyoid d. PcUdw beliy of the d#gastrkus

2. SkdWI WmpamtS. The maonchylw form a crrtiieglnousb.E at(sdItckhwrscanit.ge a Thedawipandn&h+t%MUUpform$tbrtylc+dpr~ the temml bow b The lntwmedlate plwf f o m the stybhyotd iTmment. c The ventral pan of Rokhert'scartbgef o m the superior Wd the body af &a h d b e .
3

0.m m m mrnpamt b the facial norve(aan~ai VII) m

mrdc'haw@.rJI
1 UMIIP*.kWudestlm~hmqn~aur

2. S b W rmnponna. lhe ventral W l o n prsiN to form tha grClMr cwnu of the hyoid bone and the inferior part of the body o f t hyaid bone.

""

In

A

NUTSHELL

nk and travel mtht t h w to He M the d o ~ l t

a This fint &aryn&eal arch mucm s innervated by tfm

inat-

b Ths W r w third d the tongue w w M t h m e e fourthdy T h s ~ ~ o n . o f t h a p a R a f
a

"--'c.

i s ? r o i n t t i e ~ m m . %,w#tot~h md2kp emem pweriw part of tm -h denwiw, we i n m a t e d by the
I I. WI.

d Thannerul~dmttongueis~~bytlie

rwirr
3. Tapmd maiiiy derivt'dfrom adpW smites k

9

D 3h .
1 DnM laminil. Teeth develop fmm ohig mm &r ofthe demal na, I din the splthellal llntngof the upper and lower jaws

a EplWclrvla frcm the wta dantsl lay- differmtlat.$ .rabblrt*whkkfCftngathnarL h M n u r h W e Wllr adlaurn to tiu inner dental layer hffuen *PoodontQbbu whrh form W n . c Maranchyme cells outride the tDoth dtfferentaate tnto wh~h pmducewnmtum d The pufadarital ligsnum anofher mwenchymal denvat anchon thomoth Into porltlon on the ahmolar bone

A ~ ~ i z ~ l y n d m n * o f r n a l f o r m a t ~ ~ ~ m .
to abnormal d . M b n t of

d.drrMiVa ofthe f l m arch Inrum

1. B m y d a f s * r o f ~ r b M . a n d m m e

2 MaltormadWandplatr
3. Defsctroflomryelrd
B ThymploaaJ cyrt a a r e m m t of the thyrqforral duct it k found whew alon(l the rnWawy path of thw arurture. but k w i l y r b th. midl~m may be m m d extermallybythe thymgl-l it fistula

c

ShEtbMdr*(t~a*~tommon~knadtwrp fmmaua~ofonvimmmnt.lramliat~k~Tkey~y~ bibtwll otwailstsral
1

M Wp s due to faltwe of the rnsxnlafy pmePrpr to fwe with th. I W W nasalWllrng. I t rnonohen oc~lo anthsuppr R p
f w oftb palabno shelver to f u ~ a e

2 CWi p b s uwally as%x~aied wlth cleft upper lip k is due toms

.

€MKWQ.WMAL AND GEhlRX FACTORS
A. Wur*h.(

6

.hnomunr*r ate uulRy h e to nomdkju

and 24 &mm, whldt form mnorwnk Md trMmk zy@ms and 47 chmmgom~ w ~ C I ~ lS i .m bMeavd mmmal aw r y

marlly t Mndb+meim during wgennn. S o monaMnv . e ul chhmorome, an wmc&A ( an iutoromeq u n t W y fatal. I.

m nlrornia a with hfe

~

z

r

~

~

a. In some u u 5 , the utrs rhr~mororne Lr tnn 21 a~ton~EhmmPxmre.Aumerp&( mal) &m~unm Mm ha k trawkuamr 21 w m k n * a a d d i ~ & l i a v i n g a m d ~ * b T d r n PI Kart.)~ ~

*

% a@*
r, tt Is

~~with an increawd incidence of congenta

ddsatr,umbiliethcmla, and duodenal meria.

es&lkdPrm~a+8ldsyr-.
4 I ( P h . # a r ~ ~ ~ n w i ~ n l q r o M a Thk srulnmc is dwauw~zed ner~trtx ail taste% bv m

tkns-rmw. b Withm tha nudeus a anWy ria111ing reston, or Im b n l'h pnreha of tM r e x d m M i n k du. u&

5

avh.CI ~ ! X O ) o r o w i a n ~
a rlriroyndmna-lp~bythaabse~xsnf~~~ wrhcl, and Infantile e M n a t &anWiaMd mammary b lloWLwomatmk~t c T W s sycdromc t5 oXen arvxlamd W h sm muwe. h neck, lymphedema of the ewemitses, skeletal deface. retardation, and ongenital h a defects an

URQlly due ta ChrOmasmlml p h , of the & m a m e n n *.uidndmt-tha
Is

of thranorwner thn ere mpie d this &orrnaltty a ~lts the X thmmmrne an

I

. .
Mewmurat$&s~e.bnomt.l~~rrontheX @ r e d m males anamaller

.

FA^
lsuo rpntr e -0% the @Cental kamer end Pter the faal n

b Card~acseptal -and psnbtsnm of p a t e n t d u c ~ c. DWrmtm of the orpan of Cortl m tha ear, lhdlng U , d MluocepMy andmema1mtardati~

r

emweto*

(EUV) ~ h . n a f h ~ WIY k I

a~pt0m.t~.

e*lbll ammdles, vh& i n c W a. Mutr&WIaly,hplfhydrocaphaluhmntal mtar&tsm, and

uwush8
b. Chcalotghlthand mu&%halmla
c 3

m

b

Mven rlmp*x virus can be acqu~red the fetus a€ binh if by
m o t h has a genM IntKtton This hack m abnormalids, kl choriominitk. ConpuriUl aormlia, which mult from i utero. include a Mlcrocephaty and mental retardR8on b. Mia'oahthalmla and retinaldVrpIasla
c

HePatospreRDmqlaly

4. Tonqpksrna qondll, a protozoan ~nfirtlon, can rerun In a

rvch as a Cembral cabficatlon, mlcrocephaly. hydrocephalus, and me mardat~on b MwapMalma andchiawtbkh
5 SyphElr IS caused by Trepmema paflidm Congenital ryphtl

nruk in growth retardation and abnormal brain and skeletal

opmnn
ln.di.t)on While the evidence regatdingthe b a r d s of d

dasr of r d a t ~ e n o atomk fanout are known to be Ctatogenk. Ancmnlior I defccq. bc dskrtS W M b'fida m i w d w i y , mmal rW c i d t palate. and mutewns on germ cefk which lead to anomalla in M ngenerahorn u

-

elr of rad-Mion a not definitiw.

1 Umholrxporuretoa~canrewk~nhrm

srrociatal wlth a number of f&ldofed% lncl tlon. abnormal bra~n development and CNS abnormak~a,faclal morphisrn, and jomt defects In 1960-$962 until t t war withdrawn from the market I

2 Th3idO(nkkba~~1thatmvred~byp~gnnt

a n ~ s u c h u ~ m o r ~ l a r g ~ n n u k m g
or mammdla Fa, Wi or partla1a h m of Bmrmria). tatiad*ctr.mdcefa€*
3 _ b N d *exposure I(yb

rervk I teeth and skeletal abnondttm n

Uposure can r n u i t in ear. bran, and hean malfoma.

erpaurecanouwsmybJlv.mhan..

NBDE 1: ANATOMIC SCIENCES
1
simple dumrur eplthdium a one hyer of cells that en than they are wide, as sesn ~n vart~calprofole (e g, int abaorptlvecells) d h.udntratlfl.d.pitb.Uuol~rooMidered the cells rest on the basement nambrans. thew nuclei appear to be stratmad baecna wune of tha d not reach the free surface (1) Respiratory epRhellum k wudoruatlf~ed, ctllated, nrr wlth goblet cells, as found in thdmnduct~ng the reaplratotyuact (e g trachea). (2) Tranritlonal ep!thelium, found I" the urlnrty system, n wudorvalfrd
c

.

2. ~ ~ a n d e f l m d a r O w D o r m m e l ~ y e o o f c s l t r
&h W hyer nmmthe bsqamem membrane. t p

s m m emh& are m IU~utedfol
hmmmofaProrptMdrecrehoo dmm h a r e lwlh#.

a S m lqwmau .p(theliurn umsW of muitple Ihyers of and a w r k e I w r of flattenad rquamoua cDtk (1) Svatifkd squarovr kwatln~zing epitheltum ocwm in th. dtrmn of the skm. 0 Watifiedsqvlmaa mnlcewthrbingepithdlum &tn5 in awathealovlbv.thee~)ptupuqMldmc~u~ b, smtiM o.bW +urn txhlbm Nboklaklike wfw (e.& in the ductr of salh,atyglandr) c. StraWed a l u m n r eplthel4m exhibits columnar surface (r g in partlonref the male urethra)

.

angle cells or gmupr of ceUr rpecis pan$hmQ~acwsifw*uomn*Ua,theyreqnr duct system) o endacnne (I.=,they secrete ,"to the blood r Exoolmg*nch a n generallyclsrwfied on the hrsk of the fall. f
G*ndufu .plth.#1 -of
1 Ilunb.IOf&

a Unicellular #Ian& are defined as rlngle cells interrpersed , other epMhal d k d differentfunatom (e g ,gobletccl b. MuHralluhr glands ocwr r many adlacent w e t w y cells (eg, surface mum- celk of stomach) or a the ep~thalium pfex g W with ducrr
2

o - w - n ~ = m t w ~
a Simple glands have a simple, unbranchedductwth tubvbr w nrr -ty precer. b C o m p c u d glands have a branched duct system w~th tubuk

luc or tubuloulnsr secretow unm

e a variety of vlswus rnvyns rldr m proreon

a watery fhrtd cootaining protetr. both mucur a d serwmcwwy unlk votver excqmb~ menlbfans of the ma

mKhurrm by M hboth UH1 M n t o r y l c and 8 pattidm uf the ydul ssetwy crtl qtaplawn are
rnaih.n(kn by M h66th cells nd k t m .6fiular d-th u a

mu&

d h s e b I I W ~ H that~antarn r mntrac*thrnarC(on@*Mew*Ca.RDeriired Wrn gctodwm, they ars atuated

midtKfounU at the apinr of celk lhntng

da &

deYemcandhslfcdh ofthe lmbr ear, M a r e

a l l artfacepmjectlmof cell membranethat contain

mnn

a n d m m p p c l fluid and particksIn one
than cnla but have the 8ama mKrwtrumira, a kin the lpwrrr whse the n g b Ragellurn pm-

CLINICAL

CORRELATI fuKtion of the epdennh,

2 MQnalb.are derrvattm of neural veR . in the dennlr ~ n are aka -Wad a m d m layers of t $eplderma There dand i h Nnt & n ~ntha form of d n a r m e r that a
kerat1noMn

of@md wm~Ls) Hlrtoloq~cally
A. PapUWyhyW. m0ciaW principsf* with

8. m t h h r 1y.r a the deeper dotrnal layer and &st% of cwm w bundlesmntdned wkk eladlcflko m a gul maM* Thb I k w

4dense rmguhr conrmUvetiINe.

TEGUMENT I

1 S u o plrtionr consst of perqherally lmetcd, fla((enod c n y that resemble basal kuattmqies W a r d the center of enlarged dtffinntbatsd celk ateengwgd wtth 1 p d Dwth 11. mentatton of cells nearest the dun panton result in the mechanlrm of secretion
2 . W p d o m of sehcews glands are compoxd of mat

mow epitheliumthat IS cmlnuour wtth the haw canal and surface
3 funcmm involve the lubricmonof both ham and corn8fKdI the skin. as well as resmnce to desiccat~on 4. C o w of sabueaus glands Is hormarrl Enkrgament of

G w

occwr at puberty
D H.ln are long, flkmsntaur pccWfions c M u R ~ n g dead kwm of
~IrplkEechWr&rhreslromanqndmnrli the hab Mo*igz ahich porraaur a term~nal In&, hair misar -. 1 4 from which the har h f s r m a3 murck W e uUed anrc~or muscles. am attochd pili at mw mdnd to the papillary dermis at the other Contrachonof m w c b raker the hals n d dimptes the rplderm f d W k and a d sebaceous glands ere kn

units
E Id% I .hals are a mcdHied stratum corneum of the ep k mntaln hard h r t l n that forms In a manner s~rnilar the to hair. Cells cMIinuaflyprdtterate and keratinla tmm the matun of the r d matrix

. .

lype 111
MalormmponemdW@m
Can m-polmemewrthOmer4aa-of mumen

F& O

in smooth r n d a

m hn:

rpken,kdnex and l w

! &a d bmma o f h m t %m b
memlums
in fetal membranes

pmt.inr a. Rased on thew w W t u M wear restdues several GP, Id.ntifkJ hyalumnrcacld hewran w l f m haparin faN, cbndmltm kulfate, cbndrotttn 6-sulfatz and lulfate. b The most abundant GAG K hyal duwdpolyanlon that m r l q s t o

2 WWmtdm an of proten In mw to ~ozwgtjmns pmwn r the ~ t h e ~ a b u a d a m s SHsral slrcopmtnm have barn ~ d a n V fthat are mpo ; i iim b d m g of wils tothe & ciI m me . u n rw ) I h MwuncUn. wludr r rynthsvnd by f o ( r b bm, i ka mst wnWm Mndmg dommnr for ccllh collagen. hs$rmd(.te nomral cell a d h w Md rnagrann a swmmmn& whkh IS rymhesizad by fibrmb~ Mnd(n5damains ulb cotlag4 k-spann, and fib fm

A M u i t mnnetivrtluusr
1 CPnneaY8~pDp.r
8

l.ocae cptnra(ntiruu 1 Wnpoxed of few fiberr, an a s ground wbrtlmo. and a variety ofninknt cells as mll

mourfarua, miim lamina Wp?aoforgam,and in b DM-h r . .t n (~~Durunpulncmnreth.~kmmpodad d thW mUa#en fiban with scat gmund w It 1 .blc to withstand stress in a defmte s hund I IIgamRHs, t n Denm lnvgular

a

the bone.
2

Mtiabr 9 ~ 1 1 w u h ! a sp.EiaI1c-w c D W d i v e t tnnm d w pored 05 delicate retwJlar fibem (typa Illcollagen) and r w l u ( M l a r s ) , whrch prw& the framework for bone m m rpken, a d lymphd e s
sheets interrparwd wlth f i i l a m and Ddteh delrate m l l q m

B. M l u l u 1 OqantcMWr~dfBemandgmundwbrtence

a Fhnmnrkiuftype l miisgar in the form o f c r m b. Gmvnd rubMnP& of pmteaJlycan af keratan wIf&u dmmimUns&ie,&hydurot
2. lnorganc mamZ which amounts for approximately 9 welght of hone maVux, wnslsts pnmanly of a m m d u Pholphate I the form of hydmxyapatite Calc#um n cart

R&&,

magnwm, and rodfiman a h pleulm

C. orgmiutlon of bone rm i
C L I N I C A LC O R R E L A T E In P W s d m s e there rs a daforbsm rn the & l a m ofbone lromnMdvr (an rmepcedrafeof hone desmxmnand
1 hmatun bone (I e , nonlamsllar, bundle, woven) s nr .

bone tlswe w t h laoully ~ n w l x e d collagen fiberr tl highdemlty of M 2 Matun bow s a hlghly mwhrnd W l l a r arrangcme emacellular mrtrlx mat a @zed Into ahom, Inb

-*

m n r q u e m ~ I d I n sthatkadsm tfte , ua d em m or unmwrebone PeoprP wfknng fwn f w t 5 are P=

lae, andurcumterential+ameIfse a. Ol1.onr (W.Mo*n .ymnn)are wmpowd of conct around a central neumvalcular anal (Havemian cyllndrlcal unrtr run pwallelto the long axor of camp b Int.lffitill Iam4u) are wedaes of compct bone I . m the Nl~ndr~cai ahom c chrumhrmiel bmellm a n parallel lamellar awa bone Wue wmwndfng the of(cw. the outer on drtilmfaamial lamlW7 and on the inner surface ?eMisl lamdlwl &bane
3. P.rlodeum s a douele-layeredt l r w membfane hunt wter bvne surface n m- a outer, mostly fib. i an fnnarmoncellular. byar that W e n K6 4. Eadsrtarm k a deltcate membrane of orteopnc o l h wrfacerof hones adlacantto the marrow wwti

r

-lour @POW) mrn of deuulte i n brwr trabecuiae of bone tisue ~n the form of a port f~lledwith r w mm
lamelhe, and dmmrhrennal lamella+.

2. Comaact (dense) bone consist^ of numerous astear

E. or@mk&W~fbn(lbonn 1 C p l m are e x h m l t i e of long bones comporrd bonemvarsd bya thtn layu of mmpm bene
2. Dhp-

are cyllndriul hafts of long bones c o m w

bone

bpnaawimcludemaaofUur~nddrat~ai Lrnr m devetopment amJ growfir, the untlags ir nplaudb bcrU tirws (Figwe 11-31.

thn & , a

w M s located sn

drL a h rr sf long lr b p yi

tion center hypartmphy. resorb some of the organic ma

mPrunadwMnb~~aalafiad aNL&p
tKn4tha&dtheInneflsyar&pa~m ~mo OMoMam Ti14pa(mondnum rraQlruUEdhe

m m

th. duphynal pnmMy oaiilaU0d m r c r outward. twmg

- -

he

i

NOTE

~

d

r

k

n

g

~

:

( 1 ) m t P m of G%xmbm5 m the

w** ~ 0 f t h e ~ ~

I e a l r M e

P:a l m

, p ~ ~ . r u b r e q u e n t - o n d n l ~ ~ t h c & n . h a u i h m s t h i i v . t t i k ~ m t k ~ o f

.th.booehsh. Jb ofda3gatlon d w nm necarwrlly proceed at ths rate In tutva-at l plna of a lonq ban.

m e trme, bone m removed fmm the inter benwth tho edostoum ro that the bow marmr inaure m dimmbr b Cimwm in oUBL6dr d h w t s w h horn peripheral sp barn. Growth In cav~ty diem* nrultrfmn mnl We.
a A t the

#&Ware defineda thd erlkulation between two boner Q s c0nn-e w of ttweidnu

I. w

a

r

e joints that permit very I I W or M ~

&f

dsnre e o n n ~ l v e DSW. Thir of the g m n g h a of me Wl

we-=kin h W h d c W m melolnts whprr bonBI areunlted by hyallne .
W ~ o f W ~ a f p h t a r e t h e a ~ a i p Sr-loRg bane c %m#Rses Marolntswher. bones are urutsd by bone t i . tywoikt bfwndmt h e ~ o f t h e p d v l t r k u l l d. S m p h p s ~ m ~oine wher.bonrnr am wited by combma hyallnemd flbrorsrtllaae gc spp+@ pbua and mte upb
-a=*nrmshyw. Z Wrr*rouraQlmrWmRrrm~Theyanp ~Wd0nd~bo~rudro~threlbDnrend)mse.

twBf ) w O bonas. nW w p w b 6 -of UR enma1 layer and an l m W rynonal layer. 11) Tk.duue Onnutlve tiaim flbrou. I m r s espscully d w e k d m Iwmang and roma d the Undons insertad the hone war the jomnt (2)The interne! synQv18I membrane Is llned by quamour Wboldal celk of meumshymsl wlgm wlled synov~al celk b The uprub encloses the artlcuk cavity. w h l h a f~llsd w hyalurank ad&lch smovinl Ruld:t r ftuM factlitatathe dM h the artwlar surfaced thebanesat t h e m

2

tonu orpm ace formed by two nmtlbxh. a. A 4 b D N P m f n m d b ~ a ~ k n m m olriffu8pl. h uuhlch boms dovelopdiredly

modek th.t ruMqUanny bemnw auified
B. YttY fornrstiUI. The w

ra&m

h i m ndgxrlreroaan~umfwrm *elam the

prowdma wiachmtam of the face

1. ~ S d H R d e d r n r U o W ~

a The lnLlnbnndus n ( t u m ~ I w n . consiN of flat

Mtth N$ m a i n mmbrhaw until
. R iO PMMIle, ( .i l

wlmre the two

m unm mau i

Of

the

2 ~ ~ ~ h n n W F m t t w o p h a m ~ p a l Vable 1C11.

C A p p d W l u ~ mThe peaoraland pelvtcgltdlarand the limbs .

p

m

s

~

a

~

~

<

erccpt for me chick, most bun- oi the ryaan a n nxhxhondra!. me limbs hgh u mCsenChyrna1buds with an a$%cal~ D d e r m J ridgrcowlng, filch exem an tnductivr hfhmee dver the

*

2 Borr farn*rtlon occurs by asiflation d hyallnlr wrt~lage models a. Thaprmnbeeimatthaandd~embryonlcpricdmth.W ~ryolrifiunionce~whKharelootedhthesh.Yft,or~ y k of the i h g boncr At thr .piphy#s%r bow e x t r e m i t i .. o orrjftmion begtmrhwtiya*a birth

b H m W a The mrf& md HnrlniKmusk of tongue ere tho bcdduwlirum ompi(almyotomesthatm$nhfo~rd b. The extrinsc murchs of the rye may derive from pr
c The m w l a of mastication, facial eytressbn, the p . the 1.srqnk are d c r W fmm ~ f f e r s n t phawweal mhtahthehmmwadonbythem~ofthait&of
4 UnBnr\rrru*(vnwigmeter in fhernrrnthwaekfmm urm

dam thst mlgretas mto %helimb bud. W a tm the lnrb m l turn split5 hto m r a l flsror and d n n t gm a. l l m l h n b l s i n n e ~ a t e U b y ~ n m a . w h i cpn h bid maodsrmalcondemntiom. Scgmeinsl branch ~hnMmfanlwp~doislandnnrraim~

whTp"#nCe
B. Sn)od(liW&&e

I d e t which thelimb arise.

8mmh mu&

coats of the gut

traclm%

.

2. T h e y l W W w a s b r W n im pubul-

\

3 ThelmMddrukn~~theparMalardtheocd~
C L I N K A L CO.*EtATF

Theanf9rirxfwtamUe ol%ft$aC' s ~ ~ ~ ~ ~ ~ a a t i h u p r e ~ f a I w t M a w a lS lbalMM.kthepantatwMFhthewItWnRon ofbSdYfiylks f m m t h e w ~ r a g r t -

tdvnur nleantencffon~uu*lay absesby 18 m t h s . and the wstmw
faWnnleby6mmfhs.

A The mu*fn of fwbl erpream we derivedim the wand pha N I . suppiredby w t w a w O~EHWI ( r a t r ~ ~ N ~ ~

fpn

Huukr0flhe.n

BuCnMtor

brbrculam wlr

bdy met

l k l p d ~ t k w t y b o n e thehumm ~n nor diredly armfate nrthatMm0merbMe ltrssrabr

Ibed&*aii&mwofwMUIMI5-

deraMlrYsamsna

C~rn*r. CEMME~M~
& d m # a * G & * T

magm~mtRelonaaUatd

.

h e ~ I ~ ~ ~ n l , s ? +

-W@
F l,+?

+ W

C r r u i c n ~ ORRELATE C

-

the 6rachul P I %rmiw kdude tho andwpfesnp&mVW** -

l =3 ) l l m ~ w l n p a a ~ M b l t o h h

wn(loMwnasiuautuzrcus~
IIWRrnaybeawgnofkaTtaJure Ibhenaccmp3nred&aril.m~ p e w r e m ckesuperh~ma B andm G ~ srbusrigAnmydko&asiplof

-4 mat cmwrthm nanodefdonwtoid muscle
2 A m & tdmn~h bwosw mS ~ r d ~ ) I d o m o mldlinc of the ~ d n d t h r I n k t i o r bordn o

w + ~ c

cdxtnam*&w-&

Bnroor TO CARBIOV*S<U<AR

:

!

f m w b ~ ~ w m ~ f & s b h e WuuhaePrthelamv~rn meeasmkbbodpmweMscaa1 smrin8ubrrharn&ofmRe ~ ~ m n v g s d & ~ ~

a f a W I h w & a ~ @ =wtcbral b e , IntyruI and eternal a$uoM arteries The aftery ha8 six lxandm&e7 &a LOT thy mg pharyn-I, the bpi, the fadal, the OECIPI*~
-mi

neck snd f.g

P) Vva~urnerve ( ( n X) (4) HyWglorUl nm (03 XD e 1
(5) lntrmal and external laryngeal brvrrka of th wl branch of the wag& n w c The interndl m w Jnffrom the hwee thm level of the voral fold$ and U?e emrnal

-

aur$cularanenerbes). T h e aupply structur (Flpwe 19-4)

I
\
'r

NBDE 1: AN~TOMIC SCIENCES
2 Phnnk rulv* s a branch of the w l plexus. w c4. and CS. R $9 the role motor m t a the dia a m l w vskne muscle fmm lateral to medul inlet a RKurnMiynp.al WIW Is a branch of the vWtS M !

CLINICAL CORRELATE

I

me recurrent I a v p d m a r e wlnerabk dunng thymd surge~YI f one of ksemn&m& thpqwWaf hemmwbec~,rewmngin
4.

D mdasdrnrmdr
upreston, whhdr has mlgnrpd(othen&.
C L I N I W L CORRELATI

2

up inwnnp f
toid m W e %

rurmund. tke 09erim and rtarn

: %rerpomtipmrtum =
*pMOnfral=

armbioMtreabnenthaujethe~f

4

are ,relrVavlrarBr Tmbnent lha%Ible@?&vmWmeedabIIJhmmtof cxlern61dre1MgeoflheaWaw

f W u*an the prevaItobrJ mu* IMlQusc~lll, u c f ) t w ~ 0 n r5t o a W s * &Thls a t
as theallllfpuh.li

,mdsm,rn, rnfRHM on mWefare parr
nto medlassnum, @en*!@ r e ~ h rn a fatal pencdrdrm

~ h (.~ 1 ( ~ r arrlrgmnpa .nd~ h . k h)nwatlon.. A dmpk orgm~H%$tfwftpmuxtroftheRecChbasdonMlobalcpr ~ h musrlr may be amnged fn gtoupl, acchnling t~ t h l r s Pnd ( ) PU I))UYI~I 1 in a group &are a commm innewatlon axmptlanin each group

IN

A NUTSHELL

Hmdrpnxy,lmlMtkn
Ibnpn'
~ay":

dn x

Rwnent

22 & , x % w
phmnr

ma
of&

%F
CMothW
f m l b m

6es%@ M&Srthe 1: teiwm.Nl mntr~w muylw~ls &the eanmc m u x l a 0 e. t h w c9At.iRInsthC (UtflX th( tongue an wppliad bY CN XIS % O M C K C W t I M 4 ws, whkh nruppWbvCN X. 2 W O U ~:Muscles Of OD larynx. All but one of the intrlnric m 1
1

CNXand CNX~ CNXand

stylrphuyn
~ ( O Y U O

the larynx ate ruppllec)%the recunertt laqngeal vagu new. lhe sek excapti~l the ~ic-id Is m ruppllet! by ihc external la1ynge8l bran&& the nw

sefllwlaHkh l. +

pesm

76mwuck
1cNVJ

3 trnup3: ~ u x b ofth.p h s y m ~ but 6na of the ions r AU cimuhrauof thc pixalyaxam&M by CNI ~ ~ n d ~ d

-cmrC&

7+ h& @mdofcl)

p e r H M d ' ~ ~ & * u r p t u g l l a ~ ~ ~ IUpdled by CN U. ( 7 * - * ~ d t h . * ~ 1 ~ 1 b l l ( o n . 0 f t h . ~ d
palate ate lup!Med by ' 3 s X and XI I c m W podan) Thc &bl non the temor veil paiatin!, which a w p p M bY by Va*
5 6-

phs1D (Cl,

Q 0)

5: lntnkyotd a & . All but on4 ef ( . i n h r h w W h an supplied by the anla ceNWlk of Me cnvl@l plem% 1 6 .

-May

abdwabbmluda.
8 b~Weral feature, 2 Inanh(.l g r o ~ v ~ i n d i c athe e l t ~ & the mgu~nal m I

~~

mikdmar, iraeltwdw of the snwne! o M w apo raethe abdWtreqWnwly from Wrtqwerextrern ingulrul Itga-mda fmm the ha to the pubic

l.-twmaIoMyr a m f&n run anmmriy and WIiorly (I e.. the
b Ar

fikn pas med!&+meFkoma

appneurotic a d c: tjteinai ohl~qw a(w

-t~.thra~ml4ptofthm~rhrth.
c. lntMlorly, the fkee boldw&the m s the hpuuul Ilgm*nt..

d. T ~ u ~ ~ hguiwl'dngI S M~.pning th. ~ W R I in
a ~ ~ 9 ~ w p s r i a ~ ktar&thapubic a. I" men, this *ya ~ ~ ~ W I W ~ DaI ~ u rIo rOr ) ~~ J i

-

.nOHNlrp3il(iP*tharpeWcwd

2,

h#rr*lebliqu .a r n ~ ~ brun ~ i o r l y ~ d ~ rmittargterm a r r l y ~ t tha m a 1 oblig)rrlike thaw d the internal intemstal
thethorax.

- - .**

.-

k &Po fikn piis medially,they bcomc aponeumtk and
mntributetothersnurrheath

3. I n a r h m u, 8 a Thr m u d . fibrq run horif~f@lly. ths fibers pas Al thw mmbute tp MemcWstmth h. Inferl@rIy.th. flkn IqIn wth t w of the intprnai oM h form the eDnlolMtenden, 4 . l o . c h r ~ k a Tlm f b n run vertiuil~ ie between the pub6 symphysis&
b The nght and Iefl ratl muscle5 ara qparated

*apr-.
lima alb.

medal&

*ku formed@ 4R n - bo

h a 1

reMunnfdklXaruior&blder rt*iCI+*-.andawVmrIrr
thoraxend the lnhriuremernny.

many of the

rwMcnRlthroughL4

-2. The praar major a r l m from the w a n m e p r vertebrae a I m o n , along wth lliacuh I on the I 5

NorE meclaMdehtheflmtbonemc&~n feral fife anda the mart fmqmnt+y fracmled bane ,n the tady

b Ciwld. ir an % a ++

bone, wh~ch articulatesW h wn of the sternum madially Brrd with the wmmion

I,

shotllder, and the d - which ban a , in$ "Crow's beak ' The e b l d fWa of wtth.tha hmdaftkhu4iha.7llewl)aupuL

rates the rupmpi

gmatw and h r t u are located infalor to tkbumerur. She M hswodty b m elongated,
area of Be shaft &Ehe humem. % ulL ( r p space shepad like a truncated pyrarnld, which a pasageway W e M thsnqck and the upp fomnd by the cerviwutlbw canal and Is boun ~capyl.. and firstrib. Thtt bash Is formed by the er6d skin of the am&

( t )The m b w wall is formed by the pectoralis
toralii mlnor The pRtWellr mabr form the fold.

ed by Me m b M amerfw muxk and

"

3.

ww m r u p p l E s , 'skWwqaandrninor

-

~nedtsn c nm

+)MsdblMidof

W b f btsehkiicutsh~ur

2) Uhw nerve

llpaofthehunm6ishld~th.sleheidfopubyI

*nLimuckSwla**.

don IS occupied by the radlat n&e and ttv daep bra

d ~

artlwl.ting with the headof theradhs. . n d l ~ ~ a n t h e d w l h u m a n d gnn rlreto the m w l a of

r

u

~

.,

NEMONIC

Wnha m ~ n a c u f f r r theprtchw , Won me benh swmwmtus infra
~leRImuwrnrbrapulsm

*nMor(Auor)ceawmmHUmmm awmles (1) The (~wbfwWYbrbIWU m w i e a r m W d m mMpmna

4
4

3. POR.

er
face of the humerus. b. lmaPtion 1Pu Wac heads of the Wluw are suppli.L( r a M wns.

I I

4 The wbhd fom k

a Vmngqhr m a antprior to the e l h . of thr cubit& f o m n formed by deep facia and @ epaWaW%&lcb (r p v t o f ths inlenien O Nn f contentr~twbblfbs@indude thefdiowing a. RI. n;;citn ~ b l t l l v * is a ND&I*I win. which betwen the b@k and cephalic w i m l iks supsM l bi~lpiml aPWUUfOIlA b The b*.p pnbni n w a o n the radld tuberostty.
natesbydMding into radialawl ulnar Marie d. l t m ~ n a ~ r U D g R a n o m u w l e i n t h e a r m ! 3 U r k M c e ~ n e o f n u n r b o f t h e *
tiola. rm s r t l c u w w m nrr - t e &h

the radius around the ulna @a, &&Ion
C. m k r n

and pronation).

the pottion of t rrplj.r Iimb,bmwen the aibw, k wrist joint. We forearm is e w in a @ywat dwp kYi*, bones of the forearm, the rodhutand a well a an i membrane a d two f i b u s xgtq~dividr fsnum into en the

(enulraiiaarprtnmnpndaWrrftria(portniepa~pvbnnt

4

01 %head mwkw w& tth.ca&lum of the humrw. l&hr ndul Wbswbty shs rtte of tnaertron ot h
brachi! $31 Thadoml &istdtukrcl. k located on th.poshm ffWdStalnpsrtOfthsn(lus

NBDE 1: ANATOMIC SCBNCES

F
hmonl tllmgb (Figure 19-11) mrnt superiorly, the medial border Qf tho vMrtur I the mdlpl border of the dhxtor bngw Wmlty b.

cmtme
t b f~ben m Y. U, and l + i pxiulal n a h

hnwalw 4 W a long-

branch, the Whlchruppireg tha kny laiat and the rk

b~paornsthmughmefemn~"rgam h a 1 d, apwa BI a ~ k n g may 0 1 w m C ~ I m a m k n(kan U imuiMI h m & .? t h , and ~

I ctrcumfkx, and the b M I l

Fgure 1 9 1 1 Antenor fhgh adfewalimn@

moat medial compartment of the femoral shsath. Thb partmcm Is known as the fernorel c a d , and n c with the abdomen via a small ogenhg, ulled

m.

emmal eniralis: and the loww

NBDE 1 : ANATOMICSCIENCI E
2 Knee)DIntI5 a hinge-typ. Syn0vial)omnt.

O S t - M Y
Because of t k c m m e e a f o b m ,

the r s k U v d v d W p & 7 t t a ? ~ * ~

(2) 1Btr h.tkebans afmtrwn tkr kp. lu tnde.1 a d Ittor f w, 9 J& Wl W Y r a

s

9roMsln;thed s f ma f w a

cause m

~ pmmd m mnwge 7 ~

~ n - f c o t d r q T - ~ l a o o f h . tm,"thCm&ofmCMtem-

~ r t u r n t o r w x ~ 8 a K sd I s m

uhle. IMtho thigh the leg h encased in n the owal fmda The two m n a of Me leg.
men*.

mnddrrnmwma.omarPmur ~ o l r n f c c b mh b l W d t h d ~ m a v T Lk~~eanpreaummmOhep o e d m and m annrbLW1 C

1.

OdCdqbr (FigurelS-$3)
a.

The antgrtor surfkc of Me ubla 1s davdid &mem aRd is palmblp thmugheut b t n& e! tkdiad.r end of t fibla a r t k d a t ~ h the &Q k h rilbcyYneous pmkrdron. IIUd i l malIeoU b. n d t a ir covered thmuglrwt is l&h & &us& it t only at IS head and most dirtai projectla?, the Mefa ! I aptlwlates wtth the Q i w &&
2. -wswmo.ln
; k

M

~

R

U

~

~

o

€

m

*

~

r

arrslund i n LWQ~LQW mw&b~snd dana.
Untoo* (1) ClldOUI.m(us U)Soiew 63) PbWh

Mi 3bnkpSst.riaF
(5) E l m dlgimrumb w r (6) HgqvhaU&frrrguS

b. r s m s - R . x o r - m d ~ e d b t k e w b H u L

LETAL h.47-

7g

1 Pvlprsvfty lrthe central cavity of the tooth

a R

b wmpoud of a pulp chamber t the cmwn and n

2

EnMI.1 F the hardest rubrtancsaf the body. Mlng app r 9 7 ~ l ~ f m i u m by ra a wsi8~.
enciyme.

tl]nK brgank matrix * e t d by amebblast5 6emmeP tzadralin mot41k h f l o n prinrJmptibn

a. mmnnm is a catclfltd tiow similar to bone that c m
ofthem m &-uhicraviruMal(cuIt

's. --~flWn\t)@r

S M B ~

CLINICALCORRELATE

b Dn fbt &atside, .

$ 6 fibers are BW 1 in fh.

&w&mQ!-w~a

t b e t y p i c d . l ~ m e l i a r p of uluitbom. .~

i~ FatrelcolsSa,renewal afmphyof % $
t e* Y e m t e h - R I % wh n
-hinmeirIDcYwandfdl

7. 6ingk-a (gum] Ira mucous mambfanu f i Wo m (

Qwf&?q csprMm tlaua
1

t H qwmj by a s?reQfiedMluBm6ur kemnw.

.
.

Prox#mel.mdmledmurJe Mnlparaonrmmuaofmthmd stnatedmw

W e n d smoocfirnunk.

NBDE 1 :&W&OM~G F

SCIENCES
I
'

b C h * t d s rre the mart allClIwlarit<dbdt nis tiem .
glands They arsakD found In the neck isgm a d %, '@*-the wlase Cn* *f%tasa&Webmlowdunmar cdls h a w bgaul nucplwr aranuler conWn4ng~.qmgen~orm' (22% *r(Mgens are entvatcd atter s.cnnlon by

BRIDGETO PHYSIOLOGY
Acd~rn!&esaChawm

anmrw~wmW1
drarcam&onFdrbon dw&&andmtar

m~rmocer*lrbwmM-la>
,
'$1

wtthanemiar~neer mem~ fundlon

r W ?

-7

&& -1
Norr
I

5

.

>.

W . I K A. MurqmL
1

".

Plkadrarmarammtduumof me~~unwn

G

w Uu murakl of ths mall lmemne has s

ifwriiza.
-

+

ClrNlcar Conrirrrr

tG A*

acids, m m m f f h a m s end fatty w t e mmerals, and elearolytes emer fhe ~

wear nmwiiamr

(2f bWdogCperM~ M i t a n y a t W e r e tv a ~ ' m s m a n ~ m I W h ( S f 6 ) B W prWh io be r s l W lr &ylmlMt@ ihdb

-

+

5

WUi contract w l~IIMI per mi o

tlstc$eeik in the lowor half oftha gfands
3 Tlm bmine propria 6 rich In lymphoid all% lymph n and

1A4ua,try
in UwlQPendix.

mto ~

~LUI~OIQ.

4.~ubarva~v many mph nodub, wimh am s wnmk

p ~ y

W m e l layer Is dlfferem from I . In th ht irgsthrwl urto tMhl thI& I -

NBDE 1: ANATOMIC SCIENCES
I

(e g , lopare. leclthtnase), and nuclelc acdr (e g , rtbo dmxynbonucleare)
3 ThehKtsynem of the pancreas begun w ~ t h small cubldal

extend Into the aclnar lumen smntnuclnar mils

C The liver Ir the larpen gland of the body It has mult~ple functlans including exocrine secretlo" ("la bde ducts lnto lumen), mamtenarae of optimal concentratlonr of varlous of blood, and fllterlng of the blood, whlch ~truelves vla th from the dtgen~ve tract and spleen
1 Parenchyma of the lhver or davldad rnto many rmall lobules lhke polygonal cyl~ndes (Flgutt 20 31 a Each cylrnder 1 composed of plates of cells arranged s arwnd a central vein Between the plater are radlal blo

ads.

b. A t the per~phery f the Iobuler, branches o f the po o hepatic artery. bile duds, and lymphat~r. course together
2 Hepatoqws or lwer cells. are 20-30 pm polyhedral mr~nophl a Thebr six or more surfaces may ejther contact another cell gap junctions and bile canall~ull form a free rurfa or mlcrov~llt expared to the pennnusotdalspace of Dl-.
granulesthat are clusterednear the SER c Then am several hundred mltachondr~a I w per k M

thrombin, f~brlnogcn), secretes bile, rtorer lbpldr and
matic proof gluroneogenarrs, and dctoxlfles and In

k

hk rsnrllculi tomt a network t h e p r o g a w along th.
of hrivetlobub wthedwectlwt ofthe$w?ntcanib.

w h i pddually form ther(!#t and left

d W

af the lhw are lined with fenmrtsd endomcrlal cells ad P~*Y*.Q*Iwhidruepwtoft)M~mu.
la%nn W g n ZDJ). hu

r n M l r rapJdly unda wme diwmnanccr As M 9 o W can be rephaxiI abaIRtwesk~ n u

h and contentrater bile tt Is a distemlble pearSoces
b l t h a 5&ml capact lmted on the underuds of the nght liver %wall l olthe pbllblaLWr Is camposed of three layers

BRIDGE T O EMBIYOLOGY
Ad"n,l"mu"
H*slfum,n
~ " " 7 W d f d d hMmrCdu3

Fgue 2 1-1 B a m e m s m m n thmugh the abdomen at fhe

oftWohmwI*vPd

CLINICALC o n n r r ~ r r
The~~womennrmlramdb~iemrrctwemafmaypreuenttksFm~dof -1 d m thepemMealcaeby

a F.*iknn

4

~offioi!am&amseg.an ~ ~ t h a t ~ p b w

-

attaches anddwlqsth?lluar~at(ca~

tum suqa w~thin m Wfot W omenturn a a four
f r m the greater runaturno veqecotan.

t

m

1 G m t w ac sthe major pan of the prlmneal cavity.

a

l i i @ e n d M ~ ~ ~ # s a m l m t a d a l ~ h t k and dsendkg cokm. m &

r l a r e the blood supply of the

hean A wg,rftanr&wmle W ~ H B Y ~MoksdrsopMpallbronchofthe rfrg a m W R w h d ~ d~ anro t e h m a ea Yncs thr r
~wnraresmaUandaremd

1 4

meanthwd, -heavymR-mqmsy bnae venmse and NpNre llm )weucesrb+psmtrowmnmpoos-ts

j

stal

ern

posterlw branches of the ilnwdk (I) ecum, and the e p p e ~ l ntery rupplie. s~

drain to the supenor IVuqkoftlNmondc

lcplew.

,

,

the lnferbr maen-

1. The #bdomkbf p9rtlon at the

8.

s+smuh i. n i e ; whas a t I

hepath of the F i r & tfta I w r 0nKntua. M d from wMch tho water omentwnk Npndd.

cwqura, which 4 mn

2. Thc canl*r

raa1VwhVasua

3 The domahnped uppa?pMN& of

of hm WW to a e m r t

*fiu*i**ir.

at& W r

rlor lnkttnal portal; the remalndsr of the duodanum Ir

tha rlght and left hbngubr I&wm@Xa)e

2 men

w h two surf.cn a superior, d i l d u e a 4~uhcsrataaf.g u 2 * w n 1.

Balml&ikr hub the rlpht BD. p16p1r. tho

g s w rrhkh I$ rfght free bard +he

liar in a faaY on fhe W R surface of the linr to C l

chaawmnrlsbr,
d v d ~ m s ~ ~ d u d t o f o r m ~

NBDE I : ANATOMK SCIENCES

r

A Rotdon. Cephalocavdal foldrng of the embryonc dl cardial cavlty and heart tube to rotate 180' along a become lacatcd vantral to the foregut and ~ u d ato l

g a l membrane.
B. Eady d U b n U u h . The cephahc or arterial, end of the

m n t l n w r with the aortlc PC, while the caudal, or v e n q

the atelline velnr frwn the yok sac the umbdkal vams f
ta, and the common cardlnai vemr fmm the bcdy wall expands and different~ater form, I" a cephalaauda to bvlbvr mrdii, primitive mwide, primitive.Vlum, and rl
1.

The aonlr

arther connect the truncur to the paired do whuch an* from the aorta<s and lie doMbtoralro x

2. Tbadimd @Mian the bulbus, the bu of

right aw4m end the mmnay SMI I

1 The aonk arth arteriea arbduring the fourth wnfr *din
PG mmt dMal part oftile huncurnrkrlthe

2 Each of t six pain of artprlea 1% ambedded In the b mncrpondtng pharyngeal arch and termmnata in

*a44
3 llq d m 1 aortae fuse hy the fifth week to form the

rauc aam and the abdominal aorta with branch yulk rac (v~tell~ne artend, and allantols (umblliil anwl

a

r\aa*d.lhAarn
1,

RI%I.ortic arch. The pamlrtlngpDRlanb e ~ t n tha a
whtch ruppllarthe derlvsuvesof the firs pharywpl

2 Swnd u n t i c aILh The mnlsnng pwtlon

and rt.pdW artMyrtMy supply derrvatl wh~Jl geal arch
3 Third .omk arch. it giver riw to the -mar

umtM a flnt p n a the lntemrlcamdd ~ I (thetem.Ihda f Y the crsnlal portlon of the dam1 aorta), the external branches hwn011s uch

4. k r t h .ortic arch. The left s~de farm put o f

the

imtween thP left common c a m ~ d left w k l a and rlght radc form the p d n u l portion of the *hi

ed from the rlgM dona1 a o r t a e thtthtyants

I N I\ NUTSIIELL

. '. *

Aorilcwh-

MaXhYaryarmy- lstarch MjCddhry-Uldarch SWamy-Zndam? Canmoar)uebdawy=3rdarch Pmuwl~ca~fM&=3rd

mil

to the live? bec&itt(e hepatocardiac

VoWh h IN* to the ,
BRIDGE TO

AEIATOMY

daftk.rmbry(2uld . W & W

atwolmm~hmei$m &bk'blrmdfr&~Idfth

NBDE 1 : AN~TOMIC SCIENCES

n'g aorta toweid the bra

~~PRPUrcmtb.rkMliBb*Wb *onthaw.Thca.wllMLt*waf de wall b sunilar to thst~f Wt tf* 4. @sad m tha a travals to the placenta "la t2 t!n3t#. h w~anwi~i~frmtly?lntgrmli/&argrief
I
at c ~ a t l aof pd n . bid flow dY , ! n *l In6aPrkrfkrhmueethr~ to~y~,~ktha~Rth+Isft: ,Mapaed ts tho ueslrnw41wrt-W f

~hh*ion~inrhaut.wyeeryeer

C, P M n t ducIus 8mriorur b a fallun of anatomlc obl~twat~o oxygenated bawd from the aorta la be Ifumted back 4 m r yW V .

septum m n d u m E Ynbl* rpUl am m lydue t mslfo af o mombranous l ~ t r 1 c u I 6 r ~ m .

-

F Rnht.nttntaM artwhmm k a f a l l w of patrmoningof cur art^^^ t h ~ a o n a p & n w a i y a ~ . and

H W

c wWtMb k a nYmwing of the aorta jun above or

ductur artertoru%

>

*

I Valdinnbnrlflow h maintsbKdfrom the. . a Right aMum to thanghtmontodc (Mwp(dvaln) b Rlghtvatrtle to the p r l n w ~ ~ t y ~YI m ~ 1 ~ r Left atrium to the kk vcntrkk [rnltraImINlpIdvah,

d. l&va;bIdttototha aorta fw&milunar inw)
of llbma conW e (chordu rardtnsae) and of blmd [nto Un atrla during nmnrvlar omtraction (r

<

-

ARTERIES
nndiisfft l p r M W W M .

t. ~ b D a P t l ~ i s ~ o t ~ conneaiw tissue layer. An internal dastic msmbl Lmundary b s m the intima and media.

o

m

~

d

l

k utmg t h ~ k hnyt lrrtuiggld In

of

*Ysml&tMMafuauefli.
&ion oi <ori+e al.pr +&en w a?€& p s@@ fdKohave thstr own blood W y >Opyr vlro Ilvenak that brar&pmfu+ m ths walk

rcnalkiq@br b d p d

Wd I times where rap16 ~Mtame n hitsfchange omwr ( e r i a , ndaaaa plamk).

les (up t e pm), anihit i&ubr h-rn o no lt . a c a

pmflk,

Nwr patht ard often lack a C a M n u haul lamlm. Ce ~

mc XtTVftj (mwopages) are present mthln, M Junsu i
cndoiheIIw#,

Mdatkdlal celh to contra* and w#ame fmm C.ch naked kment mnbrans Wwtr+iH Nel; to the and u t r u v m (1.e.. rnow out Into W connectbe

mMhsn:r m hast and smlllng. e d
oped Intima, a rnedla cmldng of connectwe ttau n l d lmwm murcle, and an adventitla (uruafhl the Paad of m l l m bundkr, e W fibers aml nnomh . d r h ihe hgtludhlr*ir of $he ve&L Vena. v a l v ~ a r r outloldiw of andothallurn and underlgingrrnmCtivetlsud flaw to prmlt undlrectlonalflow of blwd
C WIIaV.LILwchl)ltheuctnnal ilk. hepatlcwml.&un

tbe~Qr~lbofmuRntauaolth.~RThelnthoh

CL
um wins Although a nehvork of elastic fiben may o ~ u a r ( YY between the lnttma and mrd~a,a typical I m e m l eladc b seen in arterler 6 not Present A tunlca mcdla may w ~y
tfnt If Present Smooth muscle cells are most often arcularly 1*adventitla Is the thickest layer of the wall and -c of IDngnudInal bundles of collagen In the vena m a , this

LAR

ar&ctampMlde n a a&m4atM!ng ~ ~ n g a ~ o m d u e man m m u l a m of e m x Rudrn thepengriiiicavify The fknl ~nar&rwrovedbyww&cm%% mrdLeYPfhe~

f

Middle m@d*rtlnum. This section contains the parlcardium, m nemh and l p r t C
1 Perlurdlum Is the outer fibrous sag ~t a double-laye IS

mnnbnne that enclow the pwlurdlal cavlty beween m and vixsrnl layers a. W m s w n c pelXndIal dnw k s space paste* to th aorta and pulmonqry trunk and anterior to the w
(BM

b Oblique pakudhlsinm is a bl~ml, hrtal. U shaped tlrior to the heart and bounded by nflec*on of serous um around the rix velw enteringIhe h e m
2

Pbnnknmr a. Phcenic nerves a r b from the ventral primary ram! d name5 3.4 and 5. b. They are thesole mr supply of the diaphra$m and w o toty informton from the nm*~ pmrm si both the
and inferior portionsof Umdlaphragm c. Both phrmk n e w p a n through the supelor mediutim alto fibrous pHlcardfumand anteriortothe root of the l

3

Th.M(dbcurtcd separately below)

&mdor~.ThkMlDnwrmlmfatandanoluulsue

abWa rruhn wnour blood from fh. ntinbdv pnh the L d b M b"hm-wm.

NBOE 1 : A N A ~ M ~ ~ ~ W E N C E S

t

BRANCHES OF THE ABDOMINAL AORTA AND VENA CAVA
A Tho abdominal .om first passer through the aortk

<

dlaphragrnrt vertebral &el Ti2 (Ftgun 24-71 It ends s fwm the palred cornman lVpc arteriar and single smell arW.The bran& ofthe heoftainclude~e follavrng

Figure 24-7 BraMhmg of the aMomiMI ewfa M f n d wih f hvnil\gurA Gonf'r A t l B r o f ~ ~ ~ m f i wilbamdv 9med Ealbrmre+MQ l a p 78,)
1 mmevholnlunpahw~

a Caliactnark b. Suwriw mamPap$artuv c. Inferior-nraricrrtay

>

T h r u p p g U f n ! m e r c o ~ e R I ~ ~ s r (W I l It dmim4ha tmsterior intercoMld n r of the th& ponniorakcbnbl wail. valns lie %qrfkbI to thc c0,rrespmJing nnslblower&uursnlnuacriarth.?ambh~~ t mmttm infaw ornM w a . o

2. The&

4 . '

Wtatul* d W M W y u me infedor f fofhcl6ftr'&lUr(nJ 5. 7lmIUklurnbq drahthep04~oriibdominal wall.

6. T h i ~ r ~ W n s d r N , ~ d i a p h ~ p m .
7 kh.~icVd~0panlntpihe~@Or~a~~y1]~ avwpAthedmhragm.nKyrrclhrbpdfmmOhe n m k Ekcuiafon

a x e d m the ~(dtcrior mclbah,bwadm i ~ ~ ~ ~ t h . ~ o r w m - e n t e ; r

1.

v& drainstbe leh Iofwbr veiw. lt joins th.aW$w MII.

2. t

h

i

w uh rw@ms bldtd from tha h ~

bltllfDlPlvai&f*K1mmm.n&bthCwr~in.

&$ba Irrpaql rpWnlhrmof the farm&*,

bf~nch~.

I

NBDE
2. The bmndll divkle@yYm
1dlhWWs aftarMrthto+Wm3. ~lrtolsxps&onr tarmlnal brwKhiolerfom a m . of

-

pat*~ ~ p ~ ~ t SukM* that n. a W & r t b vilq%llltlsn. surfactant overromr

eluedidtlwspnvmathabcdrsWrwhcnthe

n nptrudby alr.

% Irrynx, trachea, bronchl, bwnthr~le$that carrier the
b r i n g uup(ratw and e x v i n a ~ a mp!mtw

item Is divided Into a conducting p o d lnrMl cavity.

wrtm

I

ghmdr that extsMI IMQthe underlyiq connective t l w e the fUR barrier to forsqn prUrb entering the r ~ r p l r o
themtlbular epithdltanbm a pmdsUtdCIfled, diu* t n

umMr M &S mlk h

~~W I w n ) .

rw s the majmpbrtlon oT the nag1 cavity
mmporaddi~dy.*d.mkumrqlthd*lm

theg!an& is carried toward

rlI

NBDE 1: ANATOMIC SCIENCES
3 The lateral wall of each nasal canty contalns thne bany the mndue, whlch Increase the surface ares and promots

of the tnrpired air This reglon s rlchly varmlar~zed In and
C Olfactory M. s located rvpar~orly and patntorly In wch

The -for ek in the olfacfwvmm l way are the oIfactoryep,theI#al &Is thwhes T k basal d b are sfem cellr

Cavltles
1

The puudortfatiflnl epithellurn Is composed of btpola
foliacmry cells), supportmg celb brush cells, and basal nuptor p d o n s of the btpobr wumm are modtfled den long, nonmotnecilia:

2 Under the epithelium. Bowman's glands produce snow flu d~solvor odorous rubstancs D Psnnu.l

slnu4es are cavitles In the fmMII, mallky, eth r p h o l d WMI that cmmvnlcats wrth the nasal cavkh.
1 The reTdratw epithelium Is s~nllar that of W nas8t to m

maplnhlt d Isthinner
2

Nunwwn gob!& cells produce mucus, whlm dralnr to the a#es fwiglahdrarefound In thethtn h i m p o p r i a

A. N a o p h u r u Is the first pan of the pharynx. 1 tt Is llnd 4 a psaudortrmlfiHL LH1.W. wlummr goblet d k .

2 underdie ephhellum, a glsnbcomamlng m m & dlrdctiyonthe pariastetdmof the bone

tw l

3 The 611s beat towards the oropharynx, whlch Is compsed of fled, quamow. nonkerahnlzedepithd~um
Narr
I

4. ?k phwngedtonsil, an aggregate of Aodular and 6 K thrul !a lootsd an the porntior wall of the

7 o1,aateo d b ' oka bear a n d p o M k me m v c f l m g md w 1 6 - m aawayr ~
bv o m l n m m mrhler and ~ c r e W

un to the ep~thel~um. r Hypenrophy of thktl ~cinflammation rasula m a condrtion k n e w

B L y n x IS a passageway Wmt connects the pha contains the volahx. la walls are mmposed o
byfibrab*mnne€twetNYh
1 The mucous fayn of the larynx forms two pain of

ekrtk t that extend Into the lumn The upmr patr are called the folds (or false vocal cords), and the lower par constdm 1 wrds.

2 The epeplthel~um the ventral stde of the eplplCttls and of of cords s composed of stratd~ed, squamour, nonkrrattnued

a y l plemoi prpMdn iwq 3Wnl aqi

m x u L q aqi

wnloa ww~opno4d ~~~n

w pawl 51W e [

NBDE 1: A N A ~ SCIENCE! R

r

clkreasna 8. w&&Mdo
not y- a Ir glan s~ Rt p

thatpdak$pmnn the m & r

srmp

t p @mhiolar ep~thdi yw
ssgm?p +win wtpauch typ0rtlpnofthhWem.
1 Tormiwl konchmlngive riw to raplntoybronchloler .

brmes)$dm b w l IMlna, th; ~ o l l ~ i a n d a R i u w-9, The?& thrckw.s of

w

plthdMm containstwo cell ty@es t calk complrtclycover the alwdar l u m i ~wrhce and pml r thin surface for gas exchange. This rlmple rquarnour h so thln (-25 nm) that & detalk are beyond the rareare rounded plump, WMldaFIke cells thet sk on t M lamtna of the eplthellurn and contain mernbrane-bound Lipid and protein (lamellar bodies). The corr r badin a n 9eueMd onto the alvsolar wrmng bf surfactantthat r e d m alvsolar sur-

ram-

(dust cell9 are found on the surface of the

m monaytm that &m&sate from a W l a r captllar-

~ a e D a 2 a f t h e ~ o n u c l N T ~
s astheir name tmpl~er,cMlUnuMnly remove pamclesand ,

h a thm mmur mernbtaae thet c m the outer rurA delicate connectivetisue layer of collagen and

pleural membranes. it zontalnr no On*hdW*.kkg., In plwF.r we6m in the p t M l l w e ) . Ifthe chsrt alr me$ enW .the pWml s w a fpneumothorax). ,Wd allowlngthe lung to r e d l

B bmnvnbn .
1 Somatic innmth. uener.8 - s o l

rnformatton f r m wall md rapturn of the nasal ovhy 1 conveyed tothe CNS s er ofVl andV2

2. *vmnnnic inMmlion. Weganglionic Panrympathetfc

-by molar tscm pmn& wa9 krm tkm~rinur~emrrethaeteetn
d n d t h e ~ ~ a m ~

tined to Npptytha gtandsotthe ~ r a l mucma and travel In the r*rvur l n m m r d ~ u the grea md branch= o the facial nerve (CN Vii). These f ptetygopalatlne ganglion. whrch is located 1 f w a W n g H O ( I I c films trsvcltnq t o the nasal cavlty, paronawl air nnuur. hard and soft p

antnlotly m ltr upper reglons, commun th8eial The anWw wall of the larynx fhe pharyngeal wall ronrrrtr of

ww.

~XulWreylrOr, u m mi&, r
0.

l @ m ~ ~ @ , Wate~hayngBuLWngaPMhOe
hlfetlwmnrtrlitu

&Wav

is the rWbn Of lhs phaWW lqC& We nzsfl cavity, I t cqmmrrnlsags with the nasal W ~e. C (4. aosteriu dlTPlapertuw1.

.

~.-?hoh.Dllllah*brr bthecartika@nowrhnotthawdlMy

underlying rapngophameus muscle. whKh npu

Urrphwnrtromttmr0~tubsrlu.
C MOphuyuis tha reg30n

'oral caulty i communka the hua.The faa 'ddmulcle, M M t W
1 Tha

rnMbr pillar of tha fauces, also known as the pa f a~iwtha@ampI~mulcI%
gee1fold, mnLainr fh.pllltophatyngnn muscle

2. ThepDIterkrplLrofthefwer.ako k n a w n a t l h $ a 3 The mnular b.d ir the SPM. &tween the plllarr th

PJ.tlnm W . I

I

Norr

RESPIRATOR
Flrsnemcx ro E M ~ R Y O L O G Y

ry artnicr aria from the pulmanantwnk
deliver deoxygenatad blood to the lungs

ade of the h w ,
h m s supply fhe bronchi and nonrr&ratay portiom of i r i e are usually b r of tha mwxk aora
puhMnyr d m : nq*rior rigM and Wt a d lnfrnor left Futmcnary velns cany oxyae~tal blood to the left

Runmngbenveen the khpulmonary ~andtheaorersafibrwsmrd cm te igamnturn anenosum It a a a ? mnanr of& fetal ~ U C M m u s m whrdrp~ashuntforbkdfrom the &t mt& of the f u heart@ e bypan the lungr

from there. dramage n to

ph i u k drbh to the rlgM lyrnphatlcdrrct rn

h sa bmnd\amnrKlirr etlect. a

NBDE 1: ANAT~MIC
A. The wu&l

end of the neural tube develops into the spin

29-1). 1 B.ulplats, which are l m t e d ventrally (anteriorly), d metor (efferen6 pan oftWsplnaI drd and brain ste the motor cells 2. Mar plates, which are located dorsally (portcnorhl). d e w l o p a senso!y (afferent) part of the spinal mrd and brain stem. 3 The sulcus lirniwns IS a groove that separates the alar .n pbtesand extends from the spinal cord rnto the brain stem.

4

Fgure 29.7 The spmalmrd!n earlydevelopmmt

*-

8. Ttmratnl and of the newel tubedmtopl tnto-thebraln.Eartyler

u m the bi.m s diaW.into three primary wskk %ha p a 1)161 pph.lon. the nuraaphllon.8nd the pnaaophblm

-3

2 Themnsorn-n .

k tha mdbrbn.

3. The pmrenrephalon, or forebra~n,d~fferentiatw form thsto cephalon and the telencephalon (Figure 29-2)

NEURAL 1 w . - &w

,

>
n-*,*<
i

-

.

of cranisl M ~ V WL I and x , X

Priphsal Mwauelynern

NBDE 1 : ANATOMIC SCIEWCI
6

b h I noi contain Nlrrl substance

W be UMnyeliMad or InyeliMnl depending upon the type l ~ ~ r o v l d e dtheir ruwortmno cells bv

n cell may ensheath several axmr

membrane ortgtn.

tt

is nch in phoapha

haw on0 a m and mo,dnndrlie+end probably durrng dwebpmmt

h.uF one uon and mugide d e n d m M neum in the body are muitlpoi~ kg.. ventral horn neurons in the

A W i y l 8 are m s d c e l l ~ o n s -we d vow ryrcern They are amprulstqd by

slim in the cmiral nmow

k e ~ r t a ~ W O m e c

also occur.

B Synaptic v w i k .ran 3-s 05 whencal or owdd m u r e t that tamaln neutotlanmmn te g ~ 1 h m ; ~ Z h N . . , i IS released Into the wnsptc deft at t & iyhspu wMn y f-wh s)praynaptkrnemb.
f. fkuroirarnmitten may elthbr ex& (depolaifre) or Inh&R CrlzeY s)twskymptk membrine, &emding on the fyp. - tor* whichit binus.

~

.

2 Certain neurBtrahynitterr are IMRlvatid In the ryn.pftt
chollncnerase, AChB whlle othen +i%y tht ei b s - 9 ~ # rmrop1nephrine>ina p m s a u l l e d m e ~ ~ ~ .

mwhnpsnsnt In Fanno!hq the mkrwwironnum of

IN A N U T S H E L L
~ s o f m u ~

6.

-

1. Thdr nuclei a n emall and their ymptarm cantalr. a

5

'

. .

them5

spmdpnddIrG"eneuwmMer khvann Eem myehnan axom rn

mae~hesonar
te hm

- .rn$Y%*+Il7 \t..
. =

pr , ad

-

NBCM 1: ANATOMIC SCIENCES
IN A NUTSHE11

Rods mntam rhoc'qm adare Iqht senvtm mr cmram iodomn andare e respons~ble mkr vtoon for

a. The p f P n n t d aplth.llum h r o m p d of m h r w M l n melmin. b. W adornm.are ~elb vdth twepoln. One pole CON

m p c a w i ! h the&

In*

b i i r IWr.

w*Cm,~the~ibeifMme.

by WRacrrurw(nmdy~itiurz0Ilght~are when low I%%& anprarant of Uaht

!!

udrimbahrod.ndane~lkik. d. Thsn W layer is f o r d by the e The autu pkvifonn b ~h r compwd
s .

-

i*.

.

f. Tha l n n r n u

IayuconWns thp nuclei

n b u w a w U u h6lbnt.l cell%amdm e

*
#Or€

mebwaaa~Inmdmk4 msrwmvi-3 thsarea otgreatm
~la-uny
rpptafihe-

tbe mtlna from the v

WM y .

1

I

%

-

r

i

w

~

wavb4tem the e d

IN A N U r s n ~ ~ l
w

'MWk ear+

.

~ W + w ~ ~ ~ m n

mr t bone CMducmn a ~ m r + ~ l o m e m

b k Iimd

h s k m b u . M,

and coiled

-w=kawww4niL

u)---stua

rplth s e k e w s 9hn&

produce e -

hny

olkrl urtlmn (esr

I. ~ d u x middlsw

-

l

a

n

l

~

u

~

f

w

~

i

n

a

~

*

;
. i

.IkmmbnrmusWnfimv)m ~ , ~ h W . W K + ' brupoahralusournuid mekhfpnfh mWnapenhh,

-.9abmomAltpkaapkaa

2.7h.--Ps-*thrnmroundedbg m h p.

,

a. ltha,lhnrp*rrr (0 The cochlear 4uCt kcal.1. rnsdim), whl& are wWl~ntha mehtrr, (2) T h e a c r u l e a n d ~ l H t H h a a K 3 m h ~ v a M u

Wlhe~sarldffu).(rdycawhKhamwithin'tfvt d r W awls

P

NBC
B R I O G ~PnvrroLoGr TO
fha rewtor cdk m tlre mtae amw,lBm of tlre m m l a r canals ds ~as~melnfhemacuheoffheLrmde a n d w l e are m u ! & fafhe m a r n t w ~ ~ e bodys balancn and of
\

I

111T r gkhelium pfaduesr the g h l to6W brmr 12) Thstscturrialm e m b r a m ~ t b hair ah1 of i m m s r y hair n d fhrn RIWI o f c b. mew

B

~

XaY M t W .

8. WsuW w small dlfWrhla~( a g W ! the wall 6f i k n r n
a . . -a"
.-A-

eau,kbnum

ur .m , z.

a. tha maculae contain nel of the vestibular nervb.

usr Knowl.dge of these rubdiv~sronr important is
the basic wganizatton and fvnmons of the ner-

us ryncrn W ) consim of all ganglla. rranlal S I rimer and all of thew bnmhsr

d M 6 h leaves the CNS through cranial nerves through the sacral r e g w (324)of the spinal r ako called tha arnkatnl s m -t S ofparrymmnmMlon of the puptk, decnaed heart !nc& perlstalra and nrlsxatronof the neral, actlorn of the parasympsmeficner-

the thorark and b m a h called the mol, ractllity, bmnchodilb

t d prwbxtion and fmm $m sdtenal medulla.

rtu @nrrovr comW of neural nructum tht mu& & r i d horn mbry~lopk romkn. that Ir, molw n

-

of eplnephrlne and no

(gaition =me)an also mmryed to the CNS *a Ulc vow sp@rnTheromatic n r 0 1 rF.m IS part of dm W .y~ S
IWX)

ard arschno~d are

IN

A

NUTSHELL

I

~nlcmcid~hslldm ndsmc~1lular wtof the brain K+

@a

866

KAPLAN ME?

IN A

NUTSHELL

' i

> ,

Muscle rprndksrrswoo'M the hgth fandrateofdulngein kngthlofslrektal m d e fiberr G tendon +s w raspMdmmsnn6deLwaiM

1. M W e ruindla mrlrtof about 10 mdlfled skeletal

lntrafwd fiberr) wRhm a mtndle-shapd comuMive t a Both and% of the intrafwal flber an cvmaaed

ofspindles than thow road qt maw r n c, TtM mll6tle splpdlaC@w c-mmy(~9an
d Gemma m

r neurons of the vmtral

clh%i#dl as either nuder bag w nuclear 7 n W by grimsty a nh . W m Iannutwl ecrbUy M w W r l w v c r w w m).

found nearthejuncHan of m d e a d n-

they rnontfar muxta atnlon.

I N A NUTSHELL

aIph8 &of neurom) or daMl roots (mntainlng affe d R )abol~has d r m& tom h a l e fane k nct an &Weletel muale.

MurckLonekdcpendemuponboM

lk&i4 d the put&of
Mta alpha m o m neur

I. Muscle rp(ndksm tof aboui 10 nmbf~ed i s rkalnal m intrafuialRben) wkhin a opmndie&a@ ronMctlvetkw a. Rat4 ends of the antrahrsal ftbar ap c o r n e d in the exmfural fibers, w, these rwptorr monltor th rate ofchapge In Isngthofemafvwlfiberr
of sp~nalnthan h w und in coarse move t

r The hermule splndte isthe sw organfor ew

a

Gamma motor neurons of the uentrai he lc+d at each p l e of the muscleIpindln

found near tin ~unctlon muscle and t m h of a. Becam G T O ~ rn m n n m in dric; with

the

b.

thy monltorrnunk bmton YVhen a muxte ixstmchedpessive1y.them i s an ~ncrarce a e up m the point a t which the tendon w w l i o t e mtaponim and InhlPR rgMln rebase of rerbiame, 9M the foilowlw lesions ofthe u p p s moto

8. Mux4~tOne Palpationof a ncfmairestingmuscle apna t mrnch6-d normally reveals s m m degrOa of m m M w 5 . ref?'S to the tendon p r e ~ qin mtlng m w l q Is Iaqely under t mntd A b nof ekher the ventral matr (contalnl ! n alpha m a r neurons) or d m 1 r w b (condning affe $fhn?Jfcr) aWkhes m e bnb. Mud&tom h not an ofsketetai muale

.

1 The gamma m m r .

neurons tnfluance the dnrltivlty of rpindkr and thlh p&y a rols In muscle ton ZrPmulf&h of ganimd m o h f h t b n i o n In u r 1& at the pale of e h rnurde sphrille m a V& alpha motor rreumra, causingan M a r e I
by ce&m

2. Mwde tone a d rrRm MMty sho a n Infln

SPINAL CORDREGULATIONOF
m e e evalwtsd cllntcally by palpation and parslve move lnlonr and dseaser c a w a decreaseof tone (hypotoen cause an mreare m tom (hypenonial

SKELETALI V I U ~ L L L .

-

fLfXES

B
t

mrdratar a variety of somatic and vkceral raRsxrr Iomatlc Ilrelatlll mu& act,*, whlte vimral nflsxer m d W unooth c muul6, snd gundular secretions. The slmplm d e x k the W M*x.&Id3 tnvolvarW nrurom and one rynepuIn the h c n stem) Most &kw, haw-, are more UII(IPIL.X 111)(( more mtdmeurons IocAtedbetwaa d~ and W w

-

tb stretch of i & i the conmNon d*Ngdr (n d s katafknff.rhatacursmdlwiWl~ fwnoaktkPsnHlOCkton6 ltmlmm-b~k

fmesmi&renrrr.

Ihs flaxion wlthdtewal and

ad by 8 PrXHl stepR1ng M 8

mic

wuusS~em

der those porhonr of th
m that innervate urooth m u K k cardlac

ANS and the endocrme W e m not only ma~ntains the internalenvironmpm dunng qubet moments but
the heightened atate of read%that xcwnpanler

ency ntunions Both rymm exert effects that are predomi-

n to the innervation of &elafal muvle by a Stngle axon from a 1 lhe fiM neuron, the pregsngllonlc neuron, h ! w e d o the n or rpinal cord. The lightly myelmated prcgangl~on~c fiber that this cell pams through elther a cranial or ynnal n ta reach an

Nursh'Ell
rheANShartwo-a~ W ~ h e C M L D ~

- %q
THEAUTONOMIC NERVOUI 5%

avWwm~aRPMadb4tdmm
in~RThepamtds~~~redYOVLX

end relat~vciy long (compared
m) and nsd, mtir rerpcth'e

rawrtnbral panglla, flbanthat psto the s l l d rnrua thmuph gray ram1cbmmunicantmanre pnn M ~ U N ~ ~ a n t r b o d v ~ w B h ' fljV a m * a w ti -r p8iWorrl blood wnwls P) P~lomotMftbas-rarrgaorpllirnuRlas the hair follicle& af

' m O

blkdoma~tirurn-rlunatgIaMk

W m m ' a f e W a t 7 ? 4 2 Gwram LRwMIXa//kv!sdksympa~4c CMm

b clic . sda(f) War fiCR tmm the ParsvarWual ganglia

mperio~, mWh, and I n f e r ceNie# with the fin? thoracic gangllon to farm

)W(@ m

#a&

e of du upper eydld, fho lurid tk W vglalr, s w a t BfanriS and Um

mladcl&atVleM

W Fiburtotkup(urSJl~naMn #hkan-t plslothaprdlxpLaxus b. M k l d k ~ ~ l 9lva rIyBo: l m (1) R b t tlu fifth and mthrarrksl n u ~ s s (2) Newesthiparr to thecardIacplexw r Inf.riorMq.nglia@ive rbew (tf Fiban to rplnal n w C7,C8. and T1 e flerw~ that w t o t k cardiacptrmr

Rf

vertebral ganglia b., W rumnor maenwu. c

mmus~(PNS)FONiRsofallneuralmuQures In and e e corcl.fWw, tho PNSts c o n w d of 31 l t n

Ths~plaal e w s hqw 0 a e n t q l orpanMbn n m the presence o t d e r m a t a n ~ ~ sp.clfic raglans snd

g

Innewahon dnd C ~ndirpmabba the dlagnms end in

w

y ~ r o ~ ~ d ! $ o r d e ~ ~ ) r @wla a t t ~ ~um

q@aim W w of ravp tha viwMm1 d through l es are often called mixed nerves
ion. whl*

aFkr&is and dfenmflbeo. lh&e ndhr8) #lv~de

skm and rrmrla of tho Wk, m -

ATOMIC
I

gangha
1 Whla rand communkanm contam flbar, twlng tho v w a i branch of postganglionic celk m the paravsrte

.

-

The white ram, also contain general

pathetk (WE) fiben, which supply Mood vauek r arreaor pill murrle. They wlginate in pilrDYFRebn throughthe gray ramisto jotn the spinal m.
D A meningeal branch re-enters the vertebral canal to
I

6. Autonomk gsnph (sympnhdlrf

1. Pamwebral WOW&.

Each s m l n e w k connected to a

2. P m w M l m o a . Co par through the white

axlal skeleton P a i d somites are wppl Spinal ncrva. The doMt rdmi of the sp dWMt m n t s of ths ne& and back. In in the cemlcai. lumbar, and raaal Rgionr join to

-

KAW

CLINICAL CORRELATE

HemarawiwWanlkr)aa~~~sthat OffwinfsnrdaMlmsand thewgap #in Ouimg ffw acavephda ~f~nkcwn, theVksrmgraaerpwi&r&~nm,
resAuqinpaa,&a
vcslcuhr wplkxr

mthelrmBotlMofomormwo

dwmaomer

MNEMONIC

C , CzWhepyouauvc(becarre *-the,&F&Wd

G

1 ~wr)u(Eftlu~lai~ind&the: . a Dar*lswwkoar. whxh mscsfmm C5 and su . b o l d N IeVdtorrcapuIwm & b. l tb(rrric'MM.which arises fmm c5-0 and r q RtUIantenw muscle.
2. B W at the trunh n m

(oniy thn upper trunk snra of$ indwlcthr a. S#pawxMm m (CS and C6), whuh w p p l h tlWt
.turandMtrpfnatur m u v h .

b SubdMW rsm (C5 a r whkh 3 U the . ni m we r
&

LMvd putowl n.R@fC5-C7), whkh wpplies th

I N A NUTSHELL
M

maldmda
b. WtebWtaMoUs MN* (C5-G). whlch suppllor bqchislk, a d coracObraclUalkmudrr. 8s b a , r&
WMIMmr.

n e m (CK7)
@ mpemamlaterel

& m M e a m r h s n d ~
smiy-ban

farwm

c ~ r o d d * R d l W ~ , w h l c h ' i n ~
madial ran. supprier all ths muscles d the ra foraarm emRt the carpl ulnarls and the flexor d fundi5. R akc uraplksthe flntand w d lurnbrioll
-4 B n N h a Q t h r ~ m r d ~ n c l ~ d t t h ~ a. WIQ.I &orel M (3and TI), which supplM the M '

b .

m%jw minor m u v l n and MadUI I a J h W e ~ cutaneous n w M I 01). which are joi l bktmc4 branchf m m n mey supply the cbn of
tksskln ofthe mMal T o m .

IN A NUTSHELL

6 .

.

UIIIKWW~,~L' bWmr U l n a r h

'

Ulnrr n m r (from C8 and T l u W s and tht ulnu portion o the forearm. in ths hand the wlfias the 6+ep head of the fl

mdardm duoFi
Hvpothenarmuscrer
In

m d e * the dbmirmd palmar I n W m i , a
tln 4fIh dthe Jnar haif dthewrlh pelm,and
5. Mlpr ncnesotthe per llmb Include: , Ttm . & U I&!(15 ) n d W, which arises f m the r

Lumb5ds4andS
SMloy: Ulnarhenofwmf

m

4th and 5th d m

cord. (1) Motor LWly lsmthe dekoid and Daermtnor m 12) 2wwnYsVpply r mth&rCinbfthe l a t e r a w a Nuneollr nwre). b nerua (CS-CB), W c a r b s from the pDItcr~orm hb

OtOr supply a to the triceps, brachforadialls, supmatot, abductor pollac~r longur. and the extenor m w b of the mM
kW supply a to the skrn of the portenor arm Lpnnrior t y btKhlal cutanem nerve), p t e r b r forearm @atenor ant*

bnchi.1 cutaneow new). and the rad~al hall of the dorrum ofthe hand down to the dktal Interphqhngaaljoint (sup&,1). M i IS fommd by the union of th. medt-

to the pmnator t e r q palmans longla flexor rsrpi radlalls k o r dtgttorum suprRaali%r&inl half of fkxQ dlsitonnn pmfundug pmnator qludrrt(y a W w pollnctr I brarls fkmpollkh longr~sad kcvl5 opponm. p011w end &two ndlal lu7lblkaInumb. SIMMy supply k to the I W of the ndlal two-thlr& of the ~ wim and wbr surfaces of the thumb, b d ~ and middle flnx m a n d t h e radial tislf ofth.rhgfinger.
is formed by the ventral miof the upper four lum-

w t i t h e w meor mqsk ihn
a formed by the ventlbtrml Of the fourth and fifth umbosacraltrunk) and the flrst four sacral nerves.

I l a . l p ~ w p a r v h c h ~ ~ & O f t h e ~

h kg. and twt Ckherbmnihn supply the WMCm l a -

~

*'

%

6 General v l m r s l efferent (GVEI fibenare the pregangi~ lc fibers that supply smooth muwle, cardlac muscle, an ff~nlalnerves Ill,Vll, I X and X carry GVE fibers There @nfc parasympathetic fiben

WEwmld~iaIW fibs&<r s

7 Specie1 vbwral efferent(SVE) flbenarry motor outpr tal muwla dsrwd from the branchla1artha a The trlgwtlnal nerve carrier SVE ftben t o the m from the fint braxh~al arch (I e . murcfer of mane $ b e ~ yof the d i i s t r r s mybhyoid) Thew S E fibers V ' r tmotw t r i g m i n d n d w . La, The factat "ewe carrier SVEfibers to the muwler de second brar~hlal arch (I e , muuler of faoal exprer belty of the dlgastrls styIohyoM) There SVE flben * + fwlatn"tkur. gl~nopharyngeal and vagur newever carry SVI mvwier derived from the fMrd an&&#rtll libRLW j * m w b s of the kynx and p F a i d m a h fib

-

,

' :g;~~he ;
X

d fheqWaccmoljrne~e
shauMcdan4tke ne&

OLFACTORY NERVE (CN f)

.

1

I*

_

-

*J&P

4 W o l h c t a y (Jh am spooallzedm u m that f u n t i c

m cU O b ~ f k t v r P ~ ~ ms s 1. one axan wen& peripherally m the a t f m a p r p ~
W FW?&*C
~vipkrrPld~~~Mnq%& IfiY
thin dfaaoty ht i&

-%el paroddoun aq) $v UnraJ e n ) hlle,aiel aAa aqa lo uo!ae!w u! q n w q>!q~ ~ '(anb!!qo lo!ls)u! ' m m ~o!dyu! 3"-A ,o!,adns 'ma

4

.pln~s~, lea~q~o ~o!lodnr q6no1 eqi aqa flaaua a ~ a u p>!qi a q 'au!!p!w aql leau u!e~qp!w aqa 40 ~ ~e'auan aqi aneal pue mapnu pa, aqa u6no~qa Aj,o!~aiue rred

'(s!ro!w) uo!u!Jrum hellldnd aae!paw

AqIeau uo 6u!m>o& raaeqlpe, q * q ~ 'rual aqalo 6u!uqqqa

I O U U ! ~ ~ he!l!dnd ~

aqa pua a p n u hell!, aqa 0%rred us

-IP aqa u! s~!a> aleu~wlaa ! q ~ ' o q g uo v 3/r9ol as!, a -nau J!MqaedwLe~ednuo!l6ueBud ru!e?um a .ma1 ( s P ! I ~ ~ aelq WI)

:*y b=$qu

'Z'

i,P

.. z

:aqa apnpu! pa!lddm r a p m u a q l '(auau ruam hq PaeNauu! r! q21q~) w d leJaael aq? pue (aNau lealq m papNauu! r! q>!qm) rnhlqo >a!dadnraq) adaxe r a p n u aqa l o 18 hddns q y m ' w ! i 3 5 3 03 as!, S A ! ~ ' ! a ~ n u 1 a 1 aqa 40 leJaael p o w aqa r! mapnu pal!ed r!qL .melmu
.u!edqp!w laddn aqap

b E f ( m t s Thlr mot01 nuclwagnrerrw to WE flbm, the d b u l a r (new) branch to w m the: p

w.1ptsnrroMmwtor) Q~rtvmwni

B MYb(Ohy0id l
(4) W r i o r telly ~f t h e d l p w ~ c NHdr (5) T ~ veil palatant M 2.

Main Pgaryaulu is iaatedlvrt h a l to tho mow nucleus a r mrUa1 contlnuatlon of the 191nai nuJ.wI gf
nal nerue. a AfhrUU* The main enroly nucleus receiver the from cells in the trigeminal ganglton, which conmy pressurerensatlonfrom the face b. Effurno Axona f r m cells in the maw sensor/ nuxleur wend in the vent1111(anterior) trigeminothabmku & nata in the WM

NOTE

.

ANsemorymhtmn fmm the face-twM ANsenrruylm&m*Mma w t o f t h e W - t VPL

3. Splnd WbmLul ndun k a caudal contmuatihnofthe mr

. .

di!

frpm the midponrtoUlecaN&lmn1

hk!"senrorymdpur~fV* d m a * rar)lof face ~l~~~~ teznW&0fface nudeus of V - t

b UbnQ m

Pmpocep~offace

s fmn cell5 of the spinal mgtmlml a d acead m the vm W i ~ ~ i a tndk a l m to thr WM

4 M ~ R r n ~ h l O c a t e d d ~ t h e M a a l ~

t d gray m the uppa porn and m&ntn. mh is the only the CNS that receive proprioceWM. inpurr fmm mwle @n funrtlon ls fuMlled by the domi rdot M a o n 4 k forhe
The mcrencephairn& ofCN V e the on@ example in Mtch the pmmw s e w cellhmler mide w t h r t e CNS h
e*VMImm.

a. Affmna a y p r o p r w p i i n Input from 101mr W d n n eatiwl emaocuiar muwies, tmh, an$ peridontiym b Etknna pa5 to the motor fiwlaus of the trlganmnal and nial nerve nude1suppiyIngthg e x t r w ~ l emutes.m e r fiberr synapse monmynaptcalfyon the motor neurons the anatomiclybsvrnefci myotadcreflew such a the j c. Mwmlnsl (remllunar, gnu&) gawlihn contains the lrrfor . ( Meamofthe Wiganllul nnw eupc fm 1 gangllon is located In the mlddle ccbnll fr*u lrsu the

LIIsinus, t m l nares, and avvty through the wparior
% oflen -nr

wtth the her-

ofthelovMrtlvodlvl~Hra~

the tr!ge&mi nsne. the nuuiC ly affected by tic dbuiaureua

or and ~nuwy. exits the mil. It

.me

'aMxnmhwdum of f skull k Mdnd~ulw brMch M)p e s

throvehmefo-amoovaccormerwr

fMed'~nnksilyby stww,

mdude W a r &.aa, Radrlpk
M, m m t l r u -0
IC

Il um

d o u w and h

m mster

Ran klam 6f the mgamkral new fnd& I of C S W1 %w r 96 , haa $W m l , and pain hanW f.a

b. SUbnandlWr gMglion. fmsQangIIw11c par fmm thlr sangIIon a n ~ w ~ t w y a(4rwm to ag bg l n@nw l saIwary$adr
3. GurUtg)r aYd.Uh The m a l pMiDn of the n u l w of*

the yagur n mhom Uw epigWf(these taste W a r e m e d u r n infs(lcy). llIe tart* afferwentr in the facial m t e ganlwiata pbnglMn. Pqripheral fibm re h th~rds the topwe by passing rhmuph ths of tympanf, and Uogulr nena.Central f i b s trawlin thp
tarlurro reacht h e n u i w dltariw.
4 Mg.nUnBI nuin l.nwny nudwr The facial .

a+tatm~ursaMt~on fmm the back ofthcw t s r y m t u a Rwr f l h travel in the inte brmn stem, when they axend with the k l m

B

o~*~MW~UN.. ~ibcrs frwntne I M [mote nucleus ~ cultam mute m thebr8h mm betore they sxlt tatetal~y tha at the pans and medula. 1. Thsrs axon%Initially project toward the medtrl borda
abducew nucleus, where they turn rhlrply and I m p

flbw then pan ventrally and IatermlIy. joining the other faddl nwve, which take a more direct route through the a The m m h and clghth cranial news pass through the audlmy m nm enter ths middleear. M b. The motor portson of the facial nerve (but not th ni, which carries taste r m b n from the anter the tongue) then enters the facial u n r l and leaves the thrw!Jh t h e ~ b r m m , .
2 The Facial n w enten the parendryma of the parotidp h i , e

R divider Into itr terminal Won&
C LUlonroftks*d.lmvu
1. Lower motor n.wMI

I W W lostom, which facial n ,m k I pl&ly5bof the inus& M n therMc of the &. Muakr In the upprm n ad equally. L a dtaste in the antwor tm-thlrds of t es gesu ffiat t IesiQn 1 proximal to the sylomamld h s the diorda tympanijoins the faoat nerve h the mtdd

2.

Bdl'rprtsy is a common nwrologk dtsorder ck+ guta w n t h n e w palsy. whkh h painlna and n

b i w tW intempt the CoM&lbar sm

half ofthe f*. rrc.frr)tertlmboC whole fhor%th%w1pphrtha -1 b r flbsn from W h . , c ~ l a t u 8 1

bnt] pMlms of th. nsrvs lie in Innat ear l'h~aresurpendsdlnper?~a~idthatts u Q c r k and ma mdla 4she cochlea are sm l

rupu andaulwcuhe Of em un*k and ~~tlR._'?Umy ncumnran4aat.d i n t h r ~ ~ m .

Norr

,whrch exlt via the vqgsnwwr. A le8w afthe
nerve resuits b ~

3
"

~

*

aF& ddU*I
.r<i

Qag

&aim **r

I

t

lramwpmn in th. mfUc arch and the vhPn d ths =Momen ~ ~ n r . ~ ~ b r m l n a t a ~ n t h e e ~ l p u t ~ ~ n ~ c

I

t

o f t h v ~ ~ . ~ 1 ~ . . i h C ~ q u 1 1 # ~ . a m e r g a a r k ~ 0 m o aI t s a t e

vary arlo~r the maiu~ajlat if caudal to the g~orropharyngaai

I

1eaBufis~orro16 ox lepnn asq qlnp" aqa la WUWJ 01-8 re sa61aure w w m6en a q ~ snapnu IBu1ws8u)lrufdl u q 4 J I U lea owl pu s 1* -saw UoUpnp I O W P U . ~ 4 ved M&VW 0
m 6 ~ n UI w
' uaq14aa 'qwfSrda awl p ~ o t ynq m4ddns uqy \IN su e

'sn6eqdcra ' e a q m %'xuQeqd 'xud~el Alddnr aqt

Bp6 ayl a sW {warp+$! ue ul sl(nmi suau 1 ayl $0 uowl v iwuausn8e.a sqa PU lbxa qxqm '

1. WeaktiesI (orparalynr) oftkcplate (and larr of gag 0% mry m u r , pmdueing naul spffh and posrbly

don U f d
2. We4Cnerr (pr p u a W of the iwlataral v w l card ra

--- - - -. -..-

1

.

l & t e n l ~ a/wwrh,w(e. ~haryru and b m l&ng ra d f i . wIDer Mth t l U ! w a n d ~ I l o M mrt

branch of the v a g a w b h lupplt@ all ~f except the dc&yroid The w t d Is su latyngssl nerve, whlch is another braneb of Wed mrdmylh IeaCto haaoenmand dim! voice
3 Bilatwal l ~ ~ i o n s the vagm nsrvs lead to perilIris of W of and tarynr fhlr owes death as a reruhof arphy*lation

s w l y the intnrylc mu$desof the lsryn putofctixl,*".~urnam,ad seal mwl.cthfwsh tbewnem lnyn

*m~ ~

Thcrearwrpasikrough ¶heforamen magnum to cntw 9d)bktXhrfibra
nil1 m l sW supply

*

.

hypoghal n e w emem fmm a nurnbr o rootlet. i u)tr th. f t lorral canal in thaopcipitslbone.

B The pomrlor (mkldh) lobe a lxated betmen the anterior and
lonodutar lobes Thlr
K

the lare* lobe of the cerebellum ar"

cernsd wlth the produnlon of mollllmtad,Roe volumuy mo n Is a b nkntdto M the nwarakllum.
C The flormlonoduhr Ick a that portion of

., 4

the cerebellum the portembteralflnure. The flocculonodular lab& corisfm of I al ncdull snd weed lateral flocculi and Is the phyfollenehcsllyd portionof the cereb.llum tt has ImpwUntcDnneLtmswrth the b r nudel It is afsa referred to as the arrhbnbdlum or the

3

D. Thnrp.lnd ceraklhr peduncles. All afferent and &went prpl

mRNAL ANATOMY

a

Fwre 39.1 lobesandfwm of the e

m

i

of the cerebellum traverse the Inferior, middle, or supriar ce

sanPIUwuewfprrnsthesulf.aof
tne nratlrr OfmsuraQIllum .Wildtt* deep within the arbor W e lie four palredanb.lhr
A

m.

d
i

llw d

w n u has three byerr, unlike tho cenbwi mnax, hhsux B1Wrs3P-lL
r

IW-x

m d

I N A &vrfHrrr

feceM eaclumy Aput fwm nwsy Abuf and fmm the Mml-

t~ad~tO&hay)ecln&oMrkyamii
usytM,bus rrnlIM#a OFPulIt.

W e bB c vra ADH i r s ne dW
~ k ~ 0 f ~ f M O m ~ ~

-dlarlm

.

1

MwI mahKaUonand & f i r t h

curtaInaypothdmnkams)a~~mtkem whfb&#rareas influacsthhfmdumion thek mguWbn o ( t h a . m a r o r ~ .

I-

an sreas&31 and rewive fiben from th. ommilram1fiberr) and afiirther are- of the

I N A NUTSHELL

A l l n m ~ r b c p q ~ C -exsptfar ~w dfmm,d y m dm thalamus a
*.
'

CY)*lWqdonthepmaearvar wall Mtha central sutw IKl"d-

3. P r l m y v i r r v l ~ f D s d m s n n l r e s l 7 : v l ) r e ~ ~ a

IN A

NUTSHELL

mmry w a l mrtex Is Ioated a u d the c a b M of t acrpiralbbe r m M
pmwyaudrforymrtexL(rn~mMu

0 u d l w #I1 a. T H prhvw audnqn a (Bmdaunn ary 41 p ( m 1 d on the transverse gyrr (Harhf'r gyro on

uerregyniofW1.bcaledonthe
~fwnForal9yNS

. asurimwla
6 The pthnwy oWactoryuu inelude the pynform,

enwhitmi wttur

C nyhaoidw pma&ng in h pmfmwl mrtex (Bmdmann . Some, but not & af Me abmfh that diNngulh hu

fm~ e n a i c a l l and n quue extensioe R humnix y
wm(lary ofthe two m e In whsnHrphanmwe ednaa and the soelled f e n apedally h M.hm

or pmklnlan not reruffin@ deiidt), while lerionihg th

IN

A

NUTSHTLL

gweaCrd rpeach.

I
a Bnxs'r aphola (motor m exprenlve aphasia), which is characterized by slow. effortful rpeech, 0.e.. patientsare nonfluent). I Wernirke's area b the auditory asaciation cortex located on the posterlor part of the superior temporal gyrur, next to the primary auditory cortu. Wernicke'r area n involved in learning patterns correspondingto different types of auditory rtimulatlon. A lesion of this area results in Wernkke's anhasia (recepttve or sensory aphasla), In which the comprehenrdon of language (spoken end wrftten) a severely ompalred Patoen* with Wernlcke'r aphar~e speak fluently and often volubly, however, thew speech Ir often lnd~rect (clrcumlocutory) and contains lncwre-3word "sager (paraphanar)

rtetal lobe m a rlght-handed ~ndw~dual) probably the single a Expertmentr on normal lnd~aduals and cl~nicsl evidence lents w h destrunrve and e p t l e p t ~ c l ~ o n r suggest that the

BLOOD >UPPLY 70 THE BRAIN r l n w drain vmow biwd from the confluence of

dn-

are located on ether ride ofthe body of the

CLINICAL CORRELATE

nus via the wparlor pctmral rinm into the l n t m i the inferlor petroul sinus, and laterally into the

lnrklbn can grrad from the faceinlo
mc~YmOUsY"~pmdOUngrnkfec

W ~and thmmboss I

' i

Z4?,
_(

*,+ t

.

e *

2~ -

IENCES
2. Durlng the fwrth month the teotk cords became Uhepsd and

the preamnof the ranlniferotntukd.a, which remain sr d i d until plheny The endr of the ranmrhmvr lubub form
tubules, which join mar tkefiblum of the labyrtnthlne &te5fIa The rete testis bsmma ca n m ofthe mronephnctubules whiiform the a testonrrone-producingIntenMW csik of Leydip.
4 Tha gukmaculum testis consilts of remnants of the uroge .

merWefy end fibem that run from thts mesentery to the s u

a. The pxemU W n a l h K a coelomlc extension onto th " b ~ n n gthat c a with R extension of the bddy %ti m
%hbulnafcunal d u r i n g t h e a U e n t e f t h e ~

b 'During the w m d month M dewlopmmq npld be& . nrvb h m o m n t o f ~ s t s r t e r b e i ~ t h e i r lofmb ml
c

-

&maibody wall In the evwth month, the testes &gin to descend bsh~nd promus vaQimalnand arrlw in the xrotal rap at the birth The pmnrwn vaginain forms the cwerlngs ofthe p ewd6mdt8@-

8.

D c s The efferent ductules empty Into the WoltRen ut.
ducts whlch, except for their most m i p l ponlon. pars&
1. The cephalic p u r t h of each of these durn bemmn

w

e

m

k

-

P

m

end fwinr the thick-cnnur lfithepmtatu u&U athert.wbwyhrcc

whith

3. The terminal pbrlion of the dtldw deferen evaglnates to fwd M n H
4. The pmrtatlcwethta gives riw to the prosme g h d

C. -lgantt.lb

membrane during the third week of developmentand cal folds. These folds unite the cransal and cloaul tarm the g e n l t d l ~ r d e By the r i m w e the ganl . ek on .achude of t h e c l w l membrane.
2 Another pdrr of &attons,

the QenltaiM m r , reon onlachnideof thegenltal folds.

3 Development of the hate external genna enbt~mKaatrdbythetrrstt~ A

tattubrctd e16ngatarf a f ~ n h phaliu the

oiled Fimbnat develop al Itr m l a l end. wcfa and m w u r nKlnbrena glvcr nss to ,unpodzandMh~nrspommsftheovfduct a s Th6 fu*d paramcsonophric ducts gwe ma t the body and *. o h e myMntrium forms from the surrounding and th+perimmlum is derived trom Ule p2rfforwl

.

4 VlplnsThsul)peronb~nfofha .

canal

Ths WwrfwMhItdr cf thr

by d m~potlhmchyim,

c. The ovary b stnpadadhm tke rimeriorwrfaq ligament by the mwouutum, or sqs&mroql@a w.q,

--

--

.

.

-

m

b At the OMS mawnty, rpermatogenlc cells are present of stages of diierentinton and a n more o kn layered. r c. Thespenn.mgonla. by repeated m m i &glve n to p r h y r

MtPgas.
d Prlmdryadsemndary~ppmatoqter (1) RlnraysWmamwme n adjacent to and are larger thn wrmaUlgonta. (2) Each primary spermatocyte produces two suondarys gtn. (3) Each secondary spermatoqte almost Immedmtely did& fwm two rprmatlds. e Spermat~drare adjacent t o the lumen of the rarnm1f.r wtbules end w e recognuoblm by t h e small size. 1-e undergo no fwther dnlnon. but become transfo maturespermatozoathrough the process of p n n l o g
SCUn*tosna(r h &vided Into three c m m % e & m

ris m e w 5 sod c w m m
1. S s U p- I HB ~ I w~th M tho rpermatogonla cMta chromplnncso awa, nfwsaueta! mitour.drvirums the r

fernlate wlthout Wlslon into primply spermam(yfa.
2. M s a unique type of nwlear dmson thrt Mcuaonly n e w ! cells. fi IS a reduction process that reducer the dtplod conditvm

- t r ~ l Md * h W ps - m a. nm mUotic (mduction) dMrlon Mcun when the paired

romer k o m e separated. Pnmary rpennatoqta divide

-w

(1) This dlvwn

spermh diffemotfrum ordinary mitot, rt docrnot c m k t of separationof sistef chro replication, hut ratOer ~nvolver sewat the paired, homotcqm chrcntolomr U)Malosir allow for trampontion of genet= mfarmatlon, ormnbehvmthechrwnatlhofthcretrM

3.

a me SpennaUUs a n enveloped by (ytOphtmlc p r of SarW elkhorn whkh they re&& novnahmrnt. b. s + m ~ W a & cmuinlngsrnallpoxraomsf pnulas fuss form a large vacuole, whkh comains the large w ~ ~ q n rgram al

L Durmr d . Was ddemnc) a mnmnsd with the d - v v m d h e u n t h r r m F U n h n k tKp L l tmmon p.tkway af th.repmductlve aid . a

s m kdw ma*. y m
1. The

qM)na*tra& f mthe bladder to th. end of tha Wn h

roMlrfurtm+wwaMaeeUIe

-.
1. Spurn pusm r.pM$ through the SfraigM tu thcItdrilge duw Mhur a n d van in r y

*-

2. ~ m a t r a r t l M r u t ~ r v l v a I o f d h r p n n h t h l w d u m k W o n from B e npitheilum, wbich, in t u n U dem&I!t

,

~

0

n

r

W

~

& PolWngepididymsl mm)Raen, R kdamd P IU Y kr . KU * a f ~ d y l r r l P ~ I n t ) U d ~ ~

s6auolut.dgomilt I*

nr

tt@ulqaWar ghndr. the bas& u the pnile ur.thra.%wua i
SumMdaI by

loMda andrellular m n e -

a,

m c ~ o ( . ~ ~ l m a , l ~ t h a

mat <on-

rnWhnybladveah.ndnwm
Ovmianfollldma n d M l l k u b r ~

1

Gvarlsn folOdcl m lQUtad in the cortical*ma

and are

cMyxnadsfobcXtcasu?w@@bg~rlwW~. a Approximately 400,000 fiollblef ere present In the newborn w a r m Only a small pcmnt.ge d ihr DMytes IappmxmW 450) reach maturity In the adult8 s .13 W l PW W x 35 rapmductwe yeard The remafnvng folltcler eventually degonmrata

NBRE f:
aM..dtre~ brmr at may

, "

.

oosr~h K One fumimwl owmandlvro pdarbdmare

.b r

Smtmtogmrlr
fMcflmaf

spenammaen pmduced

adttutkopantotha

2 *mpul* 6th t h l r w d l ~ 1 a m E I F & W l y aour ~nthsmpulle ih6 b drs
Of Kt* P'eB"1"Ey 9. l n h d R Umtfo*, ?hi&-Walled JO#m& h l a t W the

L

VnU-ory

&urn

alveoll begin to develop a puber&y,&when t the Immamammary gland com.r under the Infbnrs of ntrOBen and

5

6

trctthenawban. f , V R O t e i n a M ~ ~ m r a c r s t . d b y a ~ n e mechankm, whereas Il@Mwmpenenf, u e s h n s W by an

, a .

II a p

m t a i m M d fcmirting I ' i i l d m ,

tsHMa; and

1

CLINICAL CORRELATE

Afi W e t m y san J n o mmade dunng W ? faahtare del"eryd the r t Oo

m M head bspwrormedwfherio h 3 ~ ~ ~ n e o r m e d n / a t w Ihe ~ m 8 I pabmIbo~ta~raarr~ofthe
~anai.srhndw

&@iRubarb.ra-mrttcnoder.

wap WYrwrBbW
m~t~ruthat meivathe ovum f o h l n g owkson.

D. U M r b a m u c a l q k l ( a w o g ~ ~ .

1.-~*ths~upprtganla,0tchsunvirr.

2 ~i~&n;dOrpartdrtkmw. . 3. ~ r v i x i s f h e n n o w i n f r r l o r n & o f O I I ~ ~

W I )fromi4hr truhrvere mica Iurdin ~

?a%w aad.the=nMMne
CLra$car ConnELarE
7he~raWFdSES&EdYl~fdTWlhe

UglhUna.

uaansnearmiwxwndathpcmw
Pwaiu f k w under the h?cW s**,lhe~ ( 7 of lhe ufanneartffy)m y be

ufanmana*&wwdrPliodyoflhe

2

vmm d ~ . v ~ l w I n s C a h ~ m e 1 m c ilhta*In m l

'

3. rynrph.tltl. ~ymph r ~ m vastnr drains tq the external and f the nrl iliac noda aswall as to thesu&ci~F&ainal node6

4 ~nmrvptbn. v a g l i~ s u p p v Ths s neNesde.W from t k splaorhnicn e w and the bWgaSft& plexus

9

from the d m .
ssbacwaus plan&, r There are is20 Wtbmus duch. each of wht Iar iobuk of b r w t t i w e . The ducb radiate n@k. The tcrmmal w l o n d each duct the d W .

Wper% Ilgaments are suspensory llgarnentr that attach the

'y fiDm fiwn thc h a s t contrlbra to inarCDstal nawr a h ~ l n rympathett fib.- whkh supply y It@ smooth m u d e at theam&.

RPT =3iF%2s$

1

3. ~ ~ ~ o m p htubules f n t o t~npornlly r i c ucin and depenlrrate by t b.plnninp ot the thW month. Ths menawhrk duct r*nhtr in t ~~atiea~~nephWymidthduct~&t4ren~~ndm duct. a,-i, 3 ~ . ;;-a$
C i&twmi@m@.DwW the

Fmh malt the metauephros, or pamum(

b. lengtheningof the exvtnay tubule glue tlB to th.

' ram&Ml~4oLlpdI(n,l&1ndthed~

I

with l l ~ l t ~

n unt.na(0nw, the t

and the kid-

bewm&

-%

3 The kidneyeonUinr a Nlum, a c f u and a d u l l 8 a The hHun N looted medlally and r m as tha polnt Of e and uCn for the nn.l amy. nn.1 wbh end umW

enhtiancp

ti) m M . I p M b t h e l l a g X l e d ~ w t m d g u u ~
mm.rweQrthreenupr~upcn~arra'ntQthe TIMY. Intum d i v l d a ~ n t o ~ ~ d ~ ~ ~ ( f k ~ ~ m S 1 )

-1

c@lumm.wh~ch penetrate the entire depth of the

of the pyramid5 p i n t towardthe renal pelvis l o w st t u h ( The .pax of each pyramid d i m the urinary stream intc a m

tha ~ p h u m the ml-g and

tvbu*.

qlPkllalwgutCo.Ndswmlal%~
1 6

~

l Is made up of w u a l anwtomotic capillary loop w

6 ~(llown9uanaipltdwidesurtorIMoada~t.mOfwpdlw M the &UIYIIY , pWuh whtch fOrms a dense natwork of b l d Wgdrlrornd*ha~mc
7. &rial
3 .

supply of the medulla h pmvlded by the efferent ah&& ofbWgfMmrull msrthcbmcdulb.

u n m
Thak.ulyah#pr*naangarewsmdutrthemainekwmpdvataf thak~mu411rOfWmum)4iklmW=*d~& ws*rawmbtof t e h w qn m n c a rniddlo muwularb and n oupr *nutla

Tha urinary b!add.rfumtlcin P istoiaqenfgatvfottrlne. fhe a t n of mu the wan oftha iu&r b~kn'1lrrt~bertfi1dicnhd,ttm mmt ofthe

A WUopY of $$ U&cy

bladder h ~ l bfc&d&irq (

upon the

dcgm of thc bWdu dlstemon
MEDICAL

I
~ ~h b M l t i ~ a and the number of apparem cdl layers r 1 n aependr on the fullness of the bladder a As the organ becomes distended, the ruperflclal epctheltal layer and the m u m k o m e flattened, and the enttre ep~thel~um becomes thinner b At m fullest distentmm, the bb*.i-pithellwn may k ""ly two . or three cells t h l d

~hesurfaceplasmarnembranesofMaoL d e r ~ ~ l c e ~ a r e ~ I ~ @ p n w w t e r m o m t frm the 8nmm t t ~ a l c o m p s m t h preventsd~lum ~ dthernKwrmtedfimrr)Urrne

RHRA
1de urethra serves as an excretory duct for both urine and semen n r ipproxsmatdy 20 cm m length and has three a n a m t c dlv~rlonrprostatL membranous. and penile

.

~ "&a b

K mnnderablyshorter than that of ti.,

...

d

urethr.

bcm m wornen than men

NBDE 1 : ANATOMIC SCIENCES
I

/
\
NOTE
Therena1a~are"end~~~e. ?Jmea ~~t mUatefaI& to a rn~ntlmperWonn~casofaduaM.

contllnr glomeruli, h m a n ' s capsules, and prruhmal and distal convoluted tubules It form renal columns, whld? unMl be-n medullary pyramids b Medulb consMr of lp-18 miDhd pyramids a d contbins h g duco and lcqv of Henle. The apexof each pyramld ends ar a papilla where collectlngdM open c Wym. The minor caiyws nc& one or more papillae and unite to form major ulyce% ofwhlrh then are two to three per k~dney. d Renal pelvlr 1 the dilated upper portton of the urater that s r e the rnajorcatjces. uw a .
2. Medmt wppiy. The paired mnalrmliwa n branch- of the abdomb

.,

nd~*bita.

ar imWmat m u travel In renal columns In the cortkai area
1
+

b.(Waenpyrsm& b. Arruete anmla run parallelto bswrofpyramidr, c. ~ b u b r a ~ abranches of arcuate arteries r e

-+

-. dr * 1 & ( C 9 f a r M d l k r i t o ~ I ~ M a d s l a r n ~ I I .
3. VWIour dmlrup. follom the same patternas the arttries a. The rlght renalvein enter$the Inferior wna cava b ffte-I& renal veln recslves C e left gonadal vein, the Ibft t Y suprarenal vein, and the left Inferior phrenlc vein, and may & B a mot ofthe hmlazyqo$ vein M o r e crossing anterbr to thb h a toloin tHrlnPerior veha a v b .
4. LympWdmlnage. 7he kldneyr drain to the Lumber nodes

5, lnnmrtlon s plmrily ryqlpatbtic %qkh portganglionicall bodies located in the renalplexus a. RegangLonkrymp.thetkflbm arefrm Iplanthn~c nerves b. Pam affennts from the remi p k a travel in wlawhnlc mrwr

C L I N ~ C AConRElrrr L 7henwsl (DM1Kn*of&
mn-

URETERS
A

m M x n ~ * ~ b mkdi WherrekrmaIpdwrphathe~

Y

ummn are flbmmumiar t u b s that conned the kdneys to the urinary ~ ~ n h bMder a t e pelvis, Th6y rtbi pCstgrior to the ductus deferam in males mdponerlortothe ~ a ~ l n f e m a l s .

Whnrtheuretw~&~
inkt ~theheuretwentwsthewllof~ unrn,y LdaddU

8. They kgnn ar mminwgens oftha renal prkes and N n retroperltonasb & cmssmg themmqminLc+ri@ar they pan over thd pew brim

1. l f ~ UW

r

I rupplhd b9'*DI(.1We s

&(hr

lntMPl lllw

iP

* b?l~dNdanclrfromthe m
w&rmI

ollRcc ofthe a h

NBDE 1: ANATOMIC SCIENCES

--.,

2 The normal concentration of erythracyter In blood IS 3 5-5.5
m l l l i i m ' h waren and4 W.9 milliaJmm3 In men. Higher munu in mm ateattributedto the erythmgeniceffM of andmgens.

I

+

fhr pa*l.dWm ol blbodcdk p.r total v o l m o Mood lr lmaa, f a the Mocm Normal hematwtf valm are 36.46% for w o r n < and 4163% for men. m m s p l e a n , and l lengulf and dlgm them The Iron and h e m h of hemogfgbln ere w l e d . the imn k carried by trawfwrin m the blood 0 certain tlsron, Were It wmbiner with apoferrdn w form teRMn.The heme kcaWa!hed Into blkerdln, Wlch is mnvend m pllifub!n. Thelatterissweted with biles&,

5 When aging RBC, develop subtle change^ maoph.ppl In the b x e

B.

, or W i t ~ - b bW s iWBCsk are primaniy invalvadurlm the d cellulw & h u m ! dafennsfuris m n i m agaim W g n -ria& W e g e claplfied w aran!Jlocyhr (neutrophllr, sosinophib s a F i U and w a n u l a y p OymphWes, monccytn),
1 W . r
+c I are film& Kcwding to?hstf~stpiomg prowrnn o thelr f grwuk a kruaophk are 10-16 run In darneter. ( ) thdy have M iiuclaer loba and wmdn slumphllic gnnuks '1 (lyiolamlrl. which i a t a l h hydrolptic enwms for hKterlal terlctdalen-

1:

R g, lylozyme) .
to

@ N*utmphIla Wa &aWcW tMrbmdi.~11&.nn~.xb7
~ n ~ = m ~
leukocytn

bauerialchamWmMunt( They are the prwnary celk inwlved

w mprrfnrsi-sa% of d ~ a n

w

w

acidophtt grsnulk tlons in thelr cyt?pl@m. These gronuln contarn hydralyuc enzymerand wlo*(dpre. which am d'iarged into phsgMytic vacuoles. (2) EOI'U~O~~IIS are more nrmeran in the blood during parswt~c infections and a l l y l k disease they normally represent only (-3% d IeUkmyWz c kmphlk . (1) m 9 poncrr ldrge r&told gnnuler, M l r h are beMphllic and metschromrtk due to heparin. b gly6oraminoglycan Their granutas akUWmin hhfamln Q) Basophils degranulat6 h &*In Immune readions reieartng hep£Mvsnd hlsthW3 ~ n t tMIr pnaundlngr m y also o IelWe addltknel vlro.rthg a m h n and I W r e u t n g subotmphgla(a W*f nmdstfng of 1eukOMmn LTG LlDe and LTE4 They representless than 1% otlwkbtyta.

(1) They have a bllotMd nuclam and

-

Y--

mngrnzkabUWWtRgfinub

-.a

-'-,

2 %

pL ~ i W e f ~ n m u n ~ ~ u n t r o & R t , f I . d

,, ,

urhg lmmunolorr~c L l l a c b r m k & W 7 b e h ct and s Q o lu @3hi@m+*
(12 f -qHs i&rrnti3< In t&?'t3wWU andA+e~ arculafs 1" the perfpheral bleed, where thay are me prlnc~psl effectors of - ~ . r t l n d m fudan w*by-*lar*~arrue~n*f%

I N A NUTSHELL

W-WNB

,

.nagecrceu(cDPr t h r i r . t h n q 8 r r c ~ z ~ b e U s w . ~ a n d o t h ~ r .cyt~ox~rcdl(cw re&. s u ~ r c d
6 celb + h m * l h - W

I &#Ha dnhiarmf. n b k m r and W b l y In the sub D mw

. .

rsllc+ds-Lnm*
mffereRdBtenlhvmus

"

&mw&M*lh**YIAR* ate into p l m a & M-IHatha? are

.WWCe/&+p$uMd&d&W-

c e l h 6 n a k @ d n b ~ + ~ &

&emmure

m an@n

%m*.~*..* * ID l t w r mcki N l n Ilgbtmr thM lymphocyte nuclel because

n

w Ih.qto@run bar a gmundqfau qppearanca and

'*

wbna€h

of

u ,

thstynr-

Z
X
X
rt.lnlng hp.&l*nthat

dut flns w

c p r o m mi a

Plasma b ths extroc~llufar tompomnt of blood. It is an aqueous rolutlon containingpmtelns, ( n q a n k wla, and wganlc compounds. II ~

st

l s t k t ~ ~ ( P J O I M ~ t M ~ t h ~ ~ W a w a r pLUraCp(mIr6 wddr t #Wllnr (alpha, beta. b

t

gynaryaad~wbrhlrmce5a~foc~~offibrinin

cbbrraprrt.p4blnadcslq-.
B N m 7 k equlBWum with t l a IMwnltlai fluid thmugh caplilary 1 walb &&re, the cmwdttw 6fplWn4 m b cllM to judclr the y morn c m p ~ R i a i of thi Mtrdeelbbr fluldr rargr bl-d protclm i m W n i h f i e l n V r r r a u l M ~ u r donataqufflbmtemthiim d rmentniat fluhl.

C S m p b a dear ydw RJd tht u spafated fmm th cowulurn durmg thpwaiofblood4a~~m.nhlrtha1w~onmp~ the ciottlng t l a m h w a U y fibrinogen). n. M u

t

I N A NUTSHELL

'"""
. I

ci"'Ih
L
Rlynlphp*dm

Ilunlymphvanh

Lymphak vnrds conskt of a flm naarrak of thinaralW vassal3 that dnin into pmpnwv* 1up.r wd pmpnrr(vs)y thl&er-wallm mYMing trunks. Ttme ultimately draln, via tha honck #ud ub !bM lnnplntk dun, lnto ttw f n and right rubdni.n vaim at w a e rofjuncuonwith tx imai MI jugular veins, r.spectively. The lymphatics serve as one-way lI.e.. MwUd tka he&) drain.* system for tha return of t w fluid and other dlffusiMe subnanur, lnchrdlnp e l m ~ m t 0 i m?Wd, constantly waDC . f m n t h e M m d ~ ~ T h q r a n a h o ~ t i n ~ a s a 5m s n e lymphwyts5 and anibcrd~et pnw l produced m lymph nades lnto nto bbad orculation.
A.

-UgtlWacrxwilt~+YeBekhndw&b.ndothrlbicsbr.4ich
~ a r M i a ~ M ~ a u w l s r l n m o d ~ o f t h e

TbwiWdKt

&

1

-

YndgnofC

r

aM~&dmn

lwMwt0fR u1tRMIlW andRndKlanan

Endfshl~h.~~uetrdanalwlhr~r4mM~Bwllsmm

BDE

I: ANATOMI$SCIENCES
of I n m w W l n Mdagewatke m prrk WInMic nudey ~ . t l The r
whlchbmloy)Hclp.b*at~ir~fmmth.cell. 5. - R (polyrhmm8Caphilk ery+hroqte) h an immature XIdcphlm dh&.ncd RBC whkh d conaim roma nborarur and l mltahxrdtb~Inthn~ofamaIIqwnt~ofhema globin, AppodOmd.b 1% of the KhUM99 R 3 n t K u m WW
6.

moar E Kbe,ntemRedmdnrpectm ? t ofbone mamm munr me mwccvre
aconty
the hemat&

Er#hueqw N the mature arldophlllo an4 denurluted RBC.
Ety4rrsryor~Inth.ci~10n~bl10dsyrml1IR m r n ~ ~ ~ r g l a n , l i m , a n d ~ m m .

a s r a n m l 4 Is the ~IDNPTof gfmdoqte
1 MydebW @ a that has a !arges&dcal . cdl

Bone m#rrw ~~k~ln(orllhrr~p~otgr.nUl&yhr(Fmun5011. nuckuswntelnlq dell-

.

aa .u$hwnatIn en$ s4veraI nudeoli. It hrr a baophllu cytoplm
and no gmnuk. h4yrl&iam d W H H ( difbmmlatl ta form smawr m-'Jm@ayta. a a <dl that mtaira a largcspherlcalIndented M e w Z P ~ ~ C . a n # Wchmmatm. The qwplmrn la basodilic and a d wnialarperiphqralaaumphikgranuk.

3.

6th.LLrtnll inthisse&Upabla of divlswn.The nudnrr kentsrincrenfingly haterochrmOlc with wbswuent dlvirionr Spa6iflc gfbnuk ab fm G ~ l gapp.rm& nwltirg h w r tha l n&la toolnMWk, a 4 m l I k mnbcyte*
w h uhlbltr I& WM1 4 thnt h charmW& of the nytmphil, c~amopkll b l w h i l (, or nm ntsplmn mnURs aguumphi~k qnnvbi MHI h w g q numbm of &k @nula lhiicdt dbm not divide.

4. M.Pa)yJocyOlis@ whmmndenfed n cell

CLlNICAL CORRELATE

An4kvaredpercentage ofband* rmphhb.ban~rMuhuofa a'kkbHi'

.wtm&mpp~arHnkaatwe mferl€dk?~~w-a¶

5 GrmnqIoqt~I thr datlnitive cells that enter the blood. erq N.wcphlW gnnul-wtes urh~blt ~mcmKdiata an Sap called the band mutrophk This is the Hrst dl of this w w r C a p w r In the parlpheraiblood. a, Ith&adHsUI8pedllkC8cUNcdmdnbandblnd b Bandl mrmaliy cmstR& 0.5-2% afprlphnal WSCI; thsy s u b qwnty mtture into defihlWamuWc&%

D. nKanbap4Mbor tho formation of plate&, m W B .

atrun In the md baM

*. MWkqcWW is a I
-mew

a ~ ~ r all that contakn a U&p.d or U c DPDM lm&U4 wlth pmmJn& nucird~.it IS the Iastdi that wmkr-

I

2. MYldtuyo(ytr ate the largest of bone m w wk, wlth dimnewts d-BO r m .n*y uix?&u 44 nucisardhlidwr wlthm cw m a ~ ~ k ~ & a m u I t . a M ~ k a r v a y n k a ~ whh.Po&bWirwl po)ypfold mxWs and abundant granules In t u

ad&gl.LIPkbwete mWq1on p r rRlsl)Mm*

*-

'cwtainr' of platelet danwutlml ver~cks fwm ~n thb'c@pl.sm There VDIIJFI mk e , Mmme MbuIar, and mmtual6, torm o t a M &nmrWm

b ThCw membranes fu* to give rise to the membnnar of the

c A r!nple rnasaknwocytc fan shed (i a . produu) up to 3 . 5 ~ )

drabpa of IndMdwl w ~ a m k

d [a the anMmy rrctonr of

, +

I m m n n c m the h l l of the @lMl to the stom ~ the ~ &, kmwd Spu*nt rmdKt the h l l OD the region of the i 'f&Wdwyl l w r p * n i c ~ ~ t k ~ ~ g h tIigWmt ~ ~ I h c I

~ s e x w , ~ ~ u u w a n d o n i & c t i n w o r mW d e s a k o n. &aim thihhrw pplvk a d lwMr IimbrtntQlraby way of rnnfarh n mmmiadc@pd CM1UMO UiW w&b EffemWmm lurnbr noder tbe ~imthClWFXWVaabWhhhgdntothi.~achyfi.
9.

~AyWWtkd dl*M mlfiatbl portlon of the thMKic duct whlch

-

~ilhautrunksan€ltfmIMMTrsa~

+ Sum& doa ncekpr all the lymph fmm below the d~aphragmtIt
~~~thc~mma~radpa~atatl,ethorilxthr~theaotule&&iatthsdi.~lO.

:

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6

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Description: NBDE KAPLAN MATERIAL TO PREPARE FOR DDS.... ANATOMY...