-, ..

< *iii*'
,1** .- .?

Celk are *rated 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
mereare~baJccstqwkrofcdlr@iawZesandw~
Into and out of the cell 1
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.

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 nmint!s&ny 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~dmuhKa 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~byercomposed 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.
D. Cytaplrm. The total internal compartment of prokaryotic cells ,s

I E.
d.fkwd as the cytoplasm
CThe omer surfaceof mr bacteria are coated w ~ t hflagella,
whlQ are thread-llkestructuresthatallow the bacteria m mow raptdly

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
ranges from TO-lmw.The 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
r a
d
rn
--qz&n.

*o
c
rlt(
In euluryotes, an
uka, ihcludln~thbplasma
CIolBi
c&~U~M%
m e t c r y v.nclsr. T b ends
- n*rdmarymm
ugh
a ~ d
c r ~
NOTE
Two!%?&& the I u m of any of the
--svrarh olgalleller OI
~ i r c g t r ~ m m e w m d e ~ f
r ~ m , d ~ ~ ~ h M n o n c h O i o n M t h c ~ ~ .theI cnV
I t o
sndttandrnawawno)*ilhb~&ld~ttK~di%&r~ellulu
u w l ~ T h f l c ~ * h v m - c e F *
, *t&mmnbranoasyrram l.the Subarllirk* Orsenellas
dm$4arInthhbodi.
$ . ~ ~ o t * P q r n g g ~ ~ ~
Inmkwho@b~koRbU,*adlntc*
faEd kv.rying~bml"W&?-cgem

o. # w " s . r c r ~ l l l , e t w p" w r ~ , o&m

. m.& Muup
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
w w b r m of bse4 ! w & p t r i ~ t I w #uc&e. Wm.sr8rnellcr
d ~ . ~dY MU W l d i w w d in
e v t e ~ e s l tNC *h r i l u k r
rndmmrn
z pubrnrr -y
k*
"' P
2 pa#J*<

.rrlRlpMp.thfq haviW pofsr h.M graupr that Intarad wlth ffia

a q u d FnvfMnnient.Ihe hYa~ph6birUlb 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

g of all btologic
mmbranes, c ~ ~ m 80% )M the~total
c 50 and
membrane I*& Th. p ~ h ~ I l p l CuMl
d s in a n h 1 plasma
frletpbmw.a mrlLt&c phosphWJdy1~hel)nh pkorphatl-
phaphatidyk~ea.~ d y l i n l s ~ t aand
dy~sth.m~smlne, l,
ryjwowdin @bob W W .
12 Qd.naol k a maiormnpownt of p l a n s m e m B r ~ umakmg
~
u p b t w w n $5 and 25% of the toM lipid. ~ C h o l m e r oisl
ahnyrhtheunesMi%dfonh
c. ~ l p i l & bmake up the remainder of the plasma membrane
~ k i r l ~ t h o u $ h ~ ~ n i j d s ~ & ~to%ofthe kthm
+ 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 me-#-
2 ~ ~ ~ I u M d ~ n t a r a s a I l a y n r - w
UpiBbRqsr..ma~ny*mrtwO*d
ucarldetaketlm~~.
a. Bboapbow ummmy. The chMkwcoa@inlng lipids
LduqrhlfWd@!s snd+fWmfi 8rp w*iched m the
on$er lrr&t wkr~9arormro-sonWnlaa phwhaliptdr
f~bwhpiWor1~ LRd
c pboOphltidyt9thnoamingam found
priadYhrfheamr*.flb
-
I b, CwImWWW-
--a&dj#ddacfaund
The curbhydrate portions of born
on* tnerior o ~ h . *IN NursHELL
~ ~ * ~ ~ ( u n m o f i alln3embranecaix++bm
~ ~ m ~ @ ~
m k ~ . atgdredtol@orpmbdnsand~ "a

L h l h rsypun*trq. Proteins are not randomly tnrertcd on ~ m m c m ~ O f m e c a l l ,

aumbruaYlnrZ~WbwhmW N-tmBinusWtade the cell.
w h i i a@rs fmw drrli- on 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
3. I*dny;th,fhtLtlt ott)UIX(JnTa IlwtbrIMl is hflusnced by the

en rL&di& k &muweed by the fact that

a.& *
 the pmpomon of ewer umumted fatty xi&or $-mt.cham fatty
ad3
4. MoUltpr Pharphdlpidr mow laterally W i n the membrane at very
high r a w . Som integral membRmprc?eim un also move laterally
within the plane ofthe membram uhtreb$tAsmoment of &hen
ii m5trimd by lnteracflonwlth Oblrr*parim &er in the cyMrol w
wkkletimcell.

TRANSPORTACROSS THE P W M A MEMBRANE

Thc plasm membrane k a selective barrisr that ~ m t a h l dirtincl
r tnternal
and external environments by contmllingttn pasage of moleculer mto and
out of the cell. Swcrul nurhanlrmr are used for the tnnrpwt of molecule
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
t watw requires no expenditure of
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

to a mion ef af ccmentratlon b
a regton of higher conCMWnCMWn~ I

I
termed 'psslve transpm' b.uuse It requhr no external rsum of
ehngy. ?here are oM d plahe tranrpoMlmptc Murion and
fscilltateddiffusion.
1. Slmpk diffusion. 5maII uncharged mo)eruler such as oxygen and
IN A NUTSHELL carbar dloniida can pa%thmugh the llpkl b~layerby- dlffwion
from a region of hagher concentratron to a region of lower
arrurkM lrnotsa&i& concentration, ions can move thrwgh open lonlelective proteln
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
channck vta simpte dtffiuon.
2. F+dllt.t.d diffusion. $onn n o l ~ ~ haw
~ i m
wry low permeability
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 atnnsporters
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
region of kn* anxmntrstlon to a region of high ~~ requires
both a unk promn and ttn nymdlture of energy.The hydmlyvr of
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
and K* Into the dO: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, and barnma: T ~ Calpha-GW M t l v a m a n
lnol(utv-pmc.k,nr(,*ad**).trcyda..Thbtnmc*a I

m--*
, E-sk brr Wen divIdsd Inl. three 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~pidsand ndplpma
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~learpores, 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 Is composed of a dirttnct llpid bllayer that Is
appmx~ml6 y nm tho& Thus, the nuclear envelope is MOT than
tb plasma mcmbrana The outer nuclesr nnm(uam s rontlnunn
with the ~~r reikuium. It is araoclaMwith nbwnn?~that
ars sNvely synth&zims prmrna The inner nucher rnwnbrane is
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
do@!+ hew with maja en* mm+x 91- 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 en-
aaMty but em i r d v e d in OtU &aging. Thws am fiLe type. of
hlstoner: H1. )LZA HZB. H3. atrdalW% hhlstom are mwl~fiedport-
trsrmPtionaliV hy photphwTlation,-on, and -n. The
hlstanes s t impocFln* in t o r m ( ~ n v otype, 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~kanmipttw OM4 mplir. and r 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 dW
W Ilr Ic ~ k , -go
S throwh
ordtrlCbd-unl-.maag.51n
.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 me m*lor*PaS W d M1 WstlltC d CoWmsatlon:
hwoammmand e w k w .
I R~tctschromatinn htghly eondenled (3s-nm lolenold fheir or
hipher mes Of ~ n s a t ! u n.n
~ iih traw-lly 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 machl- used 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 of arlngb ix+ZNR that k beiw
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 mRNA. wsth the mall subunit bind~ngftrat.
Subsequent blnd~ngof the large wbuntt ts necessary before proteln
r y n k can begln lnd~vidualr h m e S are spaced approximately 80
nuclcotidar apart along the mRNA molecule Each rtbosome Is
~ndependmtly synthauzmga rlnglepobptlde

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

A Rough ~ ~ i The RER

ntirulvm (RER). r Is a rlngle llpld btlayer
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~vimgthe 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
uoll~~wu a su (8 dqs) w l
u h
utaio~d'alunqnr aqa $0 Su~pu!q6ulMollo4 as1lj Sulpu~q
alunqns leuumgl llw a41 qaw VNUWaqa 10 PU? ,5 aqa ae u m w
(v daas) s+qunanr ~eUc5CqlJ0% ayl $0 Uo1aqwsre-aql'aluori(lad
a a ~ )uo rv16aqs~saqatlr(rulaaold IIV (z-Ea~n61d)s * . w k vloltud L
,(rlla teune a ~ w ~ 'w
6 3d uopnar 4% pauwap
reaaotd p rlraqauQ aqa ut pen&e+ a e aeqa qla3 ul auau)wd Pan q
131 wnlnnaa wwreldopua q6nor aqa Kq pazmqauAs are ' w u d l
pue 'rnae~sdle16109 aqb 'aue~qwawewreld aql 'uola€u2as lo$
p a u l w a* EW wlaamd rapqdadnfod $0u o w $ ~ p o uleuolaelsuenm
pue 'rulaaold auelqww $0 uolle~o(rue1a'SlreqauL ulmodd 131
aqa qa1m pqal- me rumpun$aalql .]la>aqa jo lled aslel e f l a w
 I m n l n nuclwtrd. wquences cod^^ for approxkndsly 30
demned for RE& XR C W ~ . m h m . u Q h t h c ~ p p t Y b ~ b v

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

ef * W m i*tagaRS9-rma warn that

2 tamtwkaesat wWw3ms. Several ~~r czcur a& the

mi%ism .
w &(SCtkratad in tho
RZR :e&mne fernone tho r1OMd w t i d e wd irdtgradCd by

L ~ n ~ w h c ~ c - l v l n
protclra are d&d &to the RER
+-ryniherbw3-zwQ'h;ar+pr*lmw
-hrihshrns,0fmeeadOpllrrnk&,~01~lll~~1
w ~ ~ d g r ~ s ~ C o C m a r ~ I s l r
1 Gobi -ma and hpuma.Hawmr, am.pmrinr are d&nd
tok(noertedordnW.dinthohs.RYmnOnofad,
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 il j
~ ifl Ml
~
between diifersnt lyrar?ny. All of th. lymsomal nayFlKS am adel
hdrdprC u(th oeWfiral .Qhnyirt a pH sf ~ 0 : I m R e b5 0 Th.
nquir- for on &We MvtronmMt pmmmts ihk d.rr of etwwes

.-F
C The ma@$ f w B t t 0 ~sf Lwwme& IT
~ t . r ~ - ( - i a I t D b D D a d d
may C. +ith.r extracelJular sr IntlJutluu. T l u c*gclditlon of
nmieuak SUE^ m wm8twm or qguuUn. is known as
luautal.kretjkawb-.
r. --mprrp-rn*e(tbyw
mctisl Wumeion 96 ih. PmMnrbrqae, -king
( In an
~ ~ ~ ~ H I a h
a. -h m~ ~ Q I I~*W I C I
rwzgnizn teH an arid.lyd~rprndou.rthn plmrns
-*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 2nd a dlaarebr W wrgrr from .p~~oxhaLsly
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
y faW
r i d s ) to molrrdpr oxygen with th. format~onof hydrqrn peroxide.
 1 1. Th# eetw membune IS It
canburs an abundance of pwh. an ~msOraimernkane w e n that

I h

2.
fomn manneb m the outer membrane thmugh whtch mokuies of
rmrnwmanpass
mt Inner m e m m t5 ~mpermeableto m
&
l mall ions &a+, Kt, H?
and mpll nwkcukr WP,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 ri
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 ~ nu- E of mitochondne and the wmber of costae
per nalahondrlwr ue @reimiw@to the m e t a b ~ k&lty of the
the mamx ih& tk F, d u d of AlP cdb m whahKh t h e y wde. &I lcutDplei wdiar tlrwe and kMmy
sp"rfhm, releasngenwforATP tubule wlid both r@quueiarpa ianrntr of ATP f ~Uwir r normal
function There cell types therefore have an abundance of

-
mhhmdthwith a luge nu-of d d y p&d o ~ M e
3 7h.Mww&#mm rOlnprtmadir the space betwaenthe inner and

1 4
o u t n ~ , ~ m n t d n r e m p e s & u r A;TPtophesphonlate
other nudRldikrtucatlne
I S
e
and admyfshktnare)
the region enclosed by the Inner membrane. whlch
contams renralc@feRMt Caqonenk.
a Dehydra$enasw oxldtw msny of the substxtratsr +n the cell

I (pyrwete, amino DWds fatw BEdJ, generang NAD5l Md FADHl

tOr a bv the eW~ontranswrtM n and enerw
b ~owble-strenrldd m h r am*
. I.
ICWP~~O~
and the enzyme
rnachlnery neceswy fw i t s roplrcat~onand 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 frmthe mether, W m n g
M the maternal tram mi^ of d w e f maasolsm.
c RNA, pmtelns, and ribaomer a l k mhcbmdr~ato caw out
htatprotenrs demned for the proteln syntheer However, most mltochondrtal proteins are
m ~ r arewcorn&& tranrlated rynthes~zed~nthe cytoplssm and are transferred lnto the
h c W bvt mnwn Ntwm~nal mnwhondna
a m m o d o d mat ~ dfrectthern
B Mbckndrial funcwn. The majar f w a o n of the mltwhondrm a to
syWhsW ATP (Fwure 3-5). Cellular o W l 0 n cf slucov stet5 In the
~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+almatrix, when pyrwate dohydrogenase or~dlzerfi to
~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 type of
movement that involw m~crotubules
1 Chm-l movement dunng meloslr and mumk d e w & on !he
actlnty of miaohrbuk Mlvctvbule arwmbly Is an mpmant event
~nrp~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 adveriety of ather poWn that allow
thr beatmg acrion to~cw. Ths Smture of the axomme u shown bn
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 or onfy spstlal rvbtubule
E. D I ~ R Iassoctated whh mlrmtubula% Two d,rcare states rnvolw
m&lkuGionol maroWnlek C b & k k - A ~ Mrylldrm and bran-
chlertahk.
1 Ch&Q~k-Higahiryndrone k ct!arsnwksd by a defsu in the sbibty
of mlutdubuler to polymerlzewrthin leukocytes. Thk leadsto a delay
I n the fuwn of phsgrxomeswlth lyroro-, thue prevsntmg
fIWqwtwr of banem.
2 Aodhct& s caused by ~mmotllecllla ~nthe rwirmory epithet14
reSnMng tn the Inabltwoicllla to remove $"haled bacteria.

WERMEDWE F I H E N T Z $mZ@m%+
he* mmpohnts sf t$ qtorkeleton, with a dmmeteer of 10 nm, are
--, mere
r o p l l k e fllamentr functbon prlmarlly ~n structural roles Intermediate
ftlam+mn s n classiffed tnto three types kerattn filaments, Vlmentin-
mntalnlng 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
 ~.Tharyt&OfthcptMsir&idedintwdiunt.unl&
IN A NUrSHElL
SWW%w k h aund the mttrc lengthd the ma& f8rr.
Myofibersmlarge-
-malac&
mwafewof-
amp d ~ n w l o ~r nd w~m of
~m~2hrCfila~theeanlhe
avm@!%elements
~ri!amenrr we the thm Iacbn) and
aKt 6 n p ) fibmentr thatspdemt
onemu&dmgcwmrdm,

hWsnu src d e d to & Z Ilne +nP emmi mwwd the

centn ob&glr&pap, w&em t)wy *ve!#. 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. Tbe globular heeds d the q m t n molecule
contain ATPa* m i v i t y as well as rite5 for brndlng t o adln
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 ~ b
Qh.s~eiUler&&oftba%murdwtes

Usbn, is-, 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: ANATOMICSCIENCES
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~ngof the
sarcomere, the inyofibril, and the l q t h of ttw mwle mir Is kn- ar
~ W M ~ o f N * l q a n t u a b o .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& ATP, which e
hydrolyzed to AW and Pi by-n ATPaw ADP and 4 remadn bound
to the ATPm site.The m- 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
ATP bgnds to the myDsin head, callslng it to be r e l e d from the t h ~ n
filament. Hydrolysis of ATP n r u l b in the myoran head rcsumlng Its
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 men the BIchnn c w ~ ~ n t r n i o nn
low (lo-' M), tm- Iand troponln T arm strongly bound to

.
l
R
o ~ a n
d C+ MRdr to noponIn,
d ~ ~ ~
tropwnyom, h d n g t br the actk, amwe 60 mot it b W the myom
,
blnd~ngstte @ntho bcUn momwnen, Trapanin C i s either loosely
associated w ~ t httopfmyosin 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~ndrxalclumand 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
m e n ~ m e ~ ~ w l sbinding rb on the amn. pennrttlnp intwactlon Mween the two
I&td!au~j, therebyacbv- iD filaments to occur. This. however, does not nectrurcly result in
A m -wand fnranrnstiaflng mntranfon Contractton un result only rf ATP a p n t
mnm'llon
E CMbol d IWemWm&durn omnb.t[onr.Small membranous fokk
known as T-tubulw exunij from the u~catnnmaand wrmund each
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 as rekyed to the-k 4tlrulura (UU, a sheath of

caktum &IS ' -

flanaMd~thlemMlhthc~wdstofesBmewnMia

whereas those in the @sol ate klY (lo-' I).

me frm 1 ~ to
Upon de+&riratlm, the
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.dm11143in themahgnsne of the Pnoplaanic nbculum The
haMh in d u i n omamra(ion murr nDMY ind nHevar the inh~brtm
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
SRsp~diA c m The cabum a bound in the SR by cakqwsterfn, an
~ a hwh hmnutyof aspartate and glutamae revdues
a c t d ~ c p w WWh
 a trix

has rpclal~zed
junct~onalcomplexesthat allow cells to bmd t o
nebhbonng cells or to the extrxellular matnx, whnch provides a
structural framework for the awoatlon of cellr Thls chapter wlll
w the baric structure of the dlfferent type5 of cell ~unctlonr

QUJUNCllONS

Cell lunctlmr anchor cells to each other. seal boundar~esbetween cells, and
form channels fw dlrect tranrpon and comrnuntcatlon between cellr Each
of the three typer of junchonal nrmplem has a character#rt~ ultrartr~re
(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 ~nvenebraterand 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

1. Idh.rmr i u n ~ l n clo
a ~ COUP& ECL
w
with 0th- d s or with
BynpaMnt of the sMWllu)sr m-nK ju;Ubl@ mmpkra a
~ o f m r , n u ] c f ~ ~ ' I n ( a a H d u ~ P
0and tr-ml linke m M (nb) /\r shown

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

 --
C CHp Wm,also kwwn as

1 Structure Ths b y $trw

.-c
U i i i5 4 ~~s
-t

lent of 'gap junctlanl a the

a hollmr BaUndu made up of ~.r)smambraneprotennr
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
B l m a membrann of the twa cek are separated by a dlght gap of
2 4 nm
2 FuMtfon. Gap Junctmns

fgs $JmnSnan(n d bll coupling vla gap junctlonr provider a

lnowsd ,"rn&h,Isr Cd. ~111</megap
luncbonr M m 5 me deaLh ofooe
cell b n k!W m mpkd n e g h m
m e h a n ~ mf o r M i n a t l i ? @ t h s
h R l v W df- 1 Mr Cells
m
y be CWSW ad bothkribtnlol)nQ ) ek@IcaJly.Gap G*,jUNtionra n
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 jun- wherraran inwearc In CAMPincrease
rhcabdiiofthecelbto~wta.
 the &I larnlm The mew fwutbn of dlagan sto
orgmlxethe ritraLelWr matm

rich In .aal prDLin dhrt wmh im tka rrearalluh

1 W G ? b q r r s O Q ~ - b b r W m l i f C b rglkP * b . u l W i ~ md
~ w k * r e r s d u q r @ $ ~ ~ ~ ~Thr.nraJM
~ ~ a d w n
tuMa9A t ~ p r o v ~ ~ , ' ~ ~ snd
* ta
o large
c B ~ ""
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
c E m W x flLronacrm a hlonk lrrrclrrbla a d asbrlhs ralb
WtWI the matrk
s 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
cgsmita
2 mna A.aiw, Cortical granule mqmes alhr tha EMs pcllucida,
~ . H n r l o n s ~ I s t U ~
chninwb of nwlollr F I M I ~of the sperm and egg cell membranes
a b induces tha rwmptlon of metwh In the cxxytv
1 T h e e Mw completesthe bswcd me lot^ dwnon w h ~ hresult$In
w M ~ s c a l l a d ~ d . R n ~ ~ a s w e l l ~ t h r ~ ~ U b

-
figure €-I WEmCon

FUSION OF THE MALE AND FEMALE PROYUUEl

A wmpdtlon of the ponud.i. The famate pronucleus contains

.
22 + X
u+xrhm-
and the male pmnuckur mmpinr &u r -2

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
1 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
wnte umne N O ~s ma homm
Anamnra m,the s p m p r ~ d u c f
amf~tute.wemmmMiyured
By the 3rd or 4th day, the cnnmacted embryo <Wins I€-32
Is rlferrtd to as the rnorula

Lnwmas th? blastocek

(Flsure 7-1) The zygote, now tree of L zona pelluada, a

C
a b!astocpl and cons* of two cell groups.
Iha embryoMa bnner e l l mas) pproiecu into the wvny he
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
CLINICAL CORRELATE dwrbnic gonadov@n (M6). Ths is a hormone that matnta~nsthe
corpus luteum and Its pmaenerone secretron until the placenta
lheluerwreofhCGrnunne&-mts
begins to produce8% own progesterone
a mmm~fyuredmethodbrpwplancy
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
peg-.
CLINICAL CORRELATE a Ectopic sites af tmplantat~onoccur tn the utertne tube (tuba1
Due to the narrowness of the utenne pregnancy), on the surface of the ovary. or In the abdomen.
lube. @@PIC N b i p s m a ~ l e that
s where they often are found an the rectoutenne (Douglas') pouch
pwsstbg.ondthefifrhweek wn
WNE the be C Rorrt.rathnotthevophob*rt
1 The nophbtast prollfsratesand d~ffennttater
Into two cell layers
a. The CyMtmphoblast e the nngle-celledlayer adjacent to the
mbrynblaR
b The rynntiotmphoblan 1s a thick outer layer that lacks tell
boundartas and grow !"to the endomemal rtroma
 hsure8.1 BbVxptai 10 d a ~
"")a,
0. trt.E+lhcmml rimlation '"*,- 5 -. w*
I~S&IV' Jrl iiltZW-%amS
1 The trophobialtend extrasrabryonlc romat#cmewderm Im
c o m p e the chorion
2. Tmphab*Ltrr w o u ~d , rr19ternal b M allowr b1wd to f
from rlnuroidr (enlarged, congested cap~llaries
of the endomstul
tnto me iacunar or intervillous oaces that haw formed ~n
embryonic ryncytiotrophoblart When th~soccurs, the prmH
uteroplacemal clrmbt~onis erteblished.
C C h ~ u v i *
1. The expanded extraembryonc coelom forms the chormn~cravlty
day 13
2. The bllamlnar embiyo, amntw, 8& yolkscam sv&mnM in
cavlty by the connecting stalk, wh~cha a condenratton
emapmbryonc mewdwmthat later develop Into the umbllml co
3 At thlr tune, the W r K pinched off b
y (definitive) YOU( ~s(
the primaiyyolkrac(Flgura8-2)

r- mrrwm c = w r . n p w r m - - --
W ;6 &wW6~,rd
Wl@
,l "1Y.l- Cd-Ip*?r, ---,
I .a,L+ ,- i* A< \inom*s~t;iZ rrn
z-, vfit
,LC * &.- *r .- 6w1F&@~a-3iv7kh+ rt
. .-
-r 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 aand l
rnmbwws, + ~ e l ~ mgure 9-1) MlgraUngmerodermalmils
not -ate 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
d
bay 16. & a t this Om, cells of the prlmlwe streak mlgrate rosually
form the tube-like notochordal prDce%
I
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
r form rhoMnk viiii durlng the thtrd week of
The chorbn M e r a t ~ a t s M
devalopnent Figure S2)

1 A Rimmy dl a n formed .*am& of cytotrophobiancells migrate into

the Irregularprocessesofthe syncytiallayer.
a _
r.
NBDE 1. ANATOMICSCIENCES
6

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

4 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

.
Modmrul-.
MenowryzCwn
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
PI-, appear m the ~9phallcregion ofthe emhryo
1, T k rmc pl- mnvwuutsr to form the Imc verrde, which g m rhm

.
Vhwann&&
AdrMalmeduNa
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*of-
C 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~cmesoderm becoms.
dlffwewiated Into thne dintnn reglons hrud.1 m e s d ~ mforms 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 20,the pareual maoderm asrue bqins dlv~rion,"to
vgmemal block or rorniOl.the Rrrt pslr of uvnlter a f q ~ a rin t k
catwid wgum. suhaeqwnt WIN appear m a man-I wu~lcs,
ap+vonnwteiy three pa dw tmtd 4 2 4 HISare wesent by the anl
ofthefiw3week.
A

W"l*&-M&the-~to W a n d farm
wd*.
a. W W k a rnultofthehea44eId.(hebrammnra~
cranial t o m u &?&genci and septum tranrvanum, nh

sac becomes ~nmrpantedinto the embryo as the fo

CaVfYWl+SiutOthEmkleutviathsa&~~inte
k b~rdnala m o r l y by the buccophacyngeal

buCcwbarghp8.l m e d a m ruptures otthccnd af ME thl

W+ ta wUbli%hcommunkatzon betwan me amnbtk cavl
Md the pmrkbegutFigure 103).
b. nil fold 4s a qwll of ths tall ford, the pmxinul pan o f t
aNantois 6 mn&.a~ h doaca. rhe distal pan of
into t
atlanmk mlimIn ths InllMlng silt whlch ?a% at the e
ofmefDurthweef&theyo&ucrta~mfamth+umt,U~

I
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

yollr***-Lmg-dllfVhkhevcmud
th umb~lrclllcord.
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 npwti01~
lc of the all
vltelltne duu. DMlvaUrw also-inc$dr t b epl$beltdllini
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 Feglmern&MPdtdopmt

2. llllqRtllinnekm
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 ~UIK S , PCM.
WINbrq, WlS
r Antibe+ tranaWrrion la whrch the fstr. wUlrer paternal
.,. tr. antlbndtar rxura. Uw f e u otnpinr p i v e ~nsnunltyage
some ruh s dlphtherla w but
8. raniair fluid. The *mniotc caw IS filled with fluid d M fro1
memm~lMwd and, m laa pmgnmq. fetal unne Amntctlc fI
rapidly tumd ovar via the placental membrane Reginnlng in th
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
t may~bs ured to
e diagnae
sh
Hmrrilfmbmwka
D. U m W d .I AIm
the embor d
develops, . into
it bulges mnlotil
ty nd Ir curhroned by tb amniotk fturd ~ r a M of
h the ambryo I
aparrrion sfthe emn&U cavity and the oblrteration ofthe Wme
onk coebm. As 8 re*dt the amnm md ham fw, w k ma
rM~nd~~chManr~~m~theumbli~caicord.
1. Tka un W d cord initgthlc.m%atm gha v i t e h -1% a111
u&t raph. mnnnim of tbe & u h c cavity, momnchy
Mk IwMJ, is rirh inglpwsam~~~~plycam
hr b ~ & and d
!
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 : ANATOMICSCIENCES
f
A. In-m. The d~aphragmr e c e b innervation fmm the t h i i
and Rfh oniul sag- of the rp~nalcord With the
diaphragm to the 11
- of the flm lumbar vertsbra, ttfe
l n n bmgShem
f p i RgQ p mvrarlar ehnmntr of the dbaphr
wad by intermdal nwva. HMNevw, the bulk of bbaphr
msiwr la motor ruppiy via th &rank mews.

a P.rfunliv&tomal -Is, The thoracK and par~tonealcavities ere i

t~allycontlnwur vla plnd pencardiqwrmeal unalr on erther a&
the forwut.
B PlwmpIurdirlnmmbwWs. L u g buds gmw Intothe a ~ l and
5

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~cnerve) 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
hr*-
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~osupplyingthe lntstlnal tract.
1 DON1mC1001bMum is the mwntery of the stomach regton
a wring the fourth mek. c W appear in the mnanteryd o ~tol
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~nrcsn
~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
,3
~nofthef&esndnsdLEad,dhMIbownerannlnarveanb
mPMM+T.
A H n t pluryng.sl(eIn) a&
RmmnbRtlut hcnrmr "pha-I'
and ?na&Wman tbsame thng 1MIaamww
KwmayseemCCRm 'hxhh/"ured a Musks of marttcatum. ternpalls marmer, and pterygd
msomerw*lvW 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(hyoicR-
1. M w ) . t u n
a. M u v k of h a i eylreufon. orMwlsrls orb end occuli, p
wmcutmls buccmnor. ~ceipttofmntalk
b. S W l w
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~aimVII)
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
ntk and travel mtht t h w to He M the d o ~ l

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
i s ? r o i n t t i e ~ m m .
a
"--'c. %,w#tot~h md2kp emem pweriw part of
t-mh denwiw, we i n m a t e d by the
IWII..
d Thannerul~dmttongueis~~bytlie
rwirr
3. Tapmdk maiiiy derivt'dfrom adpW smites

9
D 3.h
1 DnM laminil. Teeth develop fmm omh& m
igr 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
w h ~ hpmducewnmtum
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~mit may be m m d extermallybythe thymgl-l 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 Rp
2 CWi p b s uwally as%x~aied wlth cleft upper lip k is due toms
faweoftb palabno shelver to f u ~

.
€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~r w ~ C I ~ lSyi .m bMeavd mmmal aw

marlly to Mndb+meim during wgennn. S m nlrornia a

monaMnv .(e ul chhmorome, an wmc&A with hfe
an iutoromeq u n t W y fatal.
I. ~ z r ~ ~
a. In some u u 5 , the utrs rhr~mororne21 Lr tnn
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~zedbv ner~trtxmail taste%
tkns-rmw.
b Withm tha nudeus a anWy ria111ingreston, or Im
bun&l'h pnreha of tM r e x d m M i n k du.

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 shm muwe.
neck, lymphedema of the ewemitses, skeletal deface.
retardation, and ongenital haan defects
 URQlly due ta ChrOmasmlml

pnhn, of the & m a m e Is

*.uidndmt-tha

of thranorwner thn ere

mpie d this &orrnaltty a
~lts an the X thmmmrne I
. .
Mew-
murat$&s~e.bnomt.l~~rrontheX
@ r e d m males anamaller
-.

FA^
lsuo rpntr en -0% the @Cental kamer end Pter the faal
 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 ~
k WIIY a~pt0m.t~.

e*lbll ammdles, vh& i n c W

a. Mutr&WIaly,hplfhydrocaphaluhmntal mtar&tsm, and
uwush8
b. Chcalotghlthand mu&%halmla
c m b
3 Mven rlmp*x virus can be acqu~redby the fetus a€ binh if
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
elr of rad-Mion a not definitiw. dasr of r d a t ~ e n
o

-
atomk fanout are known to be Ctatogenk. Ancmnlior I
defccq. brcW dskrtS W M b'fida m i w d w i y , mmal
c i d t palate. and mutewns on germ cefk which lead to
anomalla in Mungenerahorn

1 Umholrxporuretoa~canrewk~nhrm
srrociatal wlth a number of f&ldofed%lncl
tlon. abnormal bra~ndevelopment and CNS
abnormak~a,faclal morphisrn, and jomt defects
2 Th3idO(nkkba~~1thatmvred~byp~gnnt
In 1960-$962 until t t war withdrawn from the market I
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 _Ib(Nydb*exposure rervk In teeth and skeletal abnondttm
Uposure can r n u i t in ear. bran, and hean malfoma.

erpaurecanouwsmybJlv.mhan..
NBDE 1: ANATOMICSCIENCES
1
c 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
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
&thpW hyer nmmthe bsqamem membrane.
a S m lqwmau .p(theliurn umsW of muitple Ihyers of
and a w r k e I w r of flattenad rquamoua cDtk
s m m emh& are m IU~utedfol (1) Svatifkd squarovr kwatln~zingepitheltum ocwm in th.
hmmmofaProrptMdrecrehoo dtrmn of the skm.
dmm h a r e lwlh#. 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)

G*ndufu .plth.#1-of angle cells or gmupr of ceUr rpecis

pan$hmQ~acwsifw*uomn*Ua,theyreqnr
duct system) or endacnne (I.=,they secrete ,"to the blood
Exoolmg*nch a n generallyclsrwfied on the hrsk of the fall-
.-f
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
the ep~thalium(eg, surface mum- celk of stomach) or a
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~thtubuk
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~ma menlbfans of the

mKhurrm by Mlchboth UH1 M n t o r y

and 8 pattidm uf the ydul ssetwy crtl qtaplawn are

rnaih.n(kn by Mkh66th cells nd

mu& tuma.6fiular d-th

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

midtKfounU at the apinr of celk lhntng

d&a 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
d aka -Wad a m
mi layers of th$eplderma There dand
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 Iwk
4dense rmguhr conrmUvetiINe.
TEGUMENT I
 1 Scunoy plrtionr consst of perqherally lmetcd, fla((enod
that resemble basal kuattmqies W a r d the center of
enlarged dtffinntbatsd celk ateengwgd wtth 11p1d. Dwth
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 Gw
occwr at puberty
D H.ln are long, flkmsntaur pccWfions c M u R ~ n gof dead kwm
~IrplkEechWr&rhreslromanqndmnrli
the hab Mo*igz ahich porraaur a term~nalhair In&,
misar -14. from which the har haf3s r m
murck W e uUed anrc~orpili muscles. am attochd
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% Ik.hals are a mcdHied stratum corneum of the ep
mntaln hard h r t l n that forms In a manner s~rnilarto the
hair. Cells cMIinuaflyprdtterate and keratinla tmm the matun
of the r d matrix
..
lype 111
MalormmponemdW@m
Can m-polmemewrthOmer4aa-of
mumen
FO& in smooth r n d a m hn:
rpken,kdnex and lw
!%&
m b a d bmma o f h m t
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 to
2 WWmtdm an of proten
In mrw to ~ozwgtjmnsthe pmwn
~ t h e ~ a b u a d a m
s; SHsral slrcopmtnm have barn ~ d a n V fthat
i are mpo
iim b d m g of wils tothe &mceunr)IiIwm.
h MwuncUn. wludr r rynthsvnd by fbi ob(mr, 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(n5damainsfm ulb cotlag4 k-spann, and fib

A M u i t mnnetivrtluusr
1 CPnneaY8~pDp.r
8 l.ocae cptnra(ntiruu 1s Wnpoxed of few fiberr, an a
ground wbrtlmo. and a variety ofninknt cells as mll

mourfarua, miim lamina Wp?aoforgam,and in

b D.M.-thnr
(~~Durunpulncmnreth.~kmmpodad
d thW mUa#en fiban with scat gmund w
It 1s .blc to withstand stress in a defmte
hund In IIgamRHs, t
a
Denm lnvgular

the bone.
2 Mtiabr 9 ~ 1 1 w u h !d a sp.EiaI1c-w c D W d i v e tw
tnnm
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


C. orgmiutlon of bone rim
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
m n r q u e m ~ I d I n sthatkadsm
, tfte
ueamd m or unmwrebone
PeoprP wfknng fwn f w t 5 are P=
-*
E. or@mk&W~fbn(lbonn
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 In the form of hydmxyapatite Calc#umcart
R&&, magnwm, and rodfiman a h pleulm
1. hmatun bone (I e , nonlamsllar, bundle, woven) s nr
bone tlswe w t h laoully ~ n w l x e dcollagen 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
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 Im
the Nl~ndr~cai ahom
c chrumhrmiel bmellm a n parallel lamellar awa
bone Wue wmwndfng the of(cw.on the outer
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 mi- a outer, mostly fib.
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 in-
brwr trabecuiae of bone tisue ~n the form of a port
f~lledwithmrmw
2. Comaact (dense) bone consist^ of numerous astear
lamelhe, and dmmrhrennal lamella+.
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.

t h n &a, w M s located sn dlrrLbaphyrir sf long

tion center hypartmphy. resorb some of the organic ma

m P r u n a d w M n b ~ ~ a a l a f i aaNL&p
d
tKn4tha&dtheInneflsyar&pa~m
~ m oOMoMam Ti14pa(mondnum rraQlruUEdhe
mm - -
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-
, 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
:lam rate In tlutva-at plna of a lonq ban.
 a A t them 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~tydiem* nrultrfmn mnl
We.
#&Ware defineda thd erlkulation between two boner
Qwsof c0nn-e ttweidnu
I. w a r e joints that permit very I I W or
~ M

&f dsnre e o n n ~ l v eDSW. 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 ti-.
tywoikt bfwndmt h e ~ o f t h e p d v l t r k u l l
~oinewher.bonrnr am wited by combma
d. S m p h p s ~ m
hyallnemd flbrorsrtllaae gc spp+@ pubpuba and mte
-a=*nrmshyw.
Z Wrr*rouraQlmrWmRrrm~Theyanp
~Wd0nd~bo~rudro~threlbDnrend)mse.

twBf )Owbonas. 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~alcelk
b The uprub encloses the artlcuk cavity. w h l h a f~llsdw
hyalurank ad&lch smovinl Ruld:thr ftuM factlitatathe dM
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 prowdma wiachmtam
h i m ndgxrlreroaan~umfwrmthe *elam 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 nconsiN of flat

Mtth N$ m a i n mmbrhaw until

.(R.iiOlPMMIle, wlmre the two

mmuanu
im 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$%cal~ D d e r m J
ridgrcowlng, filch exem an tnductivr hfhmee dver the
*
2 Borr farn*rtlon occurs by asiflation d hyallnlr wrt~lage
models
a. Thaprmnbeeimatthaandd~embryonlcpricdmth.W
~ryolrifiunionce~whKharelootedhthesh.Yft,or~
y.k. of the i h g boncr At thr .piphy#s%or bow e x t r e m i t i
orrjftmion begtmrhwtiya*a birth
 b HWm-
a The mrf& md HnrlniKmusk of tongue ere tho
bcdduwlirum ompi(almyotomesthatm$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 tphawweal
mhtahthehmmwadonbythem~ofthait&of
4 UnBnr\rrru*(vnwigmeter in fhernrrnthwaekfmm urm
dam thst mlgretas mto %helimb bud. W a tlm the lnrb m
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 I d e t which thelimb arise.

B. Sn)od(liW&&e 8mmh mu& coats of the gut traclm%

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

\ C L I N K A L CO.*EtATF
Theanf9rirxfwtamUe ol%ft$aC'
3 ThelmMddrukn~~theparMalardtheocd~

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
l k l p d ~ t k w t y b o n e thehumm
~n
bdy met 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@ the 6rachul P-I %rmiwkdude tho
andwpfesnp&mVW** -
C r r u i c n ~C O R R E L A T E
+W
F l,+?
-l =3 ) l l m ~ w l n p a a ~ M b l t o h h

wn(loMwnasiuautuzrcus~
-4 mat cmwrthm nanodefdonwtoid muscle
IIWRrnaybeawgnofkaTtaJure 2 A m & tdmn~h o bwosw mS ~ r d ~ ) I d o m
Ibhenaccmp3nred&aril.m~ mldlinc of the ~ d n d t h r I n k t i o rbordn o
p e w r e m ckesuperh~maG B andm
~
srbusrigAnmydko&asiplof w + ~ c
cdxtnam*&w-&

Bnroor TO CARBIOV*S<U<AR

a f a W I h w & a ~ @ =wtcbral
, b e
IntyruI and eternal a$uoM arteries The
aftery ha8 six lxandm&e7&a LOT thy
: f m w b ~ ~ w m ~ f & s b h e mg pharyn-I, the bpi, the fadal, the OECIPI*~
WuuhaePrthelamv~rn -mi aur$cularanenerbes). T h e aupply structur
! meeasmkbbodpmweMscaa1
neck snd f.g (Flpwe 19-4)
smrin8ubrrharn&ofmRe

-
~ ~ m n v g s d & ~ ~ P) Vva~urnerve (n(X)
(4) HyWglorUl n em (03 X1D
(5) lntrmal and external laryngeal brvrrka of th
wl branch of the wag& n w c The interndl
mw Jnf- from the hwee
thm level of the voral fold$ and U?e emrnal
I
\
'r
NBDE 1: AN~TOMIC
SCIENCES

CLINICAL CORRELATE

me recurrent I a v p d m a r e wl-
nerabk dunng thymd surge~YI f one of
ksemn&m&
hemmwbec~,rewmngin
thpqwWaf
2 Phnnk rulv* s a branch of the wwl plexus.
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!

I 4.

D mdasdrnrmdr

upreston, whhdr has mlgnrpd(othen&.

2 up inwnnp -f rurmund. tke 09erim and rtarn
C L I N I W L CORRELATI
toid m W e %

:=%rerpomtipmrtum
*pMOnfral=

armbioMtreabnenthaujethe~f 4 f W u*an the prevaItobrJ mu*

are ,relrVavlrarBr Tmbnent lha%-
Ible@?&vmWmeedabIIJhmmtof
cxlern61dre1MgeoflheaWaw
,mdsm,rn, rnfRHM on mWefare parr
nto medlassnum, @en*!@ r e ~ h
rn a fatal pencdrdrm
IMlQusc~lll,Wusc*f&) Thls taw ~ 0 n r5t t o a
as theallllfpuh.li
~ hr (.~ 1 (arrlrgmnpa
~ .nd~ h . kh)nwatlon.. A dmpk
orgm~H%$tfwftpmuxtroftheRecChbasdonMlobalcpr
~ h musrlr
s may be amnged fn gtoupl, acchnling t~ t h l r
Pnd (1) PU I))UYI~I in a group &are a commm innewatlon
axmptlanin each group

IN A NUTSHELL
1 6es%@1: M&Srthe teiwm.Nl mntr~wmuylw~ls
&the eanmc m u x l a 0 e. t h w c9At.iRInsthC (UtflX
Hmdrpnxy,lmlMtkn th( tongue an wppliad bY CN XIS % O M C K C W t I M 4
dxn
Ibnpn'
%F-
-
ws, whkh nruppWbvCN X.
~ay": Rwnent CMothW 2 W O U ~1:Muscles Of OD larynx. All but one of the intrlnric m
2x2 &%, fbmml the larynx ate ruppllec)%the recunertt laqngeal
vagu new. lhe sek excapti~lIs the ~ic-id m
w ruppllet! by ihc external la1ynge8lbran&& the nw
phmnr CNXand stylrphuyn
CNX~ ~ ( O Y U O 3 trnup3: ~ u x b of
r th.p h s y m ~
AU but 6na of the ions
sefllwla- CNXand 76mwuck cimuhrau- of thc pixalyaxam&M by CNI ~ ~ n d ~ d
ma pesm
1cNVJ p e r H M d ' ~ ~ & * u r p t u g l l a ~ ~ ~
Hlk.h+ -cmrC& 7h+& IUpdled by CN U(. 7
of& @mdofcl) * - * ~ d t h . * ~ 1 ~ 1 b l l ( o n . 0 f t h . ~ d
phs1D (Cl,
Q 0) 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- 5: lntnkyotd a&. All but on4 ef (h. i n h r h w W
an supplied by the anla ceNWlk of Me cnvl@l plem%61.
-May

abdwabbmluda.

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

-t~.thra~ml4ptofthm~rhrth.
c. lntMlorly, the fkee boldw&the tjteinai ohl~qwa(w
m s the hpuuul Ilgm*nt..
d. T ~ u ~ ~ hguiwl'dng
~ W R I I S M~.pning
in th.
a ~ ~ 9 ~ w p sktar&thapubic r i a ~
a. I" men, this *ya ~ ~ ~ W I W ~ DaI ~~u~rIoJrO
ir)
-
2, h#rr*lebliqu
r n ~ ~ brun
- - .**
.nOHNlrp3il(iP*tharpeWcwd
.a .-
a ~r i o r l y ~ d ~ rmittargterm
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. Ihnmaur- , 8
a Thr m u d . fibrq run horif~f@lly.Al ths fibers pas
thw mmbute tp MemcWstmth
h. Inferl@rIy.th. flkn IqIn wth thw of the intprnai oM
form the eDnlolMtenden,
4 . l o . c h r ~ k
a Tlm fiben run vertiuil~between the pub6 symphysis&
*apr-.
b The nght and Iefl ratl muscle5 ara qparated medal&
lima alb.
 *ku formed@ 4-Rbno- h a 1

reMunnfdklXaruior&blder many of the

rt*iCI+*-.andawVmrIrr
thoraxend the lnhriuremernny.
rwMcnRlthroughL4
--
2. The praar major a r l m from the w a n m e pr-
vertebrae
a I m o n , along wth lliacuh I5 on the I
 NorE
b Ciwld. ir an %+a+ bone, wh~charticulatesW h
meclaMdehtheflmtbonemc&~n wn of the sternum madially Brrd with the wmmion
feral fife anda the mart fmqmnt+yfrac-
mled bane ,n the tady

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 tu- 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 mrupplEs,
'skWwqaandrninor
+)MsdblMidof

- W b f btsehkiicutsh~ur
~nedtsnncm
2) Uhw nerve

llpaofthehunm6ishld~th.sleheidfopubyI
*nLimuckSwla**.

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

artlwl.ting with the headof theradhs.

d ~ . n d l ~ ~ a n r u ~
t h e d w l h u m a n d gnn rlreto the m w l a of
., NEMONIC

Wnha m ~ n a c u f f r r theprtchw
,
Won me benh swmwmtus infra
~leRImuwrnrbrapulsm
 *nMor(Auor)ceawmmHUmmm 4
awmles 4
d IWU m w i e a r m Wm
(1) The (~wbfwWYbrb
mMpmna

3. POR.

er
face of the humerus.
b. lmaPtion 1Pu Wac heads of the Wluw are suppli.L(
r a M wns.
4 The wbhd fom k a Vmngqhr m a antprior to the e l h .

I of thr cubit& f o m n formed by deep facia and @

epaWaW%&lcb (r p v t o f ths inlenien Of Nn

I contentr~twbblfbs@indude thefdiowing
a. RI. n;;citn ~ b l t l l v * is a ND&I*Iwin. which
betwen the b@k and cephalic w i m ll iks supsM
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 -&the

4
the radius around the ulna @a,&&Ion and pronation).
C. mr
nk the pottion of tk rrplj.r Iimb,bmwen the aibw,
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 the fsnum into en
(enulraiiaarprtnmnpndaWrrftria(portniepa~pvbnnt

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

tab f~benh m Y. U, and l + i pxiulal n

hnwalw 4 W a long- branch, the

Whlchruppireg tha kny laiat and the rk

I ctrcumfkx, and the b M I l

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

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
s
f9wJ,& Wl W Y r a

9roMsln;thed s f ma f w a

cause m ~ pmmd
7 m
~ mnwge
~ 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 KIm
s ds

uhle. IMtho thigh the leg h encased in n

the owal fmda The two m n a of Me leg.

men*.
1. OdCdqbr (FigurelS-$3)
mnddrrnmwma.omarPmur
~olrnfccbm ThblWdthd~mav a. The antgrtor surfkc of Me ubla 1s davdid
Lk~~eanpreaummmOhep &mem aRd is palmblp thmugheut b ten!&
o e d m and mC annrbLW1 tkdiad.r end of tk fibla a r t k d a t ~h h the &Q
rilbcyYneous pmkrdron. IIUd i l malIeoU
b. n d t a ir covered thmuglrwt its l&h & &us& it
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 tn the cmwn and

2 EnMI.1 Fr the hardest rubrtancsaf the body. Mlng app

9 7 ~ l ~ f m i ur
aa by wsi8~.
m

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 ~

b. Dn fbt &atside, $16 fibers are BW

in fh.
CLINICALCORRELATE

&w&mQ!-w~a . ~ uluitbom.
t b e t y p i c d . l ~ m e l i a r p of
i%$~ FatrelcolsSa,renewal afmphyof 7. 6ingk-a (gum] Ira mucous mambfanu fimW(o
the-*RYIe%mwthen
-hinmeirIDcYwandfdl Qwf&?qcsprMm 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
BRIDGETO PHYSIOLOGY
Acd~rn!&esaChawm
anmrw~wmW1
drarcam&onFdrbon dw&&andmtar
m~rmocer*lrbwmM-la>
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

'$1
,
wtthanemiar~neermem~
fundlon
r W ?

-7

&& -1 5

Norr
I . >.
W I
K .
A. MurqmL ".
1 G w Uu murakl of ths mall lmemne has s
Plkadrarmarammtduumof
me~~unwn

ifwriiza.

- ClrNlcar Conrirrrr +

tG A* acids, m m m f f h a m s end fatty

w t e mmerals,
~
wear nmwiiamr -
and elearolytes emer fhe
+

(2f bWdogCperM~a M i t a n y a t W e r e tv
~
' 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 wol~IIMI per mi

tlstc$eeik in the lowor half oftha gfands

3 Tlm bmine propria 6 rich In lymphoid all%and lymph n
1A4ua,try mto ~ ~LUI~OIQ.
4.~ubarva~v
wnmk many mph nodub, wimh am s p ~ y
in UwlQPendix.

W m e l layer Is dlfferem from Ih.tIn th

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 1s composed of plates of cells arranged
arwnd a central vein Between the plater are radlal blo
ads.
b. A t the per~pheryo f the Iobuler, branches o f the po
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~ullor form a free rurfa
mlcrov~lltexpared to the pennnusotdalspace of Dl-.

granulesthat are clusterednear the SER

c Then am several hundred mltachondr~aper IkwM

thrombin, f~brlnogcn), secretes bile, rtorer lbpldr and

matic pro- of 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 Whgun ZDJ).

u r n M l r rapJdly unda wme diwmnanccr As

M 9 o W can be rephaxiIn abaIRtwesk~
hSoces and contentrater bile tt Is a distemlble pear-
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~iemrrc-
twemafmaypreuenttksFm~dof
-1 d m thepemMealcaeby
~offioi!am&amseg.an
~ ~ t h a t ~ p b w t m
4 -
a F.*iknn attaches
anddwlqsth?lluar~at(ca~
tum suqa w~thinWm Wfot
omenturn a a four
f r m the greater runaturno
veqecotan.

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 1
~MoksdrsopMpallbronchofthe 4
rfrg a m W~ R w h d d~
anro the m a era Yncs thr
~wnraresmaUandaremd
meanthwd, -heavymR-mqmsy
bnae venmse and NpNre llm )weuc-
esrb+psmtrowmnmpoos-ts j
stal
ern
 posterlw branches of the ilnwdk (I-)
s ~ rupplie.
ecum, and the e p p e ~ l ntery

drain to the supenor

IVuqkoftlNmondc

lcplew. , ,

the lnferbr maen-

 1. The #bdomkbf p9rtlon at the

8. s+smuh
i. n i e ;twhas a -I cwqura, which 4 mn
hepath of the F i r & tfta I w r 0nKntua. Md
from wMch tho water omentwnk Npndd.
2. Thc canl*r raa1VwhVasua
3 The domahnped uppa?pMN& of of h
te
o
r
tmm WW
a
*fiu*i**ir. at& Wr

rlor lnkttnal portal; the remalndsr of the duodanum Ir

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

2 men w ha two surf.cn a superior, d i l d u e

4 ~ u h c s r a t a a f . gwun21*.
 Balml&ikr hub the rlpht BD. p16p1r. tho

g s w rrhkh I$+he rfght free bard

liar in a faaY on fhe WCRl surface of the linr to

chaawmnrlsbr,

d v d ~ m s ~ ~ d u d t o f o r m ~
NBDE I : ANATOMKSCIENCES
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~aterto form, I" a cephalaauda
bvlbvr mrdii, primitive mwide, primitive.Vlum, and rl
1. The aonlr arther connect the truncur to the paired do
whuch an* from the aorta<sx and lie doMbtoralro
2. Tbadimd @Mianof the bulbus, the bu

right aw4m end the mmnay SMI I

1 The aonk arth arteriea arbduring the fourth wnfr *din

PGthe mmt dMal part oftile huncurnrkrl-
2 Each of t
bsix pain of artprlea 1% ambedded In the
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
wh~Jlsupply derrvatl
geal arch
3 Third .omk arch. it giver riw to the -mar umtM a
flnt p n af the lntemrlcamdd ~ I (the Y tem.Ihda
the crsnlal portlon of the dam1 aorta), the external
branches hwn011s uch
4. k r t h .ortic arch. The left s~defarm put of the
imtween thP left common c a m ~ dand left w k l a
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~ftf* Wt
4. @sad m tha a- travals to the placenta "la th2 t!n3t#.
w~anwi~i~frmtly?lntgrmli/&argrief
I at c ~ a t l aof, p!dnn*.l bid flow dY
In6aPrkrfkrhmueethr~
to~y~,~ktha~Rth+Isft:
,Mapaed ts tho ueslrnw41- wrt-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 malfydue to mslfo

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 aand p & n w a i y a ~ .

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 con- W 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 ~ o m ~ d l
conneaiw tissue layer. An internal dastic msmbl
Lmundary b s m the intima and media.
k utmg t h ~ kIn hnyt lrrtuiggld of

*Ysml&tMMafuauefli.
rcnalkiq@br b d p d &ion oi <or-
i+e al.pr +&en w p as?@€@& fdKo-
have thstr own blood W y >Opyr vlro
Ilvenak that brar&pmfu+ m ths walk
 Wd In times where rap16 ~Mtamehitsfchange omwr (e
r i a , ndaaaa plamk).

les (up toe pm), anihit i&ubr h

n
latc
a-rn
o
. pmflk,
Nwr patht ard often lack a C a M n u haul
~ lamlm. Ce
mic XtTVftj (mwopages) are present mthln, M Junsu
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
edm hast and smlllng.

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 LAR

um wins Although a nehvork of elastic fiben may o ~ u ar(

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
ar&ctampMlde n a a&m4atM!ng Middle m@d*rtlnum. This section contains the parlcardium,
~ ~ n g a ~ o f C and l p r t
m nemh
m d u e man m m u l a m of exm
1 Perlurdlum Is the outer fibrous sag ~tIS a double-laye
Rudrn thepengriiiicavify The fknl
~nar&rwrovedbyww&cm%% mnnbnne that enclow the pwlurdlal cavlty beween m
mrdLeYPfhe~ 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 m o r supply of the diaphra$m and w
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 ~ ~ sI r (W
l
It dmim4ha tmsterior intercoMld n r of the th&
ponniorakcbnbl wail.
2. The& valns lie %qrfkbI to thc c0,rrespmJing
nnslblower&uursnlnuacriarth.?ambh~~
to mmttm infaw ornM w a .

Wtatul*
4.' d W M W y uf me infedor
fofhcl6ftr'&lUr(nJ
5. 7lmIUklurnbq drahthep04~oriibdominalwall.
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 ~(dtcriormclbah,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+Wm- -
3. ~lrtolsxps&onrof tarmlnal brwKhiolerfom a m .

pat*~ ~ p ~ ~ t SukM* & n.r

a W that
t b vilq%llltlsn. surfactant overromr
eluedidtlwspnvmathabcdrsWrwhcnthe
n nptrudby alr.
 I
item Is divided Into a conducting p o d lnrMl cavity.
% 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 wrtm

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 epithdltanbtmna pmdsUtdCIfled, diu*

umMr Mh &S mlk ~~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~zedand In
C Olfactory M. s located rvpar~orlyand patntorly In wch
Cavltles
The -for elk in the olfacfwvmm
way are the oIfactoryep,theI#al&Is 1 The puudortfatiflnl epithellurn Is composed of btpola
thwhes T k basal d b are sfem cellr 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~solvorodorous 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~nllarto that of Wm nas8t
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 & tlw
dlrdctiyonthe pariastetdmof the bone
3 The 611s beat towards the oropharynx, whlch Is compsed of
fled, quamow. nonkerahnlzedepithd~um
4. ?kphwngedtonsil, an aggregate of Aodular and 6-
Narr K thrul !a lootsd an the porntior wall of the
urn to the ep~thel~um.
Hypenrophy of thktl
7ko1,aateo d b ' oka bear a n d p o M ~cinflammationrasula m a condrtion k n e w
I me m v c f l m g md w 1 6 - m aawayr
~
bv o m l n m m
W mrhler and ~ c r e - 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~umof the ventral stde of the eplplCttls and 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 ys-~aRItrp glan

thatpdak$pmnn the m & r

srmp

typw @mhiolar ep~thdi

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
l and pm-
r thin surface for gas exchange. This rlmple rquarnour
h so thln (-25 nm) that & detalk are beyond the rare-

are 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 wr-
mng 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 rur-

A delicate connectivetisue layer of collagen and

pleural membranes. it zontalnr no

On*hdW*.kkg., In plwF.r we6-
m 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 1s conveyed tothe CNS
er ofVl andV2
2. *vmnnnic inMmlion. Weganglionic Panrympathetfc
tined to Npptytha gtandsotthe ~ r amucma l and
travel In the r*rvur l n m m r d ~ umd the grea
-by molar tscm pmn& wa9 krm branch= of the facial nerve (CN Vii). These
tkm~rinur~emrrethaeteetn
d n d t h e ~ ~ a m ~
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 ww. The anWw wall of the
larynx fhe pharyngeal wall ronrrrtr of

l @ m ~ ~ @Wate~hayngBuLWngaPMhOe
,
~XulWreylrOr,r u m mi&, hlfetlwmnrtrlitu

0. &Wav is the rWbn Of lhs phaWW lqC&

We nzsfl cavity, I t cqmmrrnlsags with the nasal
W ~(4.e. C 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 fa- a
'ddmulcle, M M t W
1 Tha rnMbr pillar of tha fauces, also known as the pa
f a~iwtha@ampI~mulcI%
2. ThepDIterkrplLrofthefwer.ako k n a w n a t l h $ a
gee1fold, mnLainr fh.pllltophatyngnn muscle
3 The mnular b.d ir the SPM. &tween the plllarr th
PJ.tlnm WI.
I
Norr
 RESPIRATOR

Flrsnemcx ro E M ~ R Y O L O G Y
ry artnicr aria from the pulmanantwnk
Runmngbenveen the khpulmonary
deliver deoxygenatad blood to the lungs ~andtheaorersafibrwsmrd
ade of the h w , cam t?e igamnturn anenosum It a a
himr
i
e s supply fhe bronchi and nonrr&ratay portiom of
mnanr of& fetal ~ U C Mm m u s
whrdrp~ashuntforbkdfrom
are usually br- of tha mwxk aora the &t mt& of the feu heart@
bypan the lungr

puhMnyr d m : nq*rior rigM and Wt a d lnfrnor

left Futmcnary velns cany oxyae~talblood to the left

from there.dramage n to

ph irunk drbh to the rlgM lyrnphatlcdrrct

hasa bmnd\amnrKlirr etlect.

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

upma the bi.m s diaW.into three primary wskk %ha1)161
pph.lon. the nuraaphllon.8nd the pnaaophblm -3

2. Themnsorn-n k tha mdbrbn.

3. The pmrenrephalon, or forebra~n,d~fferentiatwto form ths-
cephalon and the telencephalon (Figure 29-2)
-
NEURAL 1w&.w , >
n-*,*< i - .
, IX and x
of cranisl M ~ V WL
Priphsal Mwauelynern
NBDE 1 : ANATOMICSCIEWCI
6
 b h I noi contain Nlrrl substance
W be UMnyeliMad or InyeliMnl depending upon the type
l~~rovldebvdtheir ruwortmno cells

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 Mm neu-

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 sd -we
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 30-5swhencal or owdd m u r e t
that tamaln neutotlanmmn te g., ~ 1 h m ; ~ Z h Ni .
IS released Into the wnsptc deft at t& iyhspu wMn y
f-wh s)praynaptkrnemb.
f. fkuroirarnmitten may elthbr ex& (depolaifre) or Inh&R

~ - tor* whichit binus. .

CrlzeY s)twskymptk membrine, &emding on the fyp.

2 Certain neurBtrahynitterr are IMRlvatid In the ryn.pftt

chollncnerase, AChB whlle othen +i%y tht

e#i 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

' .
.
them5
mae~hesonar
spmdpnddIrG"eneuwmMer
khvann Eem myehnan axom rn
them

pard,
- .rn$Y%*+Il7
\t..

. = -
NBCM 1: ANATOMIC
SCIENCES

a. The p f P n n t d aplth.llum h r o m p d of m h r
IN A NUTSHE11
w M l n melmin.
Rods mntam rhoc'qm adare Iqht b. W adornm.are ~elb vdth twepoln. One pole CON
senvtm mer cmram iodomn andare
respons~blefor mkr vtoon
m p c a w i ! h the& In* b i i r IWr.

w*Cm,~the~ibeifMme.

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

udrimbahrod.ndane~lkik.
d. Ths- n W layer is f o r d by the
e The autu pkvifonn b ~h rcompwd

s. -
i*.
. f. Tha l n n r nu- IayuconWns thp nuclei
n b u w a weU u h6lbnt.l cell%amdm
*
#Or€

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

rpptafihe-

tbe mtlna from the v WM y .

I
 %

- r i

IN A N U r s n ~ ~ l
w ~ wavb4tem
d the e w
~ W + w ~ ~ ~ m n
.
'MWk ear+
mr ta bone CMducmn
~ 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 l a n l ~ u ~ f w ~ i n a ~
middlsw -

* .IkmmbnrmusWnfimv)m
; ~ , ~ h W . W K + '
.i brupoahralusournuid
mekhfpnfh mWnapenhh, 2.7h.--Ps-*thr-
-.9abmomAltpkaapkaa
nmroundedbg mph.
, a. ltha,lhnrp*rrr
(0The cochlear 4uCt kcal.1. rnsdim), whl& are
wWl~nthamehtrr,
(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

I
111Thr gkhelium pfaduesr the g l to6W ~
BRIOG
TO~PnvrroLoGr

fha rewtor cdk m tlre mtae

brmr
12) Thstscturrialm e m b r a m ~ t b - hair ah1
B
amw,lBm of tlre m m l a r canals ds b. mew of im m s r y hair n d fhrn RIWI o f c
~as~melnfhemacuheoffheLrm-
XaY M t W .
de a n d w l e are m u ! & fafhe
marntw~~ ofe bodys balancn and 8. WsuW w
n small dlfWrhla~(r a g W !n the wall 6f i k
\ eau,kbnum a
.
.-
-a"
.-A-
u,rz..m

a. tha maculae contain nel

of the vestibular nervb.
 usr Knowl.dge of these rubdiv~sronris important
the basic wganizatton and fvnmons of the ner-

us ryncrn WS) consim of all ganglla. rranlal

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 -St ofparrym-
mnmMlon 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

rtu @nrrovr -
d prwbxtion and
fmm $m sdtenal medulla.
of eplnephrlne and no

comW of neural nructum tht

mu& & r i d horn mbry~lopkromkn. that Ir, molw n

- -
IWX)(gaition =me)an also mmryed to the CNS *a Ulc
vow sp@rnTheromatic n.ry0~1 rF.m IS part of dm WS
ard arschno~dare

IN A NUTSHELL
I K+ wtof the brain
~ n l c m c i d ~ h s l l dndsmc~1lular
m @a
866 KAPLAN ME?
 IN A NUTSHELL
1. M W e ruindla mrlrtof about 10 mdlfled skeletal
Muscle rprndksrrswoo'M the hgth
fandrateofdulngein kngthlofslrektal lntrafwd fiberr) wRhm a mtndle-shapd comuMive t
'i m d e fiberr Gw tendon +s a Both and% of the intrafwal flber an cvmaaed
>, raspMdmmsnn6deLwaiM

ofspindles than thow road qt maw rn

c, TtM mll6tle splpdlaC@wc-mmy(~9an
d Gemma m r neurons of the vmtral

clh%i#dl as either nuder bag w nuclear

7nnhW.W by grimsty a m Iannutwl
ecrbUy M w W r l w v c r w w m).

found nearthejuncHan of m d e and-

they rnontfar muxta atnlon.

aIph8 &of neurom) or daMl roots (mntainlng affe

ddRr)abol~has m& tom h a l e fane k nct an
I N A NUTSHELL
&Weletel muale.
MurckLonekdcpendemuponboM

lk&i4 d the put&of

Mta alpha m o m neur
 I. Muscle rp(ndksmistof aboui 10 nmbf~edrkalnal 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~nalnthant h w und in coarse move

r The hermule splndte isthe seww organfor
a Gamma motor neurons of the uentrai he
lc+d at each p l e of the muscleIpindln

found near tin ~unctlonof muscle and t m h

a. Becam G T O ~rn m n n m in dric; with the
thy monltorrnunk bmton
b. YVhen a muxte ixstmchedpessive1y.them i s an ~ncrarce
awe up m the point a t which the tendon
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 m5m. M w
ref?'S to the tendon p r e ~ qin
t mtlng m w l q Is Iaqely under
mntd A b!nnof ekher the ventral matr (contalnl
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 ounr In
1& at the pale of eah rnurde sphrille m
V& alpha motor rreumra, causingan M a r e I
2. Mwde tone and rrRm MMty sho a n Infl- by ce&m
 SPINAL CORDREGULATIONOF SKELETALI V I U ~ L L L . -
m e e evalwtsd cllntcally by palpation and parslve move
lnlonr and dseaser c a w a decreaseof tone (hypoto-
en cause an mreare m tom (hypenonial

fLfXES

B 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

t id& is the conmNon d*Ngdr (n tb stretch of

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 on the Nursh'Ell
or rpinal cord. The lightly myelmated prcgangl~on~c fiber that rheANShartwo-a-
this cell pams through elther a cranial or ynnal n- ta reach an ~ W ~ h e C M L D ~
 - %q
THEAUTONOMICNERVOUI5%

avWwm~aRPMadb4tdmm
in~RThepamtds~~~redYOVLX

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

rawrtnbral panglla, flbanthat

psto the splnlnd rnrua thmuph gray ram1cbmmunicantmanre
M ~ U N ~ ~ a n t r b o d v ~ w B h '
fljV a m * a w ti- -r p8iWorrl blood wnwls 'Om
P) P~lomotMftbas-rarrgaorpllirnuRlasaf the hair follicle&
blkdoma~tirurn-rlunatgIaMk W m m ' a f e W a t 7 ? 4 2 Gwram
LRwMIXa//kv!sdksympa~4c
CMm
b. csldiac-
(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 e of du upper eydld, fho lurid

#a& 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 l m
rIyBo:
(1) R b tstlu fifth and mthrarrksl n u ~ s
(2) Newesthiparr to thecardIacplexw
r Inf.riorMq.nglia@ive rbew
(tf Fiban to rplnal new C7,C8. and T1
Rf flerw~that w t o t k cardiacptrmr

vertebral ganglia b.,

c W rumnor maenwu.
 mmus~(PNS)FONiRsofallneuralmuQures
In and e
lnet corcl.fWw, tho PNSts c o n w d of 31

g Ths~plaaln e w s hqw 0 a e n t q l orpanMbn

m the presence o t d e r m a t a n ~ ~ sp.clfic raglans
snd

Innewahon dnd C ~ndirpmabbain the dlagnms end

w y ~ r o ~ ~ d ! $ o r d e ~ ~ ) r @wla
~umatt~

ion. whl* q@aim Ww of

ravp tha viwMm1 d lthrough
es are often called mixed nerves
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,G CzWhepyouauvc(becarre
*-the,&F&Wd
 1. ~ w r ) u ( E f t l u ~ l a i ~ i n d & t h e :
a. Dar*lswwkoar. whxh mscsfmm C5 and su
b o l d N IeVdtorrcapuIwm&
b. lqtb(rrric'MM.which arises fmm c5-0 and r
RtUIantenw muscle.
2. BnWm at the trunh
(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 anrim whkh 3
w Ur the
e

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

I N A NUTSHELL maldmda
b. WtebWtaMoUs MN* (C5-G). whlch suppllor
-M n e m (CK7)
& m M e a m r h s n d ~ bqchislk, a d coracObraclUalkmudrr. 8s bra&,
smiy-ban @ mpemamlaterel
farwm WMIMmr.
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 MM ('3and TI), which supplM the
m%jwand minor m u v l n
b. MadUI IWaeJ~hcutaneous
l n w M I 01). which are joi
bktmc4 branchf m m n mey supply the cbn of

tksskln ofthe mMal T o m .

IN A NUTSHELL 6. Ulnrr n m r (from C8 and T l

u W s and tht ulnu portion o

.
UIIIKWW~,~L'
bWmr U l n a r h
mdduaorFdim
' the forearm. in ths hand the
wlfias the 6+ep head of the fl
m d e * the dbmirmd palmar I n W m i , a
Hvpothenarmuscrer
In-
Lumb5ds4andS tln 4fIh dthe Jnar haif dthewrlh pelm,and
SMloy: Ulnarhenofwmf 5. Mlpr ncnesotthe per llmb Include:
m ,& Ttm .
U )I&!(15 n d W, which arises frm the
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), Whcb a r b s from the pDItcr~orm
 OtOr supply a to the triceps, brachforadialls, supmatot,
abductor pollac~rlongur. and the extenor m w b of the mM

ktWy supply a to the skrn of the portenor arm Lpnnrior

btKhlal cutanem nerve), p t e r b r forearm @atenor ant*
bnchi.1 cutaneow new). and the rad~alhall 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 fkx-
QI dlsitonnn pmfundug pmnator qludrrt(y a W w pollnctr
brarls fkmpollkh longr~sadkcvl5 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 x middle fln-
m a n d t h e radial tislf ofth.rhgfinger.
is formed by the ventral miof the upper four lum-
within t h e w meor mqsk
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
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~alarch (I e . murcfer of mane
$ b e ~ yof the d i i s t r r s mybhyoid) Thew SVE fibers
' 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~hlalarch (I e , muuler of faoal exprer
- ,
belty of the dlgastrls styIohyoM) There SVE flben
* + fwlatn"tkur.
fibs&<-
WEwmld~iaIW '; :g;~~hegl~nopharyngealand vagur newever carry SVI
mvwier derived from the fMrd an&&#rtll libRLW
r s j * mFw ba s ofi the
d kynxm a and h p fib
X
d fheqWaccmoljrne~e
shauMcdan4tke ne&

OLFACTORY NERVE (CN f) .

- *J&P
1 I* _
4 W o l h c t a y (Jh am spooallzedm u m that f u n t i c
mmcsUs O b ~ f k t v r P ~ ~
1. one axan wen& peripherally m the a t f m a p r p ~
W FW?&*C IfiY&
~vipkrrPld~~~Mnq%
thin dfaaoty hit&
-%elparoddoun 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!lodnreqi q6no1
aqa flaaua a ~ a up>!qi a q 'au!!p!w
~ aql leau u!e~qp!w aqa 40
~e'auan aqi aneal pue mapnu pa, aqa u6no~qaAj,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>uo aleu~wlaav ! q ~ ' o q g3/r9ol as!, a

-nau J!MqaedwLe~ednuo!l6ueBud ru!e?um a .ma1

(sP!I~
WI)
~ aelq
'Z' i,P
:*yb=$qu .z .

- :aqa apnpu! pa!lddm r a p m u a q l '(auau ruam

hq PaeNauu! r! q21q~)m w d leJaael aq? pue (aNau lealq
papNauu! r! q>!qm) rnhlqo >a!dadnraq) adaxe r a p n u
aqa l o 118 hddns q y m ' w ! i 3 5 3 03 as!, S A ! ~
a1 ' ! a ~ n u
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 wpm the:

w.1ptsnrroMmwtor)
Q~rtvmwni
Bl MYb(Ohy0id
NHdr
(4) W r i o r telly ~f t h e d l p w ~ c
(5) T ~ veilM palatant
2. Main Pgaryaulu is iaatedlvrt h a l to tho mow
nucleus a r mrUa1 contlnuatlon of the 191nai nuJ.wI gf
nal nerue.
NOTE a AfhrUU* The main enroly nucleus receiver the
from cells in the trigeminal ganglton, which conmy

.
ANsemorymhtmn fmm the
pressurerensatlonfrom the face
face-twM
ANsenrruylm&m*Mma b. Effurno Axona f r m cells in the maw sensor/ nuxleur
w t o f t h e W - t VPL wend in the vent1111(anterior) trigeminothabmku&
nata in the WM
3. Splnd WbmLul ndun k a caudal contmuatihnofthe mr
di! frpm the midponrtoUlecaN&lmn1

. hk!"senrorymdpur~fV*

. d m a *
~l~~~~
rar)lof face

teznW&0fface
nudeus of V - t b UbnQ m s fmn cell5 of the spinal mgtmlml
Pmpocep~offace a d acead m the vaml W i ~ ~ i a tnd m kto
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
e*VMImm.
The mcrencephairn& ofCN V e
the on@ example in Mtch the pmmw a. Affmna any p r o p r w p i i n Input from 101mr nW d
s e w cellhmler mide w t h r the CNS 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.
r m e
fiberr synapse monmynaptcalfyon the motor neurons
the anatomiclybsvrnefci myotadcreflew such a the j
c. Mwmlnsl (remllunar, gnu&) gawlihn contains the
lrrfor .1( Meamofthe Wiganllul nnw eupc fm

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.It exits the mil.

.me'aMxnmhwdum of f
kskull
Mdnd~ulwbrMch M)pse
throvehmefo-amoovaccormerwr

fMed'~nnksilyby stww,

mdude W a r &.aa, Radrlpk

M, m m t l r u -0 Iulm
IC d o u w and h m mster

Ran klam 6f the mgamkral new fnd& ICofS

W9$16W%
, hwamral, and pain hanW f.a
 b. SUbnandlWr gMglion. fmsQangIIw11cpar
a(4rwm
fmm thlr sangIIon a n ~ w ~ t w y to
ang@bn
lgwl saIwary$adr
3. GurUtg)r aYd.Uh The m a l pMiDn of the n u l w of*

the yagur nemhom Uw epigWf(these taste W a r e m

d u r n infs(lcy). llIe tart* afferwentr in the facial
m the ganlwiata pbnglMn. Pqripheral fibm re
th~rdsof the topwe by passing rhmuph ths
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~onfmm 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 klm
B o~*~MW~UN.. ~ibcrsfrwntne I M [mote
~ nucleus
cultam mute m thebr8h mm betore they sxlt tatetal~y
at tha
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 mMnm enter ths middleear.
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 new enten the parendryma of the parotidp h i ,
R divider Into itr terminal Won&
C LUlonroftks*d.lmvu
1. Lower motor n.wMI I W W lostom, which
facial nM,m k In pl&ly5bof the inus&
therMc of the &n. Muakr In the upprm
ad equally. Leas dtaste in the antwor tm-thlrds of t
gesu ffiat t h IesiQn 1s proximal to the sylomamld
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
 bsimw tW intempt the CoM&lbar

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 csrmk and mla mdla 4she cochlea are

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 ~ aFI& ddU*- Qag
" * .r<i

&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 aIe t s a t
vary arlo~rifthe maiu~ajlatcaudal to the g~orropharyngaai I
1eaBufis~orro16aqa ox lepnn asq qlnp"
la WUWJ 01-8 re sa61aure w w m6en a q ~

snapnu IBu1ws8u)lrufdl
w UI
m6~n usq14* J I U lea owl pu
-saw UoUpnp I O W P U . ~ 4 ved0 M&VW

uaq14asau 'qwfSrda awl p ~ o t ynq

e m4ddns uqy \IN'

'sn6eqdcra ' e a q m %'xuQeqd 'xud~elaqt Alddnr

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

.
--- - - -. -..-
l & t e n l ~ a/wwrh,w(e.
branch of the v a g a w b h lupplt@ all ~f

1 ~haryruand b m l&ng ra d f i .
wIDer Mth t l U ! w a n d ~ I l o M mrt
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 nofs the vagm nsrvs lead to perilIris of W
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

Thcrearwrpasikrough ¶heforamen magnum to cntw

9d)bktXhrfibra
*m-
nil1 mslW supply
~ ~ * .
 hypoghal n e w emem fmm
a nurnbr of rootlet. it u)tr th.
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. 4
C The flormlonoduhr Ick a that portion of 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

-
Fwre 39.1 lobesandfwm of the e m

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

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

mRNAL ANATOMY
sanPIUwuewfprrnsthesulf.aof
tne nratlrr OfmsuraQIllum .Wildtt*
deep within the arbor W e lie four palredanb.lhr m. d
A llw d a w n u has three byerr, unlike tho cenbwi mnax,
r
hhsux B1Wrs3P-lL
i
 IW-x md I N A &vrfHrrr

feceM eaclumy Aput fwm nwsy Abuf and fmm the Mml-
 t~ad~tO&hay)ecln&oMrkyamii
ursryntlMI,Mb#uas OFPulIt.

WiderWbsBncevra ADH
~ k ~ 0 f ~ f M O m ~ ~
-dlarlm
1 curtaInaypothdmnkams)a~~mtkem
.
MwI mahKaUonand & f i r t h
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,day m dm thalamus
*. '
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
0 u d l w #I1
mmry w a l mrtex Is Ioated a u d a. T(H prhvw audnqn am (Bmdaunn ary 41 p
the c a b Mrm of tM acrpiralbbe
pmwyaudrforymrtexL(rn~mMu
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
y n quue extensioe R humnix

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 charac-
terized 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 learn-
ing patterns correspondingto different types of auditory rtim-
ulatlon. 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~espeak 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)

a probably the single

Expertmentr on normal lnd~adualsand cl~nicslevidence

lents w h destrunrve and e p t l e p t ~ c l ~ o nsuggest
r 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 CLINICALCORRELATE

nus via the wparlor pctmral rinm into the l n t m i lnrklbn can grrad from the faceinlo
the inferlor petroul sinus, and laterally into the mc~YmOUsY"~pmdOUngrnkfec
W ~and
I thmmboss

'i

*,+ t .
Z4?,

_(

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
nam ofthe mronephnctubules whiiform the

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
am with R extension of the bddy %ti
%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
&maibody wall
c 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. Ducts. The efferent ductules empty Into the WoltRen
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-c- nnur whith
- lfithepmtatu u&U athert.wbwyhrcc
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 week the ganl
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
e n b t ~ m K a a t r d b y t h e t r r s t tA~
tattubrctd e16ngatarf a f ~ n hthe phaliu
 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 to the body and
. 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 OMSof mawnty, rpermatogenlc cells are present
stages of diierentinton and a n more or kn layered.
c. Thespenn.mgonla. by repeated m m i &glve nr to p r h y
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 cem&mm%
ris m e w 5 sod c w m m
1. Sps-HUIB ~ M tho rpermatogonla cMta
I w~th
chromplnncsor awa, nfwsaueta! mitour.drvirums the
fernlate wlthout Wlslon into primply spermam(yfa.
2. M w s a unique type of nwlear dmson thrt Mcuaonly n
e !
cells. fi IS a reduction process that reducer the dtplod conditvm
-*thrW~plsM-dm
a. nm mUotic (mduction) dMrlon Mcun when the paired
romer k o m e separated. Pnmary rpennatoqta divide
-w sperm-
(1) This dlvwn h diffemotfrum ordinary mitot,
rt docrnot c m k t of separationof sistef chro
replication, hut ratOer ~nvolverthe sewat
paired, homotcqm chrcntolomr
U)Malosir allow for trampontion of genet= mfarmatlon,
ormnbehvmthechrwnatlhofthcretrM

3.

a me SpennaUUs a n enveloped by (ytOphtmlc pr- 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 Lal tmmon p.tkway af th.repmductlve aid
symm kdw ma*.
1. The qM)na*tra& fhmthe bladder to th. end of tha Wn
roMlrfurtm+wwaMaeeUIe

-.
1. Spurn pusm r.pM$ through the SfraigM tu

*-
thcItdrilge duw Mhur a nrdy van in

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 PKIUUY kr
* a f ~ d y l r r l P ~ I n t ) U d ~ ~

s6auolut.dgomilt I* nr

tt@ulqaWar ghndr.

the bas& ui the pnile ur.thra.%wua 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 rapm-
ductwe yeard The remafnvng folltcler eventually degonmrata
NBRE f:

aM..dtre~
may brmr at

, "
.
oosr~h K
One fumimwl
owmandlvro
.b r
Smtmtogmrlr
fMcflmaf
spenammaen adttutkopantotha
pdarbdmare pmduced

FE&I
2 *mpul* 6th t h l r w d l ~ 1 a m
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 alveoll begin to develop at puber&y,&when the Imma-
&urn mammary gland com.r under the Infbnrs of ntrOBen and

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

1
-,a.
II a p m t a i m M d fcmirting I ' i i l d m , tsHMa; and
 CLINICAL CORRELATE

Afi W e t m y san J n o mmade dunng

W rO ? to faahtare del"eryd the
mhM3 head bspwrormedwfherio
~ ~ ~ n e o r m e d n / a t w Ihe
8 I ~ m
pabmIbo~ta~raarr~ofthe
~anai.srhndw

&@iRubarb.ra-mrttcnoder.

wap WYrwrBbW
meivathe ovum f o h l n g owkson.
m~t~ruthat
 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 ; d O r p a r t d r t k m w .
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 UglhUna.

CLra$car ConnELarE
7he~raWFdSES&EdYl~fdTWlhe
ufanmana*&wwdrPliodyoflhe
uaansnearmiwxwndathpcmw
Pwaiu f k w under the h?cW
s**,lhe~
( 7 of lhe ufanneartffy)m y be

2 vmm d ~ . v ~ l w I n s C a h ~ m e 1 m c ilht
m a*In
l '
3. rynrph.tltl. ~ymphf r ~ m the vastnr drains tq the external and
nrl iliac noda aswall as to thesu&ci~F&ainal node6
4 ~nmrvptbn. 9
Ths v a g l i~s s u p p v neNesde.W from tk
splaorhnicn e w and the bWgaSft&plexus

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
y fib.- whkh supply
smooth m u d e at theam&.
It@

RPT =3iF%2s$
1 3. ~ ~ ~ o m p htubules
r i c function t~npornllyand 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 nthe unt.na(0nw,
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 rem as tha polnt Of enhtiancp

and uCn for the nn.l amy. nn.1 wbh end umW
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~chpenetrate 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
and the ml-g tvbu*.

qlPkllalwgutCo.Ndswmlal%~
1 6 ~ l Is made
w up of w u a l anwtomotic capillary loop
 6 ~(llown9uanaipltdwidesurtorIMoada~t.mOfwpdlw
M, the &UIYIIY pWuh whtch fOrms a dense natwork of b l d
Wgdrlrornd*ha~mc
7. &rial supply of the medulla h pmvlded by the efferent ah&&
ofbWgfMmrull msrthcbmcdulb.
3 .

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

Tha urinary b!add.rfumtlcin P istoiaqenfgatvfottrlne. fhe amtun of

the wan oftha iu&r b~kn'1lrrt~bertfi1dicnhd,ttm ofthe mmt
A WUopY of $$ U&cy bladder h ~ l bfc&d&irq
( upon the
dcgm of thc bWdu dlstemon

MEDICAL
 I
~ ~h b M l tr i ~ a and
1 nthe number of apparem cdl layers
aependr on the fullness of the bladder
a As the organ becomes distended, the ruperflclal epctheltal layer ~hesurfaceplasmarnembranesofMaoL
and the m u m k o m e flattened, and the enttre ep~thel~um d e r ~ ~ l c e ~ a r e ~ I ~ @ p n
becomes thinner wt w t e r m o m t frm the 8nmm
t ~ a l c o m p s m t h preventsd~lum
~
b At m fullest distentmm, the bb*.i- -pithellwn may k.""ly two dthernKwrmtedfimrr)Urrne
or three cells t h l d

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~rlonrprostat-
L membranous. and penile

. ~ "&a
b K mnnderablyshorter than that of ti., ...
d urethr.

bcm m wornen than men

NBDE 1 : ANATOMIC
SCIENCES
I
contllnr glomeruli, h m a n ' s capsules, and prruhmal and
/
a.
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 1s the dilated upper portton of the urater that
ruewthe rnajorcatjces.
NOTE
2. Medmt wppiy. The paired mnalrmliwa n branch- of the abdomb
Therena1a~are"end~~~e. nd~*bita.
?Jmea ~~t mUatefaI&a to ar imWmat m u travel In renal columns In the cortkai area
rn~ntlmperWonn~casofadu- 1
aM. + b.(Waenpyrsm&
b. Arruete anmla run parallelto bswrofpyramidr,
c. ~ b u b r a ~ abranches r e of arcuate arteries
-+ -. 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$the Inferior wna cava
b ffte-I& renal veln recslves CtYe left gonadal vein, the Ibft
suprarenal vein, and the left Inferior phrenlc vein, and may
&B a mot ofthe hmlazyqo$ 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 %qkhportganglionicall bodies
located in the renalplexus
a. RegangLonkrymp.thetkflbm arefrm Iplanthn~cnerves
b. Pam affennts from the remi p k a travel in wlawhnlc mrwr

URETERS
C L I N ~ C AConRElrrr
L
7henwsl (DM1Kn*of& mn- A ummn are flbmmumiar t u b s that conned the kdneys to the urinary
m M x n ~ * ~ b Y ~ ~ an the pelvis, Th6y rtbi pCstgrior to the ductus deferam in males
bMder
mkdi
mdponerlortothe ~ a ~ l n f e m a l s .
WherrekrmaIpdwrphathe~
Whnrtheuretw~&~ 8. They kgnn ar mminwgens oftha renal prkes and N n retroperltonasb
inkt & cmssmg themmqminLc+ri@ar they pan over thd pew brim
~theheuretwentwsthewllof~
unrn,y LdaddU
1. l f ~ UW r Is rupplhd b9'*DI(.1We &(hr lntMPl lllw

iP

*mb ? l ~ d N d a n c l r f r o m t h e
w&rmI ollRcc ofthe a h
 - --.,
NBDE 1: ANATOMICSCIENCES

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 of Mood lr lmaa,
a the Mocm Normal hematwtf valm are 36.46% for w o r n <
and 4163% for men.
5 When aging RBC, develop subtle change^ maoph.ppl In the b x e
m m s p l e a n , and lhlengulf and dlgm them The Iron and h e m
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&,
B. -
, or W i t ~ - b bW
d s iWBCsk are primaniy invalvadurlm the
cellulw & h u m ! dafennsfuris m n i m agaim W g n -ria&
Wsea g e claplfied w aran!Jlocyhr (neutrophllr, sosinophib
F i U and w a n u l a y p OymphWes, monccytn),
1. W-r are film& Kcwding to?hstf~stpiomg prowrnn of thelr
+Ic grwuk
a kruaophk are 10-16 run In darneter.
('1) thdy have M iiuclaer loba and wmdn slumphllic gnnuks
(lyiolamlrl. which i a t a l h hydrolptic enwms for hKterlal

1: terlctdalen- R g., lylozyme)

@ N*utmphIla Wa &aWcW tMrbmdi.~11&.nn~.xb7
bauerialchamWmMunt( They are the prwnary celk inwlved
to

~ n ~ = m ~ w mprrfnrsi-sa%
~ a n of d
leukocytn
w w
(1) They have a bllotMd nuclam and 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~~IISare 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
o pnaundlngr m y also
IelWe addltknel vlro.rthg a m h n and I W r e u t n g sub-
otmphgla(a W*fnmdstfng of 1eukOMmn LTG
LlDe and LTE4 They representless than 1% otlwkbtyta.
 -'-,
Y--
- -.a

2%

mngrnzkabUWWtRgfinub

pL ~ i W e f ~ n m u n ~ ~ u n t r o & R t , f I . d
urhg lmmunolorr~cand L l l a c b r m k & W 7 bseQhocltu
,,, @3hi@m+*
(12 f -qHs i&rrnti3< In t&?'t3wWU andA+e~arculafs 1" the I N A NUTSHELL
perfpheral bleed, where thay are me prlnc~psleffectors of
- ~ . r t l n d m
w*by-*lar*~arrue~n*f%
fudan W-WNB .
rsllc+ds-Lnm*
mffereRdBtenlhvmus
.nagecrceu(cDPr
,
re&.
ID&#Ha dnhiarmf. n b k mmrw and W b l y In the sub
.
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
s u ~ r c d
6 celb + h m * l h - W

c e l h 6 n a k @ d n b ~ + ~ &
" &mw&M*lh**YIAR* .WWCe/&+p$uMd&d&W-
ate into p l m a & M-IHa- tha? are &emmure m an@n

n w Ih.qto@run bar a gmundqfau qppearanca and

%m*.~*..* *
ID l t w r mcki N l n Ilgbtmr thM lymphocyte nuclel because
'* wbna€h u ,
of

thstynr-
Z
X
X
rt.lnlng hp.&l*nthat dut flns w c p r o m mi a
 Plasma b ths extroc~llufartompomnt 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
b #Wllnr (alpha, beta.
t
gynaryaad~wbrhlrmce5a~foc~~offibrinin
cbbrraprrt.p4blnadcslq-.
B N m 71 k equlBWum with t l a IMwnltlai fluid thmugh caplilary
walb &&re, the cmwdttw 6fplWn4 my b cllM to judclr the
i thi Mtrdeelbbr fluldr rargr bl-d protclm
morn c m p ~ R i a i of
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~
nu. M the ciottlng t l a m h w a U y fibrinogen). t
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 fen and right rubdni.n vaim at wr a- ofjuncuonwith tix ima-
MI jugular veins, r.spectively. The lymphatics serve as one-way lI.e..
MwUd tka he&) drain.* system for tha return of tw fluid and other
dlffusiMe subnanur, lnchrdlnp e l m ~ m t 0 i m?Wd,
. constantly waDC
I N A NUTSHELL
f m n t h e M m d ~ ~ T h q r a n a h o ~ t i n ~ a s a
'""" ci"'Ih 5m s p
ln n ew lymphwyts5 and anibcrd~etproduced m lymph
nades lnto nto bbad orculation.
Ilunlymphvanh
.
I L A. -UgtlWacrxwilt~+YeBekhndw&b.ndothrlbicsbr.4ich
TbwiWdKt Rlynlphp*dm ~ a r M i a ~ M ~ a u w l s r l n m o d ~ o f t h e
& 1 Endfshl~h.~~uetrdanalwlhr~r4mM~Bwllsmm
YndgnofC lwMwt0fR
- u1tRMIlW
aM~&dmn andRndKlanan
r
 BDE I: ANATOMI$SCIENCES
E?Ktmoar ofbone mamm aconty
be,ntemRedmdnrpectm
the hemat&me mwccvre munr
a s r a n m l 4 Is the ~IDNPTof gfmdoqte
CLlNICAL CORRELATE
An4kvaredpercentageofband*
rmphhb.ban~rMuhuofa
.wtm&mpp~arHnkaatwe
mferl€dk?~~w-a¶
a'kkbHi'
of I n m w W l n Mdagewatke m~p.rtrlkr WInMic nudey
The
whlchbmloy)Hclp.b*at~ir~fmmth.cell.
5. - R (polyrhmm8Caphilk ery+hroqte) h an immature XI-
dcphlm dh&.ncd RBC whkh dl conaim roma nborarur and
mltahxrdtb~Inthn~ofamaIIqwnt~ofhema
6.
globin, AppodOmd.b 1% of the KhUM99 RW3W n t K u m
Er#hueqw N the mature arldophlllo an4 denurluted RBC.
Ety4rrsryor~Inth.ci~10n~bl10dsyrml1IR
m r n ~ ~ ~ r g l a n , l i m , a n d ~ m m .
Bone m#rrw -.
~~k~ln(orllhrr~p~otgr.nUl&yhr(Fmun5011.
1. MydebW @ acdl that has a !arges&dcal nuckuswntelnlq dell-
aa .u$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.
Z P a a <dlthat mtaira a largcspherlcalIndented M e w
~ ~ C . a n # Wchmmatm. a d The qwplmrn la basodilic and
wnialarperiphqralaaumphikgranuk.
3. 6th.LLrtnll inthisse&Upabla of divlswn.The nudnrr
kentsrincrenfingly haterochrmOlc with wbswuent dlvirionr
Spa6iflc gfbnuk arb fmtha G ~ l gapp.rm&
l nwltirg h w
n&la toolnMWk, a 4 m l I k mnbcyte*
4. M.Pa)yJocyOlis@cell whmmndenfed n w h uhlbltr I& WM-
1(4,thnt h charmW& of the nytmphil, c~amopkllor b l w h i l
nm ntsplmn mnURs aguumphi~kqnnvbi MHI h w g q numbm
of &k @nula lhiicdt dbm not divide.
5 GrmnqIoqt~Ierq thr datlnitive cells that enter the blood.
N.wcphlW gnnul-wtes urh~bltan ~mcmKdiataSap 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&, atrun In the md baM
mBW.
*. MWkqcWW is a I a ~ ~ r allU thatc contakn a U&p.d or
DPDM lm&U4 wlth pmmJn& nucird~.it IS the Iastdi that wmkr-
-mew
2. MYldtuyo(ytr ate the largest of bone m w wk, wlth dimnewts
d-BOm r m .n*y uix?&u 44 nucisardhlidwr wlthm cw
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

I ad&gl.LIPkbwete mWq1on pr- 'cwtainr' of platelet

danwutlml ver~cksfwm ~n thb'c@pl.sm There VDIIJFIm-
k e , Mmme MbuIar, and mmtual6, torm o t a M &nmrWm
rRlsl)Mm*
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

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

~ s e x w , ~ ~ u u w a n d o n i & c t i n w o r mW
n . desako
&aim thihhrw pplvk and lwMr IimbrtntQlraby way of rnnfarh
mmmiadc@pdCM1UMO UiW w&b EffemWmmtbe lurnbr noder
~imthClWFXWVaabWhhhgdntothi.~achyfi.
9. ~ A y W W t k ddl*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~theaot-
ule&&iatthsdi.~lO. :
'
- 6 -
- 2 '->