{"id":4774,"date":"2019-06-24T14:49:36","date_gmt":"2019-06-24T14:49:36","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-5-central-nervous-system-3\/"},"modified":"2023-11-30T18:50:48","modified_gmt":"2023-11-30T18:50:48","slug":"10-5-central-nervous-system-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-5-central-nervous-system-3\/","title":{"raw":"8.5\u00a0Central Nervous System","rendered":"8.5\u00a0Central Nervous System"},"content":{"raw":"&nbsp;\r\n\r\n[caption id=\"attachment_3070\" align=\"aligncenter\" width=\"804\"]<img class=\"wp-image-3070\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Sensory_Homunculus-en.svg_-2.png\" alt=\"Sensory Homunculus\" width=\"804\" height=\"791\" \/> <em>Figure 8.5.1 This picture is called an <\/em>homunculus<em>.\u00a0<\/em>[\/caption]\r\n<h1>Homunculus<\/h1>\r\nThe very odd-looking drawing in Figure 8.5.1 is called a homunculus. The beige mass represents a cross-sectional wedge of the human brain, and the drawing shows some areas of the brain associated with different parts of the body. As you can see, larger areas of the brain in this region are associated with the hands, face, and tongue, as compared to the areas associated with the legs and feet. Given the importance of speech, manual dexterity, and face-to-face social interactions in human beings, it is not surprising that relatively large areas of the brain are needed to control these body parts. The brain is the most complex organ in the human body and part of the central nervous system.\r\n<div>\r\n<h1>What Is the Central Nervous System?<\/h1>\r\n<\/div>\r\nThe [pb_glossary id=\"5933\"]central nervous system[\/pb_glossary] (CNS) is the part of the nervous system that includes the [pb_glossary id=\"5915\"]brain[\/pb_glossary] and [pb_glossary id=\"3010\"]spinal cord[\/pb_glossary]. The drawing below (Figure 8.5.2) shows the central nervous system as one of two main divisions of the total nervous system. The other main division is the [pb_glossary id=\"3009\"]peripheral nervous system[\/pb_glossary] (PNS). The CNS and PNS work together to control virtually all body functions.\r\n\r\n[caption id=\"attachment_3013\" align=\"aligncenter\" width=\"712\"]<img class=\" wp-image-3013\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Overview_of_Nervous_System-2.jpg\" alt=\"Central and Peripheral Nervous System\" width=\"712\" height=\"643\" \/> <em>Figure 8.5.2 The two main divisions of the nervous system: the central nervous system (CNS) \u2014 which includes the brain and spinal cord \u2014 and the peripheral nervous system (PNS), which includes nerves and ganglia (singular, ganglion), which transmit information between the CNS to the rest of the body.<\/em>[\/caption]\r\n\r\nThe delicate nervous tissues of the central nervous system are protected by major physical and chemical barriers. Physically, the brain and spinal cord are surrounded by tough [pb_glossary id=\"2929\"]meninges[\/pb_glossary], a three-layer protective sheath that also contains cushioning [pb_glossary id=\"5939\"]cerebrospinal fluid[\/pb_glossary]. The\u00a0bones\u00a0of the skull and spinal vertebrae also contribute to physically protecting the brain and spinal cord. Chemically, the brain and spinal cord are isolated from the circulation\u00a0\u2014\u00a0and most toxins or pathogens in the\u00a0blood\u00a0\u2014\u00a0by the\u00a0<strong>[pb_glossary id=\"5909\"]blood-brain barrier[\/pb_glossary].<\/strong>\u00a0The blood-brain barrier is a highly selective membrane formed of endothelial\u00a0cells\u00a0that separates the circulating\u00a0blood\u00a0from extracellular fluid in the CNS. The barrier allows\u00a0water, certain gases, glucose, and some other molecules needed by the brain and spinal cord to cross from the blood into the CNS, while keeping out potentially harmful substances. These physical and chemical barriers make the CNS less susceptible to injury than the PNS. However, damage to the CNS is likely to have more serious consequences.\r\n<div>\r\n<h1>The Brain<\/h1>\r\n<\/div>\r\nThe\u00a0<strong>[pb_glossary id=\"5915\"]brain[\/pb_glossary]<\/strong> is the control center of not only the rest of the nervous system, but of the entire organism. The adult brain makes up only about 2% of the body\u2019s weight, but it uses about 20% of the body\u2019s total energy. The brain contains an estimated 100 billion neurons, and each [pb_glossary id=\"2984\"]neuron[\/pb_glossary] has thousands of synaptic connections to other neurons. The brain also has about the same number of [pb_glossary id=\"2985\"]neuroglia[\/pb_glossary] as neurons. No wonder the brain uses so much energy! In addition, the brain uses mostly [pb_glossary id=\"5451\"]glucose[\/pb_glossary] for energy. As a result, if the brain is deprived of glucose, it can lead to unconsciousness. The brain is able to store some glucose in the form of [pb_glossary id=\"327\"]glycogen[\/pb_glossary], but in much smaller amounts than are found in the liver and skeletal muscles.\r\n\r\nThe brain controls such mental processes as reasoning, imagination, memory, and language. It also interprets information from the senses and commands the body to respond appropriately. It controls basic physical processes (such as breathing and heartbeat), as well as voluntary activities (such as walking and writing). The brain has three major regions: the hindbrain, the midbrain and the forebrain. These parts are shown in Figure 8.5.3 and described below.\r\n\r\n[caption id=\"attachment_3072\" align=\"aligncenter\" width=\"630\"]<img class=\"wp-image-3072\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata_the_pons_and_the_midbrain_2_CRUK_294.svg_-2.png\" alt=\"Diagram of forebrain, midbrain, and hindbrain\" width=\"630\" height=\"529\" \/> <em>Figure 8.5.3 Diagram of the forebrain, midbrain and hindbrain. <\/em>[\/caption]\r\n\r\n<div>\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\n<h2>The Hindbrain<\/h2>\r\n[caption id=\"attachment_3077\" align=\"alignright\" width=\"367\"]<img class=\" wp-image-3077\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Brain_bulbar_region.svg_-2.png\" alt=\"Hindbrain\" width=\"367\" height=\"372\" \/> <em>Figure 8.5.4 The hindbrain consists of the cerebellum,<\/em> <em>medulla oblongata, and the pons. It plays the extremely important role of connecting the brain to the rest of the body via the spinal cord.<\/em>[\/caption]\r\n\r\nThe\u00a0<strong>[pb_glossary id=\"3073\"]hindbrain[\/pb_glossary], <\/strong>which includes the [pb_glossary id=\"5935\"]cerebellum[\/pb_glossary], [pb_glossary id=\"3075\"]medulla oblongata[\/pb_glossary], and the [pb_glossary id=\"3076\"]pons[\/pb_glossary]. The hindbrain is the lowest part of the brain. It resembles a stalk and platform on which the cerebrum is perched. The components of the hindbrain connect the rest of the brain with the spinal cord and passes nerve impulses between the brain and spinal cord.\r\n<h3>Cerebellum<\/h3>\r\nThe\u00a0<strong>[pb_glossary id=\"5935\"]cerebellum[\/pb_glossary]<\/strong> is located just below the cerebrum and at the back of the brain behind the brain stem. It coordinates your voluntary movements, balance, and posture.\u00a0 Information from your inner ear, joints and muscles, and eyes are all knitted together in the cerebellum so that you have awareness of where you are in 3-dimensional space.\u00a0 Patients who have suffered damage to their cerebellum may suffer from balance disorder. In addition the cerebellum plays a major role in motor learning (like how to ride a bike or how to do a backflip on a trampoline) through trial and error.\u00a0 While traditionally, the cerebellum was thought to only be involved in motor functions, we now know that it also plays an important role in memory and learning.\r\n<h3>Medulla Oblongata<\/h3>\r\nThe\u00a0<strong>[pb_glossary id=\"3075\"]medulla oblongata[\/pb_glossary]<\/strong> makes up part of the brainstem and sits in front of and just below the cerebellum, at the very top of the spinal cord.\u00a0 It is responsible for control of heart rate, respiration rate and blood pressure, as well as reflexes such as vomiting, coughing, sneezing and swallowing.\r\n<h3>Pons<\/h3>\r\nThe\u00a0<strong>[pb_glossary id=\"3076\"]pons[\/pb_glossary]<\/strong> is located in front of the cerebellum and above the medulla oblongata.\u00a0 It has several functions, including receiving sensory information from the face, regulating rate and depth of breaths, as well as sleep cycles.\r\n<h2>Midbrain<\/h2>\r\n[caption id=\"attachment_3079\" align=\"alignleft\" width=\"317\"]<img class=\"wp-image-3079\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Midbrain-2.png\" alt=\"Midbrain\" width=\"317\" height=\"317\" \/> <em>Figure 8.5.5 The brainstem includes the midbrain, the pons and the medulla oblongata.<\/em>[\/caption]\r\n\r\nThe midbrain is the topmost part of the brainstem and is the essential connection between and brain and spinal cord.\u00a0 The three main parts of the midbrain are the colliculi, the tegmentum, and the cerebral peduncles.\u00a0 These structures are all considered part of the brainstem, which consists of the medulla oblongata, the pons and the midbrain.\r\n<h3>Reticular Activating System<\/h3>\r\nThe [pb_glossary id=\"3082\"]reticular activating system[\/pb_glossary] (RAS) is responsible for the sleep-wake cycle and wakefulness.\u00a0 It also regulates attention, ability to focus and arousal.\r\n<h2>Forebrain<\/h2>\r\nThe forebrain is the anterior (forwardmost) part of the brain and includes the cerebrum, the thalamus and hypothalamus, hippocampus, amygdala, and limbic system.\u00a0 This portion of the brain is responsible for processing incoming sensory information, performing complex cognitive activities (speech, abstract thought, etc) and governing voluntary motor movements.\u00a0 \u00a0The forebrain also controls body temperature, reproductive functions, eating, sleeping and the display of emotions.\r\n<h3>Cerebrum<\/h3>\r\nThe\u00a0<strong>[pb_glossary id=\"5941\"]cerebrum[\/pb_glossary]<\/strong>\u00a0is the largest part of the brain. It controls conscious, intellectual functions.\u00a0Among other things,\u00a0it controls reasoning, language, memory, sight, touch, and hearing. When you read a book, play a video game, or recognize a classmate, you are using your cerebrum.\r\n<h4>Hemispheres and Lateralization of the Cerebrum<\/h4>\r\nThe cerebrum is divided from front to back into two halves called the left and right\u00a0<strong>[pb_glossary id=\"3083\"]hemispheres[\/pb_glossary].<\/strong>\u00a0The two hemispheres are connected by a thick bundle of axons, known as the [pb_glossary id=\"5955\"]corpus callosum[\/pb_glossary], which lies deep within the brain. The corpus callosum is the main avenue of\u00a0communication between the two hemispheres. It connects each point in the cerebrum to the mirror-image point in the opposite hemisphere.\r\n\r\nThe right and left hemispheres of the cerebrum are similar in shape, and most areas of cerebrum are found in both hemispheres. Some areas, however, show\u00a0<strong>[pb_glossary id=\"3085\"]lateralization[\/pb_glossary],<\/strong>\u00a0or a\u00a0concentration\u00a0in one hemisphere or the other.\u00a0In most people, for example, language functions are more concentrated in the left hemisphere, whereas abstract reasoning and visual-spatial abilities are more concentrated in the right hemisphere.\r\n\r\nFor reasons that are not yet clear, each hemisphere of the brain interacts primarily with the opposite side of the body. The left side of the brain receives messages from and sends commands to the right side of the body, and the right side of the brain\u00a0receives messages from and sends commands to the left side of the body. Sensory nerves from the spinal cord to the brain and motor nerves from the brain to the spinal cord both cross the midline of the body at the level of the brain stem.\r\n<h4>Lobes of the Cerebrum<\/h4>\r\nEach [pb_glossary id=\"3083\"]hemisphere[\/pb_glossary] of the cerebrum is further divided into the four lobes shown in Figure 8.5.6 and described below.\r\n\r\n[caption id=\"attachment_3086\" align=\"aligncenter\" width=\"680\"]<img class=\" wp-image-3086\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/BrainLobes-2.png\" alt=\"\" width=\"680\" height=\"408\" \/> <em>Figure 8.5.6 The cerebrum is organized into four lobes: frontal, parietal, occipital, and temporal.<\/em>[\/caption]\r\n\r\n<div>\r\n\r\nEach hemisphere of the cerebrum consists of four parts, called lobes. Each lobe is associated with particular brain functions. Just one function of each lobe is listed here.\r\n\r\n<\/div>\r\n<ul>\r\n \t<li>The\u00a0<strong>[pb_glossary id=\"6021\"]frontal lobes[\/pb_glossary]<\/strong>\u00a0are located at the front of the brain behind the forehead. The frontal lobes are associated with executive functions, such as attention, self-control, planning, problem solving, reasoning, abstract thought, language, and personality.<\/li>\r\n \t<li>The\u00a0<strong>[pb_glossary id=\"3088\"]parietal lobes[\/pb_glossary]<\/strong>\u00a0are located behind the frontal lobes at the top of the head. The parietal lobes are involved in sensation \u2014 including\u00a0temperature, touch, and taste. Reading and arithmetic are also functions of the parietal lobes.<\/li>\r\n \t<li>The\u00a0<strong>[pb_glossary id=\"3089\"]temporal lobes[\/pb_glossary]<\/strong>\u00a0are located at the sides of the head below the frontal and parietal lobes. The temporal lobes enable hearing, the formation and retrieval of memories, and the integration of memories and sensations.<\/li>\r\n \t<li>The\u00a0<strong>[pb_glossary id=\"3090\"]occipital lobes[\/pb_glossary]<\/strong>\u00a0are located at the back of the head below the parietal lobes. The occipital lobes are the smallest of the four pairs of lobes. They are dedicated almost solely to\u00a0vision.<\/li>\r\n<\/ul>\r\n<h4>Cerebral Cortex<\/h4>\r\nMost of the information processing in the brain actually takes place in the\u00a0<strong>[pb_glossary id=\"5937\"]cerebral cortex[\/pb_glossary]<\/strong>, a rind of gray matter and other tissues just a few millimetres thick that makes up the outer surface of the cerebrum in both hemispheres of the brain. The cerebral cortex has many folds in it, greatly increasing the amount of surface area of the brain that can fit within the skull. Because of all the folds in the human cerebral cortex, it has a surface area of about 2,500 cm<sup>2<\/sup>\u00a0(2.5 ft<sup>2<\/sup>). The size and importance of the cerebral cortex is far greater in the human brain than the brains of any other vertebrates, including nonhuman\u00a0primates.\r\n<h3>The Limbic System<\/h3>\r\nThe limbic system consists of the hypothalamus, thalamus, the hippocampus and amygdala. The structures and interacting areas of the\u00a0<b>[pb_glossary id=\"3098\"]limbic system[\/pb_glossary]<\/b>\u00a0are involved in motivation, emotion, learning, and memory.\r\n<h4>Thalamus and Hypothalamus<\/h4>\r\nSeveral structures are located deep within the brain and are important for communication between the brain and spinal cord (or the rest of the body). These structures include the hypothalamus and thalamus. The diagram below (Figure 8.5.7) shows where these structures are located in the brain. Like the two halves of the cerebrum, the hypothalamus and thalamus exist in two halves, one in each hemisphere.\r\n\r\n[caption id=\"attachment_3092\" align=\"alignleft\" width=\"363\"]<img class=\" wp-image-3092\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diencephalon-2.jpg\" alt=\"Thalamus and Hypothalamus\" width=\"363\" height=\"288\" \/> <em>Figure 8.5.7 Structures deep within the brain include the hypothalamus and thalamus.<\/em>[\/caption]\r\n\r\nThe\u00a0<strong>[pb_glossary id=\"2937\"]hypothalamus[\/pb_glossary]<\/strong>\u00a0is located just above the brain stem, and is about the size of an almond. The hypothalamus is responsible for certain metabolic processes and other activities of the [pb_glossary id=\"5899\"]autonomic nervous system[\/pb_glossary], including body\u00a0temperature,\u00a0heart\u00a0rate, hunger, thirst, fatigue, sleep, wakefulness, and circadian (24-hour) rhythms. The hypothalamus is also an important emotional center of the brain. The hypothalamus can regulate so many body functions because it responds to many different internal and external signals, including messages from the brain, light, steroid hormones, stress, and invading pathogens, among others.\r\n\r\nOne way the hypothalamus influences body functions is by synthesizing hormones that directly influence body processes. It synthesizes the hormone [pb_glossary id=\"3093\"]oxytocin[\/pb_glossary], which stimulates uterine contractions during childbirth and the letdown of milk during lactation. It also synthesizes [pb_glossary id=\"5893\"]antidiuretic hormone[\/pb_glossary], which stimulates the kidneys to reabsorb more water and excrete more concentrated urine. These two hormones are sent from the hypothalamus via a stalk-like structure called the infundibulum (see Figure 8.5.7) directly to the posterior (back) portion of the pituitary gland, which secretes them into the blood.\r\n\r\nThe main way the hypothalamus influences body functions is by controlling the\u00a0[pb_glossary id=\"2938\"]pituitary gland[\/pb_glossary], known as the master gland of the\u00a0endocrine system. The hypothalamus synthesizes neurohormones called releasing factors that travel through the infundibulum directly to the anterior (front) part of the pituitary gland. The releasing factors generally either stimulate or inhibit the secretion of anterior pituitary hormones, most of which control other glands of the endocrine system.\r\n\r\nThe\u00a0<strong>[pb_glossary id=\"3095\"]thalamus[\/pb_glossary],<\/strong> which is located near the hypothalamus (see Figure 8.5.7), is a major hub for information traveling back and forth between the spinal cord and cerebrum. It relays sensory signals to the cerebral cortex and motor signals to the spinal cord. It is also involved in the regulation of consciousness, sleep, and alertness.\r\n<div>\r\n<h4>Hippocampus and Amygdala<\/h4>\r\nThe [pb_glossary id=\"3096\"]hippocampus[\/pb_glossary] is a complex structure embedded deep in the temporal lobe.\u00a0 It plays a major role in learning and memory and contributes to regulation of motivation and emotion. The amygdala is the part of the brain responsible for formation and storage of memories associated with emotional events.\r\n\r\nWatch \"The Limbic System\" by Soton Brain Hub to learn about the location and functions of the limbic system.\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=jcrWPo_s6EE\r\n<p style=\"text-align: center;\">The Limbic System, Soton Brain Hub, 2016.<\/p>\r\n\r\n<h1>Spinal Cord<\/h1>\r\n<\/div>\r\nThe\u00a0<strong>[pb_glossary id=\"3010\"]spinal cord[\/pb_glossary]<\/strong> is a long, thin, tubular bundle of nervous tissues that extends from the brain stem and continues down the center of the back to the pelvis. It is highlighted in yellow in Figure 8.5.8. The spinal cord is enclosed within, but is shorter than, the vertebral column.\r\n\r\n[caption id=\"attachment_3099\" align=\"alignnone\" width=\"482\"]<img class=\" wp-image-3099\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/SpinalCord-2.png\" alt=\"Spinal Cord\" width=\"482\" height=\"643\" \/> <em>Figure 8.5.8 The spinal cord (yellow) runs from the bottom of the brain to the lower back.<\/em>[\/caption]\r\n<h2>Structure of the Spinal Cord<\/h2>\r\nThe center of the spinal cord consists of gray matter, which is made up mainly of cell bodies of neurons, including interneurons and motor neurons. The gray matter is surrounded by white matter that consists mainly of myelinated axons of motor and sensory neurons. Spinal nerves, which connect the spinal cord to the PNS, exit from the spinal cord between vertebrae (see Figure 8.5.9).\r\n\r\n&nbsp;\r\n<div>\r\n\r\n[caption id=\"attachment_3100\" align=\"alignleft\" width=\"291\"]<img class=\" wp-image-3100\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Spinal_readjustment_3-2.jpg\" alt=\"Vertebrae\" width=\"291\" height=\"324\" \/> <em>Figure 8.5.9 This model shows three vertebrae (white) with branching spinal nerves (yellow) emerging from the either side of the spinal cord between vertebrae.<\/em>[\/caption]\r\n\r\n<\/div>\r\n<h2>Functions of the Spinal Cord<\/h2>\r\nThe spinal cord serves as an information superhighway. It passes messages from the body to the brain and from the brain to the body. Sensory (afferent) nerves carry\u00a0nerve impulses\u00a0to the brain from sensory receptor\u00a0cells\u00a0everywhere in and on the body. Motor (efferent) nerves carry nerve impulses away from the brain to glands, organs, or\u00a0muscles throughout the body.\r\n\r\nThe spinal cord also independently controls certain rapid responses called\u00a0<strong>reflexes<\/strong> without any input from the brain. You can see how this may happen in Figure 8.5.10. A sensory receptor responds to a sensation and sends a nerve impulse along a sensory nerve to the spinal cord. In the spinal cord, the message passes to an interneuron and from the interneuron to a motor nerve, which carries the impulse to a muscle. The muscle contracts in response. These neuron connections form a reflex arc, which requires no input from the brain. No doubt you have experienced such reflex actions yourself. For example, you may have reached out to touch a pot on the stove, not realizing that it was very hot. Virtually at the same moment that you feel the burning heat, you jerk your arm back and remove your hand from the pot.\r\n\r\n&nbsp;\r\n<div>\r\n\r\n[caption id=\"attachment_3101\" align=\"alignnone\" width=\"1038\"]<img class=\" wp-image-3101\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1507_Short_and_Long_Reflexes-2.jpg\" alt=\"Reflex pathway diagram\" width=\"1038\" height=\"999\" \/> <em>Figure 8.5.10 This diagram shows what happens in a long reflex (top), in which sensory nerves carry the message all the way to the spinal cord; and in a short reflex (bottom), in which sensory nerves travel only to a ganglion outside the spinal cord. Note that interneurons are involved in reflexes, connecting sensory and motor neurons, but they are not actually shown in the diagram.<\/em>[\/caption]\r\n\r\n<\/div>\r\n<h2>Injuries to the Spinal Cord<\/h2>\r\nPhysical damage to the spinal cord may result in\u00a0<strong>[pb_glossary id=\"3102\"]paralysis[\/pb_glossary],<\/strong> which is loss of sensation and movement in part of the body. Paralysis generally affects all the areas of the body below the level of the injury, because nerve impulses are interrupted and can no longer travel back and forth between the brain and body beyond that point. If an injury to the spinal cord produces nothing more than swelling, the symptoms may be transient. However, if nerve fibres (axons) in the spinal cord are badly damaged, the loss of function may be permanent. Experimental studies have shown that spinal nerve fibres attempt to regrow, but tissue destruction usually produces scar tissue that cannot be penetrated by the regrowing nerves, as well other factors that inhibit nerve fibre regrowth in the central nervous system.\r\n<div>\r\n<h1>Feature: My\u00a0Human Body<\/h1>\r\n<\/div>\r\nEach year, many millions of people have a <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/stroke\/symptoms-causes\/syc-20350113\">stroke<\/a>, and stroke is the second leading cause of death in adults.\u00a0<strong>[pb_glossary id=\"3103\"]Stroke[\/pb_glossary],<\/strong>\u00a0also known as cerebrovascular accident, occurs when poor blood flow to the brain results in the death of brain cells. There are two main types of strokes:\r\n<ul>\r\n \t<li>Ischemic strokes occur due to lack of blood flow because of a blood clot in an artery going to the brain.<\/li>\r\n \t<li>Hemorrhagic strokes occur due to bleeding from a broken blood vessel in the brain.<\/li>\r\n<\/ul>\r\nEither type of stroke may result in paralysis, loss of the ability to speak or comprehend speech, loss of bladder control, personality changes, and many other potential effects, depending on the part of the brain that is injured. The effects of a stroke may be mild and transient or more severe and permanent. A stroke may even be fatal. It generally depends on the type of stroke and how extensive it is.\r\n\r\nAre you at risk of a stroke? The main risk factor for stroke is age \u2014 about two-thirds of strokes occur in people over the age of 65. There is nothing you can do about your age, but most other stroke risk factors can be reduced with lifestyle changes or medications. The risk factors include high blood pressure, tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, and atrial fibrillation.\r\n\r\nChances are good that you or someone you know is at risk of a stroke, so it is important to recognize a stroke if one occurs. A stroke is a medical emergency, and the more quickly treatment is given, the better the outcome is likely to be. In the case of ischemic strokes, the use of clot-busting drugs may prevent permanent brain damage if administered within three or four hours of the stroke. Remembering the signs of a stroke is easy. They are summed up by the acronym FAST.\r\n<div>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Summary<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ul>\r\n \t<li>The [pb_glossary id=\"5933\"]central nervous system[\/pb_glossary] is the part of the nervous system that includes the [pb_glossary id=\"5915\"]brain[\/pb_glossary] and [pb_glossary id=\"3010\"]spinal cord[\/pb_glossary]. It is physically protected by\u00a0bones, meninges, and [pb_glossary id=\"5939\"]cerebrospinal fluid[\/pb_glossary]. It is chemically protected by the blood-brain barrier.<\/li>\r\n \t<li>The brain is the control center of the nervous system and of the entire organism. The brain uses a relatively large proportion of the body\u2019s\u00a0energy, primarily in the form of glucose.<\/li>\r\n \t<li>The brain is divided into three major parts, each with different functions: the hindbrain, the midbrain and the forebrain.<\/li>\r\n \t<li>Hindbrain consists of the medulla oblongata, the pons and the cerebellum, each of which perform specific functions.<\/li>\r\n \t<li>The midbrain is primarily responsible for motor movement and in auditory and visual processing.<\/li>\r\n \t<li>The forebrain contains many structures including:\r\n<ul>\r\n \t<li>The cerebrum, which is further divided into left and right hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal, and occipital. Each lobe is associated with specific senses or other functions.<\/li>\r\n \t<li>The cerebrum\u00a0has a\u00a0thin outer layer called the cerebral cortex. Its many folds give it a large surface area. This is where most information processing takes place.<\/li>\r\n \t<li>Inner structures of the brain include the hypothalamus \u2014 which controls the\u00a0endocrine system\u00a0via the\u00a0pituitary gland\u00a0\u2014 and the thalamus, which has several involuntary functions.<\/li>\r\n \t<li>The hippocampus and amygdala, which are part of the limbic system and play important roles in memory, learning and emotions.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>The spinal cord is a tubular bundle of nervous tissues that extends from the head down the middle of the back to the pelvis. It functions mainly to connect the brain with the\u00a0peripheral nervous system. It also controls certain rapid responses called reflexes without any input from the brain.<\/li>\r\n \t<li>A spinal cord injury may lead to paralysis (loss of sensation and movement) of the body below the level of the injury, because nerve impulses can no longer travel up and down the spinal cord beyond that point.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox textbox--exercises\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Review Questions<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>What is the central nervous system?<\/li>\r\n \t<li>How is the central nervous system protected?<\/li>\r\n \t<li>What is the overall function of the brain?<\/li>\r\n \t<li>Identify the three main parts of the brain and one function of each part.<\/li>\r\n \t<li>Describe the hemispheres of the brain.<\/li>\r\n \t<li>Explain and give examples of lateralization of the brain.<\/li>\r\n \t<li>Identify one function of each of the four lobes of the cerebrum.<\/li>\r\n \t<li>[h5p id=\"562\"]<\/li>\r\n \t<li>[h5p id=\"563\"]<\/li>\r\n \t<li>Summarize the structure and function of the cerebral cortex. Explain how the hypothalamus controls the endocrine system.<\/li>\r\n \t<li>Describe the spinal cord.<\/li>\r\n \t<li>What is the main function of the spinal cord?<\/li>\r\n \t<li>Explain how reflex actions occur.<\/li>\r\n \t<li>Why do severe spinal cord injuries usually cause paralysis?<\/li>\r\n \t<li>What do you think are some possible consequences of severe damage to the brain stem? How might this compare to the consequences of severe damage to the frontal lobe? Explain your answer.<\/li>\r\n \t<li>Information travels very quickly in the nervous system, but generally, the longer the path between areas, the longer it takes. Based on this, explain why you think reflexes often occur at the spinal cord level, and do not require input from the brain.<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox textbox--examples\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Explore More<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=sewhbmh0ECg\r\n<p style=\"text-align: center;\">What if we could look inside human brains? - Moran Cerf, TED-Ed, 2013.<\/p>\r\nhttps:\/\/www.youtube.com\/watch?v=ZMSbDwpIyF4\r\n<p style=\"text-align: center;\">The left brain vs. right brain myth - Elizabeth Waters, TED-Ed, 2017.<\/p>\r\nhttps:\/\/www.youtube.com\/watch?time_continue=1&amp;v=aCv4K5aStdU&amp;feature=emb_logo\r\n<p style=\"text-align: center;\">Split-brain patient 'Joe' being tested with stimuli presented in different visual fields,\r\nmarkmcdermott, 2010.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<h2>Attributes<\/h2>\r\n<strong>Figure 8.5.1<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sensory_Homunculus-en.svg\" rel=\"cc:attributionURL\">Sensory_Homunculus-en.svg<\/a> by <a title=\"User:Popadius\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Popadius\">Popadius<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en) license. (This is a derivative work from File:1421 <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1421_Sensory_Homunculus.jpg\">Sensory Homunculus<\/a>.jpg by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-2-central-processing\">OpenStax College<\/a>)\r\n\r\n<strong>Figure 8.5.2<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1201_Overview_of_Nervous_System.jpg\" rel=\"cc:attributionURL\">Overview_of_Nervous_System<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/12-1-basic-structure-and-function-of-the-nervous-system\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.\r\n\r\n<strong>Figure 8.5.3<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata,_the_pons_and_the_midbrain_(2)_CRUK_294.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata,_the_pons_and_the_midbrain_(2)_CRUK_294.svg<\/a> by <a href=\"https:\/\/www.cancerresearchuk.org\/\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0 <\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.\r\n\r\n<strong>Figure 8.5.4<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_bulbar_region.svg\" rel=\"cc:attributionURL\">Brain_bulbar_region.svg<\/a> by <a title=\"User:Fvasconcellos\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fvasconcellos\">Fvasconcellos<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en\" rel=\"license\">CC BY 2.5<\/a> license (derivative work from <a title=\"File:Brain human sagittal section.svg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_human_sagittal_section.svg\">Brain human sagittal section.svg<\/a>\u00a0 by Patrick J. Lynch; <a title=\"File:Brain bulbar region.PNG\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_bulbar_region.PNG\">Brain bulbar region.PNG<\/a> by <a class=\"extiw\" title=\"w:User:DO11.10\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:DO11.10\">DO11.10<\/a>).\r\n\r\n<strong>Figure 8.5.5<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0114_BrainstemAnatomy.png\" rel=\"cc:attributionURL\">Midbrain<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\r\n\r\n<strong>Figure 8.5.6<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0111_BrainLobes.png\" rel=\"cc:attributionURL\">BrainLobes<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a><span style=\"text-align: initial; font-size: 1em;\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span>\r\n\r\n<strong>Figure 8.5.7<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1310_Diencephalon.jpg\" rel=\"cc:attributionURL\">Diencephalon<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/13-2-the-central-nervous-system\">OpenStax<\/a> Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\" rel=\"license\">CC BY 4.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/4.0) license.\r\n\r\n<strong>Figure 8.5.8<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0822_SpinalCord.png\" rel=\"cc:attributionURL\">SpinalCord<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a><span style=\"text-align: initial; font-size: 1em;\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span>\r\n\r\n<strong>Figure 8.5.9<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Spinal_readjustment_3.jpg\" rel=\"cc:attributionURL\">Spinal_readjustment_3<\/a> by <a title=\"User:Tomwsulcer\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Tomwsulcer\">Tomwsulcer<\/a> on\u00a0 Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\">CC0 1.0<\/a> Universal Public Domain Dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en).\r\n\r\n<strong>Figure 8.5.10<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1507_Short_and_Long_Reflexes.jpg\" rel=\"cc:attributionURL\">1507_Short_and_Long_Reflexes<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/15-2-autonomic-reflexes-and-homeostasis\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.\r\n<h2>References<\/h2>\r\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, 28 May). Figure <span class=\"os-number\">14.23<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"30258\" class=\"os-title\" data-type=\"title\">The sensory homunculus <\/span>[digital image]. In <em>Anatomy and Physiology<\/em> (Section 14.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-2-central-processing\r\n<\/span><\/span><\/p>\r\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, 28 May). Figure 15.8 Short and long reflexes [digital image]. In <em>Anatomy and Physiology<\/em> (Section 15.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/15-2-autonomic-reflexes-and-homeostasis<\/p>\r\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). <\/span><\/span>Figure 12.2 Central and peripheral nervous system <span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">[digital image]. In <em>Anatomy and Physiology<\/em> (Section 12.1). https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/12-1-basic-structure-and-function-of-the-nervous-system<\/span><\/span><\/p>\r\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 13.11 The diencephalon [digital image]. In <em>Anatomy and Physiology<\/em> (Section 13.2). https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/13-2-the-central-nervous-system<\/p>\r\n<p class=\"hanging-indent\"><span style=\"text-align: initial; font-size: 1em;\">Blausen.com staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine,<\/em> <em>1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436<\/span><\/p>\r\n<p class=\"hanging-indent\">markmcdermott. (2010). Split-brain patient 'Joe' being tested with stimuli presented in different visual fields. YouTube. https:\/\/www.youtube.com\/user\/markmcdermott\/search?query=split<\/p>\r\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Stroke [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/stroke\/symptoms-causes\/syc-20350113<\/p>\r\n<p class=\"hanging-indent\">Soton Brain Hub. (2016, July 29). The limbic system. YouTube. https:\/\/www.youtube.com\/watch?v=jcrWPo_s6EE&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">TED-Ed. (2013, January 31). What if we could look inside human brains? - Moran Cerf. YouTube. https:\/\/www.youtube.com\/watch?v=sewhbmh0ECg&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">TED-Ed. (2017, July 24). The left brain vs. right brain myth - Elizabeth Waters. YouTube. https:\/\/www.youtube.com\/watch?v=ZMSbDwpIyF4&amp;feature=youtu.be<\/p>\r\n&nbsp;","rendered":"<p>&nbsp;<\/p>\n<figure id=\"attachment_3070\" aria-describedby=\"caption-attachment-3070\" style=\"width: 804px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3070\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Sensory_Homunculus-en.svg_-2.png\" alt=\"Sensory Homunculus\" width=\"804\" height=\"791\" \/><figcaption id=\"caption-attachment-3070\" class=\"wp-caption-text\"><em>Figure 8.5.1 This picture is called an <\/em>homunculus<em>.\u00a0<\/em><\/figcaption><\/figure>\n<h1>Homunculus<\/h1>\n<p>The very odd-looking drawing in Figure 8.5.1 is called a homunculus. The beige mass represents a cross-sectional wedge of the human brain, and the drawing shows some areas of the brain associated with different parts of the body. As you can see, larger areas of the brain in this region are associated with the hands, face, and tongue, as compared to the areas associated with the legs and feet. Given the importance of speech, manual dexterity, and face-to-face social interactions in human beings, it is not surprising that relatively large areas of the brain are needed to control these body parts. The brain is the most complex organ in the human body and part of the central nervous system.<\/p>\n<div>\n<h1>What Is the Central Nervous System?<\/h1>\n<\/div>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5933\">central nervous system<\/a> (CNS) is the part of the nervous system that includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5915\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3010\">spinal cord<\/a>. The drawing below (Figure 8.5.2) shows the central nervous system as one of two main divisions of the total nervous system. The other main division is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3009\">peripheral nervous system<\/a> (PNS). The CNS and PNS work together to control virtually all body functions.<\/p>\n<figure id=\"attachment_3013\" aria-describedby=\"caption-attachment-3013\" style=\"width: 712px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3013\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Overview_of_Nervous_System-2.jpg\" alt=\"Central and Peripheral Nervous System\" width=\"712\" height=\"643\" \/><figcaption id=\"caption-attachment-3013\" class=\"wp-caption-text\"><em>Figure 8.5.2 The two main divisions of the nervous system: the central nervous system (CNS) \u2014 which includes the brain and spinal cord \u2014 and the peripheral nervous system (PNS), which includes nerves and ganglia (singular, ganglion), which transmit information between the CNS to the rest of the body.<\/em><\/figcaption><\/figure>\n<p>The delicate nervous tissues of the central nervous system are protected by major physical and chemical barriers. Physically, the brain and spinal cord are surrounded by tough <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2929\">meninges<\/a>, a three-layer protective sheath that also contains cushioning <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5939\">cerebrospinal fluid<\/a>. The\u00a0bones\u00a0of the skull and spinal vertebrae also contribute to physically protecting the brain and spinal cord. Chemically, the brain and spinal cord are isolated from the circulation\u00a0\u2014\u00a0and most toxins or pathogens in the\u00a0blood\u00a0\u2014\u00a0by the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5909\">blood-brain barrier<\/a>.<\/strong>\u00a0The blood-brain barrier is a highly selective membrane formed of endothelial\u00a0cells\u00a0that separates the circulating\u00a0blood\u00a0from extracellular fluid in the CNS. The barrier allows\u00a0water, certain gases, glucose, and some other molecules needed by the brain and spinal cord to cross from the blood into the CNS, while keeping out potentially harmful substances. These physical and chemical barriers make the CNS less susceptible to injury than the PNS. However, damage to the CNS is likely to have more serious consequences.<\/p>\n<div>\n<h1>The Brain<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5915\">brain<\/a><\/strong> is the control center of not only the rest of the nervous system, but of the entire organism. The adult brain makes up only about 2% of the body\u2019s weight, but it uses about 20% of the body\u2019s total energy. The brain contains an estimated 100 billion neurons, and each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2984\">neuron<\/a> has thousands of synaptic connections to other neurons. The brain also has about the same number of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2985\">neuroglia<\/a> as neurons. No wonder the brain uses so much energy! In addition, the brain uses mostly <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5451\">glucose<\/a> for energy. As a result, if the brain is deprived of glucose, it can lead to unconsciousness. The brain is able to store some glucose in the form of glycogen, but in much smaller amounts than are found in the liver and skeletal muscles.<\/p>\n<p>The brain controls such mental processes as reasoning, imagination, memory, and language. It also interprets information from the senses and commands the body to respond appropriately. It controls basic physical processes (such as breathing and heartbeat), as well as voluntary activities (such as walking and writing). The brain has three major regions: the hindbrain, the midbrain and the forebrain. These parts are shown in Figure 8.5.3 and described below.<\/p>\n<figure id=\"attachment_3072\" aria-describedby=\"caption-attachment-3072\" style=\"width: 630px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3072\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata_the_pons_and_the_midbrain_2_CRUK_294.svg_-2.png\" alt=\"Diagram of forebrain, midbrain, and hindbrain\" width=\"630\" height=\"529\" \/><figcaption id=\"caption-attachment-3072\" class=\"wp-caption-text\"><em>Figure 8.5.3 Diagram of the forebrain, midbrain and hindbrain. <\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>The Hindbrain<\/h2>\n<figure id=\"attachment_3077\" aria-describedby=\"caption-attachment-3077\" style=\"width: 367px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3077\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Brain_bulbar_region.svg_-2.png\" alt=\"Hindbrain\" width=\"367\" height=\"372\" \/><figcaption id=\"caption-attachment-3077\" class=\"wp-caption-text\"><em>Figure 8.5.4 The hindbrain consists of the cerebellum,<\/em> <em>medulla oblongata, and the pons. It plays the extremely important role of connecting the brain to the rest of the body via the spinal cord.<\/em><\/figcaption><\/figure>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3073\">hindbrain<\/a>, <\/strong>which includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5935\">cerebellum<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3075\">medulla oblongata<\/a>, and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3076\">pons<\/a>. The hindbrain is the lowest part of the brain. It resembles a stalk and platform on which the cerebrum is perched. The components of the hindbrain connect the rest of the brain with the spinal cord and passes nerve impulses between the brain and spinal cord.<\/p>\n<h3>Cerebellum<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5935\">cerebellum<\/a><\/strong> is located just below the cerebrum and at the back of the brain behind the brain stem. It coordinates your voluntary movements, balance, and posture.\u00a0 Information from your inner ear, joints and muscles, and eyes are all knitted together in the cerebellum so that you have awareness of where you are in 3-dimensional space.\u00a0 Patients who have suffered damage to their cerebellum may suffer from balance disorder. In addition the cerebellum plays a major role in motor learning (like how to ride a bike or how to do a backflip on a trampoline) through trial and error.\u00a0 While traditionally, the cerebellum was thought to only be involved in motor functions, we now know that it also plays an important role in memory and learning.<\/p>\n<h3>Medulla Oblongata<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3075\">medulla oblongata<\/a><\/strong> makes up part of the brainstem and sits in front of and just below the cerebellum, at the very top of the spinal cord.\u00a0 It is responsible for control of heart rate, respiration rate and blood pressure, as well as reflexes such as vomiting, coughing, sneezing and swallowing.<\/p>\n<h3>Pons<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3076\">pons<\/a><\/strong> is located in front of the cerebellum and above the medulla oblongata.\u00a0 It has several functions, including receiving sensory information from the face, regulating rate and depth of breaths, as well as sleep cycles.<\/p>\n<h2>Midbrain<\/h2>\n<figure id=\"attachment_3079\" aria-describedby=\"caption-attachment-3079\" style=\"width: 317px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3079\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Midbrain-2.png\" alt=\"Midbrain\" width=\"317\" height=\"317\" \/><figcaption id=\"caption-attachment-3079\" class=\"wp-caption-text\"><em>Figure 8.5.5 The brainstem includes the midbrain, the pons and the medulla oblongata.<\/em><\/figcaption><\/figure>\n<p>The midbrain is the topmost part of the brainstem and is the essential connection between and brain and spinal cord.\u00a0 The three main parts of the midbrain are the colliculi, the tegmentum, and the cerebral peduncles.\u00a0 These structures are all considered part of the brainstem, which consists of the medulla oblongata, the pons and the midbrain.<\/p>\n<h3>Reticular Activating System<\/h3>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3082\">reticular activating system<\/a> (RAS) is responsible for the sleep-wake cycle and wakefulness.\u00a0 It also regulates attention, ability to focus and arousal.<\/p>\n<h2>Forebrain<\/h2>\n<p>The forebrain is the anterior (forwardmost) part of the brain and includes the cerebrum, the thalamus and hypothalamus, hippocampus, amygdala, and limbic system.\u00a0 This portion of the brain is responsible for processing incoming sensory information, performing complex cognitive activities (speech, abstract thought, etc) and governing voluntary motor movements.\u00a0 \u00a0The forebrain also controls body temperature, reproductive functions, eating, sleeping and the display of emotions.<\/p>\n<h3>Cerebrum<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5941\">cerebrum<\/a><\/strong>\u00a0is the largest part of the brain. It controls conscious, intellectual functions.\u00a0Among other things,\u00a0it controls reasoning, language, memory, sight, touch, and hearing. When you read a book, play a video game, or recognize a classmate, you are using your cerebrum.<\/p>\n<h4>Hemispheres and Lateralization of the Cerebrum<\/h4>\n<p>The cerebrum is divided from front to back into two halves called the left and right\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3083\">hemispheres<\/a>.<\/strong>\u00a0The two hemispheres are connected by a thick bundle of axons, known as the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5955\">corpus callosum<\/a>, which lies deep within the brain. The corpus callosum is the main avenue of\u00a0communication between the two hemispheres. It connects each point in the cerebrum to the mirror-image point in the opposite hemisphere.<\/p>\n<p>The right and left hemispheres of the cerebrum are similar in shape, and most areas of cerebrum are found in both hemispheres. Some areas, however, show\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3085\">lateralization<\/a>,<\/strong>\u00a0or a\u00a0concentration\u00a0in one hemisphere or the other.\u00a0In most people, for example, language functions are more concentrated in the left hemisphere, whereas abstract reasoning and visual-spatial abilities are more concentrated in the right hemisphere.<\/p>\n<p>For reasons that are not yet clear, each hemisphere of the brain interacts primarily with the opposite side of the body. The left side of the brain receives messages from and sends commands to the right side of the body, and the right side of the brain\u00a0receives messages from and sends commands to the left side of the body. Sensory nerves from the spinal cord to the brain and motor nerves from the brain to the spinal cord both cross the midline of the body at the level of the brain stem.<\/p>\n<h4>Lobes of the Cerebrum<\/h4>\n<p>Each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3083\">hemisphere<\/a> of the cerebrum is further divided into the four lobes shown in Figure 8.5.6 and described below.<\/p>\n<figure id=\"attachment_3086\" aria-describedby=\"caption-attachment-3086\" style=\"width: 680px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3086\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/BrainLobes-2.png\" alt=\"\" width=\"680\" height=\"408\" \/><figcaption id=\"caption-attachment-3086\" class=\"wp-caption-text\"><em>Figure 8.5.6 The cerebrum is organized into four lobes: frontal, parietal, occipital, and temporal.<\/em><\/figcaption><\/figure>\n<div>\n<p>Each hemisphere of the cerebrum consists of four parts, called lobes. Each lobe is associated with particular brain functions. Just one function of each lobe is listed here.<\/p>\n<\/div>\n<ul>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_6021\">frontal lobes<\/a><\/strong>\u00a0are located at the front of the brain behind the forehead. The frontal lobes are associated with executive functions, such as attention, self-control, planning, problem solving, reasoning, abstract thought, language, and personality.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3088\">parietal lobes<\/a><\/strong>\u00a0are located behind the frontal lobes at the top of the head. The parietal lobes are involved in sensation \u2014 including\u00a0temperature, touch, and taste. Reading and arithmetic are also functions of the parietal lobes.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3089\">temporal lobes<\/a><\/strong>\u00a0are located at the sides of the head below the frontal and parietal lobes. The temporal lobes enable hearing, the formation and retrieval of memories, and the integration of memories and sensations.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3090\">occipital lobes<\/a><\/strong>\u00a0are located at the back of the head below the parietal lobes. The occipital lobes are the smallest of the four pairs of lobes. They are dedicated almost solely to\u00a0vision.<\/li>\n<\/ul>\n<h4>Cerebral Cortex<\/h4>\n<p>Most of the information processing in the brain actually takes place in the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5937\">cerebral cortex<\/a><\/strong>, a rind of gray matter and other tissues just a few millimetres thick that makes up the outer surface of the cerebrum in both hemispheres of the brain. The cerebral cortex has many folds in it, greatly increasing the amount of surface area of the brain that can fit within the skull. Because of all the folds in the human cerebral cortex, it has a surface area of about 2,500 cm<sup>2<\/sup>\u00a0(2.5 ft<sup>2<\/sup>). The size and importance of the cerebral cortex is far greater in the human brain than the brains of any other vertebrates, including nonhuman\u00a0primates.<\/p>\n<h3>The Limbic System<\/h3>\n<p>The limbic system consists of the hypothalamus, thalamus, the hippocampus and amygdala. The structures and interacting areas of the\u00a0<b><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3098\">limbic system<\/a><\/b>\u00a0are involved in motivation, emotion, learning, and memory.<\/p>\n<h4>Thalamus and Hypothalamus<\/h4>\n<p>Several structures are located deep within the brain and are important for communication between the brain and spinal cord (or the rest of the body). These structures include the hypothalamus and thalamus. The diagram below (Figure 8.5.7) shows where these structures are located in the brain. Like the two halves of the cerebrum, the hypothalamus and thalamus exist in two halves, one in each hemisphere.<\/p>\n<figure id=\"attachment_3092\" aria-describedby=\"caption-attachment-3092\" style=\"width: 363px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3092\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diencephalon-2.jpg\" alt=\"Thalamus and Hypothalamus\" width=\"363\" height=\"288\" \/><figcaption id=\"caption-attachment-3092\" class=\"wp-caption-text\"><em>Figure 8.5.7 Structures deep within the brain include the hypothalamus and thalamus.<\/em><\/figcaption><\/figure>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2937\">hypothalamus<\/a><\/strong>\u00a0is located just above the brain stem, and is about the size of an almond. The hypothalamus is responsible for certain metabolic processes and other activities of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5899\">autonomic nervous system<\/a>, including body\u00a0temperature,\u00a0heart\u00a0rate, hunger, thirst, fatigue, sleep, wakefulness, and circadian (24-hour) rhythms. The hypothalamus is also an important emotional center of the brain. The hypothalamus can regulate so many body functions because it responds to many different internal and external signals, including messages from the brain, light, steroid hormones, stress, and invading pathogens, among others.<\/p>\n<p>One way the hypothalamus influences body functions is by synthesizing hormones that directly influence body processes. It synthesizes the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3093\">oxytocin<\/a>, which stimulates uterine contractions during childbirth and the letdown of milk during lactation. It also synthesizes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5893\">antidiuretic hormone<\/a>, which stimulates the kidneys to reabsorb more water and excrete more concentrated urine. These two hormones are sent from the hypothalamus via a stalk-like structure called the infundibulum (see Figure 8.5.7) directly to the posterior (back) portion of the pituitary gland, which secretes them into the blood.<\/p>\n<p>The main way the hypothalamus influences body functions is by controlling the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2938\">pituitary gland<\/a>, known as the master gland of the\u00a0endocrine system. The hypothalamus synthesizes neurohormones called releasing factors that travel through the infundibulum directly to the anterior (front) part of the pituitary gland. The releasing factors generally either stimulate or inhibit the secretion of anterior pituitary hormones, most of which control other glands of the endocrine system.<\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3095\">thalamus<\/a>,<\/strong> which is located near the hypothalamus (see Figure 8.5.7), is a major hub for information traveling back and forth between the spinal cord and cerebrum. It relays sensory signals to the cerebral cortex and motor signals to the spinal cord. It is also involved in the regulation of consciousness, sleep, and alertness.<\/p>\n<div>\n<h4>Hippocampus and Amygdala<\/h4>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3096\">hippocampus<\/a> is a complex structure embedded deep in the temporal lobe.\u00a0 It plays a major role in learning and memory and contributes to regulation of motivation and emotion. The amygdala is the part of the brain responsible for formation and storage of memories associated with emotional events.<\/p>\n<p>Watch &#8220;The Limbic System&#8221; by Soton Brain Hub to learn about the location and functions of the limbic system.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"The Limbic System\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/jcrWPo_s6EE?feature=oembed&#38;rel=0&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">The Limbic System, Soton Brain Hub, 2016.<\/p>\n<h1>Spinal Cord<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3010\">spinal cord<\/a><\/strong> is a long, thin, tubular bundle of nervous tissues that extends from the brain stem and continues down the center of the back to the pelvis. It is highlighted in yellow in Figure 8.5.8. The spinal cord is enclosed within, but is shorter than, the vertebral column.<\/p>\n<figure id=\"attachment_3099\" aria-describedby=\"caption-attachment-3099\" style=\"width: 482px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3099\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/SpinalCord-2.png\" alt=\"Spinal Cord\" width=\"482\" height=\"643\" \/><figcaption id=\"caption-attachment-3099\" class=\"wp-caption-text\"><em>Figure 8.5.8 The spinal cord (yellow) runs from the bottom of the brain to the lower back.<\/em><\/figcaption><\/figure>\n<h2>Structure of the Spinal Cord<\/h2>\n<p>The center of the spinal cord consists of gray matter, which is made up mainly of cell bodies of neurons, including interneurons and motor neurons. The gray matter is surrounded by white matter that consists mainly of myelinated axons of motor and sensory neurons. Spinal nerves, which connect the spinal cord to the PNS, exit from the spinal cord between vertebrae (see Figure 8.5.9).<\/p>\n<p>&nbsp;<\/p>\n<div>\n<figure id=\"attachment_3100\" aria-describedby=\"caption-attachment-3100\" style=\"width: 291px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3100\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Spinal_readjustment_3-2.jpg\" alt=\"Vertebrae\" width=\"291\" height=\"324\" \/><figcaption id=\"caption-attachment-3100\" class=\"wp-caption-text\"><em>Figure 8.5.9 This model shows three vertebrae (white) with branching spinal nerves (yellow) emerging from the either side of the spinal cord between vertebrae.<\/em><\/figcaption><\/figure>\n<\/div>\n<h2>Functions of the Spinal Cord<\/h2>\n<p>The spinal cord serves as an information superhighway. It passes messages from the body to the brain and from the brain to the body. Sensory (afferent) nerves carry\u00a0nerve impulses\u00a0to the brain from sensory receptor\u00a0cells\u00a0everywhere in and on the body. Motor (efferent) nerves carry nerve impulses away from the brain to glands, organs, or\u00a0muscles throughout the body.<\/p>\n<p>The spinal cord also independently controls certain rapid responses called\u00a0<strong>reflexes<\/strong> without any input from the brain. You can see how this may happen in Figure 8.5.10. A sensory receptor responds to a sensation and sends a nerve impulse along a sensory nerve to the spinal cord. In the spinal cord, the message passes to an interneuron and from the interneuron to a motor nerve, which carries the impulse to a muscle. The muscle contracts in response. These neuron connections form a reflex arc, which requires no input from the brain. No doubt you have experienced such reflex actions yourself. For example, you may have reached out to touch a pot on the stove, not realizing that it was very hot. Virtually at the same moment that you feel the burning heat, you jerk your arm back and remove your hand from the pot.<\/p>\n<p>&nbsp;<\/p>\n<div>\n<figure id=\"attachment_3101\" aria-describedby=\"caption-attachment-3101\" style=\"width: 1038px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3101\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1507_Short_and_Long_Reflexes-2.jpg\" alt=\"Reflex pathway diagram\" width=\"1038\" height=\"999\" \/><figcaption id=\"caption-attachment-3101\" class=\"wp-caption-text\"><em>Figure 8.5.10 This diagram shows what happens in a long reflex (top), in which sensory nerves carry the message all the way to the spinal cord; and in a short reflex (bottom), in which sensory nerves travel only to a ganglion outside the spinal cord. Note that interneurons are involved in reflexes, connecting sensory and motor neurons, but they are not actually shown in the diagram.<\/em><\/figcaption><\/figure>\n<\/div>\n<h2>Injuries to the Spinal Cord<\/h2>\n<p>Physical damage to the spinal cord may result in\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3102\">paralysis<\/a>,<\/strong> which is loss of sensation and movement in part of the body. Paralysis generally affects all the areas of the body below the level of the injury, because nerve impulses are interrupted and can no longer travel back and forth between the brain and body beyond that point. If an injury to the spinal cord produces nothing more than swelling, the symptoms may be transient. However, if nerve fibres (axons) in the spinal cord are badly damaged, the loss of function may be permanent. Experimental studies have shown that spinal nerve fibres attempt to regrow, but tissue destruction usually produces scar tissue that cannot be penetrated by the regrowing nerves, as well other factors that inhibit nerve fibre regrowth in the central nervous system.<\/p>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<p>Each year, many millions of people have a <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/stroke\/symptoms-causes\/syc-20350113\">stroke<\/a>, and stroke is the second leading cause of death in adults.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3103\">Stroke<\/a>,<\/strong>\u00a0also known as cerebrovascular accident, occurs when poor blood flow to the brain results in the death of brain cells. There are two main types of strokes:<\/p>\n<ul>\n<li>Ischemic strokes occur due to lack of blood flow because of a blood clot in an artery going to the brain.<\/li>\n<li>Hemorrhagic strokes occur due to bleeding from a broken blood vessel in the brain.<\/li>\n<\/ul>\n<p>Either type of stroke may result in paralysis, loss of the ability to speak or comprehend speech, loss of bladder control, personality changes, and many other potential effects, depending on the part of the brain that is injured. The effects of a stroke may be mild and transient or more severe and permanent. A stroke may even be fatal. It generally depends on the type of stroke and how extensive it is.<\/p>\n<p>Are you at risk of a stroke? The main risk factor for stroke is age \u2014 about two-thirds of strokes occur in people over the age of 65. There is nothing you can do about your age, but most other stroke risk factors can be reduced with lifestyle changes or medications. The risk factors include high blood pressure, tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, and atrial fibrillation.<\/p>\n<p>Chances are good that you or someone you know is at risk of a stroke, so it is important to recognize a stroke if one occurs. A stroke is a medical emergency, and the more quickly treatment is given, the better the outcome is likely to be. In the case of ischemic strokes, the use of clot-busting drugs may prevent permanent brain damage if administered within three or four hours of the stroke. Remembering the signs of a stroke is easy. They are summed up by the acronym FAST.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5933\">central nervous system<\/a> is the part of the nervous system that includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5915\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3010\">spinal cord<\/a>. It is physically protected by\u00a0bones, meninges, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_5939\">cerebrospinal fluid<\/a>. It is chemically protected by the blood-brain barrier.<\/li>\n<li>The brain is the control center of the nervous system and of the entire organism. The brain uses a relatively large proportion of the body\u2019s\u00a0energy, primarily in the form of glucose.<\/li>\n<li>The brain is divided into three major parts, each with different functions: the hindbrain, the midbrain and the forebrain.<\/li>\n<li>Hindbrain consists of the medulla oblongata, the pons and the cerebellum, each of which perform specific functions.<\/li>\n<li>The midbrain is primarily responsible for motor movement and in auditory and visual processing.<\/li>\n<li>The forebrain contains many structures including:\n<ul>\n<li>The cerebrum, which is further divided into left and right hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal, and occipital. Each lobe is associated with specific senses or other functions.<\/li>\n<li>The cerebrum\u00a0has a\u00a0thin outer layer called the cerebral cortex. Its many folds give it a large surface area. This is where most information processing takes place.<\/li>\n<li>Inner structures of the brain include the hypothalamus \u2014 which controls the\u00a0endocrine system\u00a0via the\u00a0pituitary gland\u00a0\u2014 and the thalamus, which has several involuntary functions.<\/li>\n<li>The hippocampus and amygdala, which are part of the limbic system and play important roles in memory, learning and emotions.<\/li>\n<\/ul>\n<\/li>\n<li>The spinal cord is a tubular bundle of nervous tissues that extends from the head down the middle of the back to the pelvis. It functions mainly to connect the brain with the\u00a0peripheral nervous system. It also controls certain rapid responses called reflexes without any input from the brain.<\/li>\n<li>A spinal cord injury may lead to paralysis (loss of sensation and movement) of the body below the level of the injury, because nerve impulses can no longer travel up and down the spinal cord beyond that point.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the central nervous system?<\/li>\n<li>How is the central nervous system protected?<\/li>\n<li>What is the overall function of the brain?<\/li>\n<li>Identify the three main parts of the brain and one function of each part.<\/li>\n<li>Describe the hemispheres of the brain.<\/li>\n<li>Explain and give examples of lateralization of the brain.<\/li>\n<li>Identify one function of each of the four lobes of the cerebrum.<\/li>\n<li>\n<div id=\"h5p-562\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-562\" class=\"h5p-iframe\" data-content-id=\"562\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Label the brain\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-563\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-563\" class=\"h5p-iframe\" data-content-id=\"563\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Brain\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Summarize the structure and function of the cerebral cortex. Explain how the hypothalamus controls the endocrine system.<\/li>\n<li>Describe the spinal cord.<\/li>\n<li>What is the main function of the spinal cord?<\/li>\n<li>Explain how reflex actions occur.<\/li>\n<li>Why do severe spinal cord injuries usually cause paralysis?<\/li>\n<li>What do you think are some possible consequences of severe damage to the brain stem? How might this compare to the consequences of severe damage to the frontal lobe? Explain your answer.<\/li>\n<li>Information travels very quickly in the nervous system, but generally, the longer the path between areas, the longer it takes. Based on this, explain why you think reflexes often occur at the spinal cord level, and do not require input from the brain.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"What if we could look inside human brains? - Moran Cerf\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/sewhbmh0ECg?feature=oembed&#38;rel=0&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">What if we could look inside human brains? &#8211; Moran Cerf, TED-Ed, 2013.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-3\" title=\"The left brain vs. right brain myth - Elizabeth Waters\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ZMSbDwpIyF4?feature=oembed&#38;rel=0&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">The left brain vs. right brain myth &#8211; Elizabeth Waters, TED-Ed, 2017.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-4\" title=\"Split-brain patient &#39;Joe&#39; being tested with stimuli presented in different visual fields\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/aCv4K5aStdU?start=1&#38;feature=oembed\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">Split-brain patient &#8216;Joe&#8217; being tested with stimuli presented in different visual fields,<br \/>\nmarkmcdermott, 2010.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2>Attributes<\/h2>\n<p><strong>Figure 8.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sensory_Homunculus-en.svg\" rel=\"cc:attributionURL\">Sensory_Homunculus-en.svg<\/a> by <a title=\"User:Popadius\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Popadius\">Popadius<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en) license. (This is a derivative work from File:1421 <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1421_Sensory_Homunculus.jpg\">Sensory Homunculus<\/a>.jpg by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-2-central-processing\">OpenStax College<\/a>)<\/p>\n<p><strong>Figure 8.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1201_Overview_of_Nervous_System.jpg\" rel=\"cc:attributionURL\">Overview_of_Nervous_System<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/12-1-basic-structure-and-function-of-the-nervous-system\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.<\/p>\n<p><strong>Figure 8.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata,_the_pons_and_the_midbrain_(2)_CRUK_294.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_brain_stem_which_includes_the_medulla_oblongata,_the_pons_and_the_midbrain_(2)_CRUK_294.svg<\/a> by <a href=\"https:\/\/www.cancerresearchuk.org\/\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0 <\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 8.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_bulbar_region.svg\" rel=\"cc:attributionURL\">Brain_bulbar_region.svg<\/a> by <a title=\"User:Fvasconcellos\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fvasconcellos\">Fvasconcellos<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en\" rel=\"license\">CC BY 2.5<\/a> license (derivative work from <a title=\"File:Brain human sagittal section.svg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_human_sagittal_section.svg\">Brain human sagittal section.svg<\/a>\u00a0 by Patrick J. Lynch; <a title=\"File:Brain bulbar region.PNG\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Brain_bulbar_region.PNG\">Brain bulbar region.PNG<\/a> by <a class=\"extiw\" title=\"w:User:DO11.10\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:DO11.10\">DO11.10<\/a>).<\/p>\n<p><strong>Figure 8.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0114_BrainstemAnatomy.png\" rel=\"cc:attributionURL\">Midbrain<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 8.5.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0111_BrainLobes.png\" rel=\"cc:attributionURL\">BrainLobes<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a><span style=\"text-align: initial; font-size: 1em;\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/p>\n<p><strong>Figure 8.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1310_Diencephalon.jpg\" rel=\"cc:attributionURL\">Diencephalon<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/13-2-the-central-nervous-system\">OpenStax<\/a> Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\" rel=\"license\">CC BY 4.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong>Figure 8.5.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0822_SpinalCord.png\" rel=\"cc:attributionURL\">SpinalCord<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial; font-size: 1em;\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\" rel=\"license\">CC BY 3.0 <\/a><span style=\"text-align: initial; font-size: 1em;\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/p>\n<p><strong>Figure 8.5.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Spinal_readjustment_3.jpg\" rel=\"cc:attributionURL\">Spinal_readjustment_3<\/a> by <a title=\"User:Tomwsulcer\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Tomwsulcer\">Tomwsulcer<\/a> on\u00a0 Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\">CC0 1.0<\/a> Universal Public Domain Dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en).<\/p>\n<p><strong>Figure 8.5.10<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1507_Short_and_Long_Reflexes.jpg\" rel=\"cc:attributionURL\">1507_Short_and_Long_Reflexes<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/15-2-autonomic-reflexes-and-homeostasis\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, 28 May). Figure <span class=\"os-number\">14.23<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"30258\" class=\"os-title\" data-type=\"title\">The sensory homunculus <\/span>[digital image]. In <em>Anatomy and Physiology<\/em> (Section 14.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-2-central-processing<br \/>\n<\/span><\/span><\/p>\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, 28 May). Figure 15.8 Short and long reflexes [digital image]. In <em>Anatomy and Physiology<\/em> (Section 15.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/15-2-autonomic-reflexes-and-homeostasis<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). <\/span><\/span>Figure 12.2 Central and peripheral nervous system <span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595633638606\" data-highlight-id=\"256b2cf6-30ee-42bf-bd28-c8888f9c63bd\" data-highlighted=\"true\">[digital image]. In <em>Anatomy and Physiology<\/em> (Section 12.1). https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/12-1-basic-structure-and-function-of-the-nervous-system<\/span><\/span><\/p>\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure 13.11 The diencephalon [digital image]. In <em>Anatomy and Physiology<\/em> (Section 13.2). https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/13-2-the-central-nervous-system<\/p>\n<p class=\"hanging-indent\"><span style=\"text-align: initial; font-size: 1em;\">Blausen.com staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine,<\/em> <em>1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436<\/span><\/p>\n<p class=\"hanging-indent\">markmcdermott. (2010). Split-brain patient &#8216;Joe&#8217; being tested with stimuli presented in different visual fields. YouTube. https:\/\/www.youtube.com\/user\/markmcdermott\/search?query=split<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Stroke [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/stroke\/symptoms-causes\/syc-20350113<\/p>\n<p class=\"hanging-indent\">Soton Brain Hub. (2016, July 29). The limbic system. YouTube. https:\/\/www.youtube.com\/watch?v=jcrWPo_s6EE&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, January 31). What if we could look inside human brains? &#8211; Moran Cerf. YouTube. https:\/\/www.youtube.com\/watch?v=sewhbmh0ECg&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, July 24). The left brain vs. right brain myth &#8211; Elizabeth Waters. YouTube. https:\/\/www.youtube.com\/watch?v=ZMSbDwpIyF4&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_4774_5933\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5933\"><div tabindex=\"-1\"><p>One of two main divisions of the nervous system that includes the brain and spinal cord.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5915\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5915\"><div tabindex=\"-1\"><p>The central nervous system organ inside the skull that is the control center of the nervous system.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3010\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3010\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1545\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Steak-and-Kidney-Pie-by-Charles-Haynes-on-flickr.jpg\" alt=\"16.4.1 Kidney Pie\" width=\"400\" height=\"356\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.1 Steak and kidney pie!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Kidneys on the Menu<\/h1>\n<\/div>\n<p>Pictured in Figure 16.4.1 is a steak and kidney pie; this savory dish is a British favorite. When kidneys are on a menu, they typically come from sheep, pigs, or cows. In these animals (as in the human animal), kidneys are the main organs of excretion.<\/p>\n<div>\n<h1>Location\u00a0of the Kidneys<\/h1>\n<\/div>\n<p>The two bean-shaped\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2988\">kidneys<\/a><\/strong>\u00a0are located high in the back of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2475\">abdominal cavity<\/a>, one on each side of the spine. Both kidneys sit just below the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4292\">diaphragm<\/a>, the large\u00a0breathing\u00a0muscle that separates the abdominal and thoracic cavities. As you can see in the\u00a0following\u00a0figure, the right kidney is slightly smaller and lower than the left kidney. The right kidney is behind the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a>, and the left kidney is behind the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4497\">spleen<\/a>. The\u00a0location\u00a0of the liver explains why the right kidney is smaller and lower than the left.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 455px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1547\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gray-Kidneys.png\" alt=\"16.4.2 Classic Kidney Illustration from Gray's Anatomy\" width=\"455\" height=\"600\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.2 This classic illustration of the abdominal cavity provides a view of the internal organs from the back of the body. It clearly shows the locations of the right and left kidney, as well as the large blood vessels that connect the kidneys to the body\u2019s main artery (aorta) and vein (inferior vena cava). The ureter exiting each kidney is also shown in the diagram.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Kidney Anatomy<\/span><\/p>\n<p>The shape of each kidney gives it a convex side (curving outward) and a concave side (curving inward). You can see this clearly in the detailed diagram of kidney anatomy shown in Figure 16.4.3. The concave side is where the renal artery enters the kidney, as well as where the renal vein and ureter leave the kidney. This area of the kidney is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4739\">hilum<\/a><\/strong>. The entire kidney is surrounded by tough fibrous tissue \u2014 called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4740\">renal capsule<\/a><\/strong>\u00a0\u2014 which, in turn, is surrounded by two layers of protective, cushioning fat.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 765px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1549\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0592_KidneyAnatomy_01.png\" alt=\"16.4.3 Kidney Anatomy\" width=\"765\" height=\"574\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.3 This diagram shows the location and relative size of the two kidneys, as well as the internal structure of each kidney.<\/em><\/figcaption><\/figure>\n<p>Internally, each kidney is divided into two major layers: the outer <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4741\"><strong>renal cortex<\/strong><\/a> and the inner <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4742\"><strong>renal medulla<\/strong><\/a> (see Figure 16.4.3 above). These layers take the shape of many cone-shaped renal lobules, each containing renal cortex surrounding a portion of medulla called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4743\"><strong>renal pyramid<\/strong><\/a>. Within the renal pyramids are the structural and functional units of the kidneys, the tiny <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephron<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. Between the renal pyramids are projections of cortex called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4744\"><strong>renal columns<\/strong><\/a>. The tip, or papilla, of each pyramid empties urine into a minor calyx (chamber). Several minor calyces empty into a major calyx, and the latter empty into the funnel-shaped cavity called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4724\">renal pelvis<\/a>, which becomes the ureter as it leaves the kidney.<\/span><\/p>\n<div>\n<h3>Renal\u00a0Circulation<\/h3>\n<\/div>\n<p>The renal circulation is an important part of the kidney\u2019s primary function of filtering waste products from the blood. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2702\">Blood<\/a> is supplied to the kidneys via the renal arteries. The right renal artery supplies the right kidney, and the left renal artery supplies the left kidney. These two arteries branch directly from the aorta, which is the largest artery in the body. Each kidney is only about 11 cm (4.4 in) long, and has a mass of just 150 grams (5.3 oz), yet it receives about ten per cent of the total output of blood from the heart. Blood is filtered through the kidneys every 3 minutes, 24 hours a day, every day of your life.<\/p>\n<p>As indicated in Figure 16.4.4, each renal artery carries blood with waste products into the kidney. Within the kidney, the renal artery branches into increasingly smaller <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4385\">arteries<\/a> that extend through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4744\">renal columns<\/a> between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4743\">renal pyramids<\/a>. These arteries, in turn, branch into arterioles that penetrate the renal pyramids. Blood in the arterioles passes through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephrons<\/a>, the structures that actually filter the blood. After blood passes through the nephrons and is filtered, the clean blood moves through a network of venules that converge into small <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4386\">veins<\/a>. Small veins merge into increasingly larger ones, and ultimately into the renal vein, which carries clean blood away from the kidney to the inferior <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4410\">vena cava<\/a>.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 683px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1551\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_how_the_kidneys_work_CRUK_138.svg_.png\" alt=\"16.4.4 Kidney and Nephron\" width=\"683\" height=\"719\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.4 The renal artery and renal vein carry blood to and from the kidney, respectively. As blood passes through a nephron within the kidney, it is filtered. Substances filtered from the blood are eventually collected in a tubule (collecting duct).<\/em><\/figcaption><\/figure>\n<div>\n<h1>Nephron Structure and Function<\/h1>\n<\/div>\n<p>Figure 16.4.4 gives an indication of the complex structure of a nephron. The <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephron<\/a><\/strong>\u00a0is the basic structural and functional unit of the kidney, and each kidney typically contains at least a million of them. As blood flows through a nephron, many materials are filtered out of the blood, needed materials are returned to the blood, and the remaining materials form urine. Most of the waste products removed from the blood and excreted in urine are byproducts of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2368\">metabolism<\/a>. At least half of the waste is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4708\">urea<\/a>, a waste product produced by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2422\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2299\">catabolism<\/a>. Another important waste is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4709\">uric\u00a0acid<\/a>, produced in\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4727\">nucleic acid<\/a>\u00a0catabolism.<\/p>\n<h2>Components of a Nephron<\/h2>\n<p>Figure 16.4.5 shows in greater detail the components of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephron<\/a>. Each nephron is composed of an initial filtering component that consists of a network of capillaries called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4747\">glomerulus<\/a><\/strong>\u00a0(plural, glomeruli), which is surrounded by a space within a structure\u00a0called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4748\">glomerular capsule<\/a> <\/strong>(also known as the Bowman's capsule). Extending from glomerular capsule is the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4749\">renal tubule<\/a><\/strong>. The proximal end (nearest glomerular capsule) of the renal tubule is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4750\">proximal convoluted (coiled) tubule<\/a><\/strong>. From here, the renal tubule continues as a loop (known as the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4751\"><strong>loop of Henle<\/strong><\/a>) (also known as the loop of the nephron), which in turn becomes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4752\"><strong>distal convoluted tubule<\/strong><\/a>. The latter finally joins with a collecting duct. As you can see in the diagram, arterioles surround the total length of the renal tubule in a mesh called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4753\"><strong>peritubular capillary network<\/strong><\/a>.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 425px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1554\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blood_Flow_in_the_Nephron.jpg\" alt=\"16.4.5 Nephron\" width=\"425\" height=\"600\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.5 This model of an individual nephron shows each of the structures that are involved in filtering blood, returning needed materials to blood, or excreting wastes that form urine.<\/em><\/figcaption><\/figure>\n<div><\/div>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 257px\" class=\"wp-caption alignright\"><img class=\"size-medium wp-image-1556\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Physiology_of_Nephron-257x300.png\" alt=\"16.4.6 Urine Formation at the Nephron\" width=\"257\" height=\"300\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\">Figure 16.4.6 This diagram of a nephron shows the parts of the nephron where different stages of nephron function take place. These stages are filtration, reabsorption, secretion, and excretion.<\/figcaption><\/figure>\n<h2>Function of a Nephron<\/h2>\n<p>The simplified diagram of a nephron in Figure 16.4.6 shows an overview of how the nephron functions. Blood enters the nephron through an arteriole called the afferent arteriole. Next, some of the blood passes through the capillaries of the glomerulus. Any blood that doesn\u2019t pass through the glomerulus \u2014 as well as blood after it passes through the glomerular capillaries \u2014 continues on through an arteriole called the efferent arteriole. The efferent arteriole follows the renal tubule of the nephron, where it continues\u00a0playing a role\u00a0in nephron functioning.<\/p>\n<p>&nbsp;<\/p>\n<h3>Filtration<\/h3>\n<p>As blood from the afferent arteriole flows through the glomerular capillaries, it is under pressure. Because of the pressure, water and solutes are filtered out of the blood and into the space made by glomerular capsule, almost like the water you cook pasta is is filtered out through a strainer. This is the filtration stage of nephron function. The filtered substances \u2014 called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1971\">filtrate<\/a><\/strong> \u2014 pass into glomerular capsule, and from there into the proximal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4749\">renal tubule<\/a>.\u00a0 Anything too large to move through the pores in the glomerulus, such as blood cells, large proteins, etc., stay in the cardiovascular system.\u00a0 At this stage, filtrate (fluid in the nephron) includes water, salts, organic solids (such as nutrients), and waste products of metabolism (such as urea).<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 403px\" class=\"wp-caption alignright\"><img class=\" wp-image-1557\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nephron_Secretion_Reabsorption.jpg\" alt=\"16.4.7 Nephron Secretion and Reabsorption\" width=\"403\" height=\"769\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.7 Secretion and reabsorption happen along the length of the renal tubule as the nephron balances blood pH and volume and maintains homeostasis of ions in the blood. Reabsorption is the movement of substance back into the bloodstream and secretion is movement of substances from the blood into the nephron for excretion.<\/em><\/figcaption><\/figure>\n<h3>Reabsorption and Secretion<\/h3>\n<p>As filtrate moves through the renal tubule, some of the substances it contains are reabsorbed from the filtrate back into the blood in the efferent arteriole (via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4753\">peritubular capillary network<\/a>). This is the reabsorption stage of nephron function and it is about returning \"the good stuff\" back to the blood so that it doesn't exit the body in urine. About two-thirds of the filtered salts and water, and all of the filtered organic solutes (mainly <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1945\">glucose<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2279\">amino acid<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">) are reabsorbed from the filtrate by the blood in the peritubular capillary network. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4757\">Reabsorption<\/a> occurs mainly in the proximal convoluted tubule and the loop of Henle, as seen in Figure 16.4.7.<\/span><\/p>\n<p>At the distal end of the renal tubule, some additional reabsorption generally occurs. This is also the region of the tubule where other substances from the blood are added to the filtrate in the tubule. The addition of other substances to the filtrate from the blood is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4758\">secretion<\/a><\/strong>. Both reabsorption and secretion (shown in Figure 16.4.7) in the distal convoluted tubule are largely under the control of endocrine hormones that maintain <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2350\">homeostasis<\/a> of water and mineral salts in the blood. These hormones work by controlling what is reabsorbed into the blood from the filtrate and what is secreted from the blood into the filtrate to become urine. For example, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3467\">parathyroid hormone<\/a> causes more calcium to be reabsorbed into the blood and more phosphorus to be secreted into the filtrate.<\/p>\n<h2>Collection of Urine and Excretion<\/h2>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 219px\" class=\"wp-caption alignleft\"><img class=\" wp-image-1558\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Weewee.jpg\" alt=\"16.4.8 Urine\" width=\"219\" height=\"478\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.8 Fresh urine is typically yellow or amber in colour.<\/em><\/figcaption><\/figure>\n<p>By the time the filtrate has passed through the entire renal tubule, it has become the\u00a0liquid\u00a0waste known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">urine<\/a>. Urine empties from the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4749\">renal tubule<\/a> into a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4759\">collecting duct<\/a><\/strong>. From there, the urine flows into increasingly larger collecting ducts. As urine flows through the system of collecting ducts, more water may be reabsorbed from it. This will occur in the presence of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2050\">antidiuretic\u00a0hormone\u00a0<\/a>from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2938\">pituitary gland<\/a>. This\u00a0hormone\u00a0makes the collecting ducts permeable to water, allowing water molecules to pass through them into capillaries by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2221\">osmosis<\/a>, while preventing the passage of ions or other solutes. As much as 75% of the water may be reabsorbed from urine in the collecting ducts, making the urine more concentrated.<\/p>\n<p>Urine finally exits the largest collecting ducts through the renal papillae. It empties into the renal calyces, and finally into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4724\">renal pelvis<\/a>. From there, it travels through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4725\">ureter<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4731\">urinary bladder<\/a> for eventual excretion from the body. An average of roughly 1.5 litres (a little over 6 cups) of urine is excreted each day. Normally, urine is yellow or amber in colour (see <span style=\"font-size: 1em\">Figure 16.4.8<\/span><span style=\"text-align: initial;font-size: 1em\">). The darker the colour, generally speaking, the more concentrated the urine is.<\/span><\/p>\n<p>&nbsp;<\/p>\n<div><span style=\"font-size: 1.602em;font-weight: bold\">Other Functions of the Kidneys<\/span><\/div>\n<p>Besides filtering blood and forming urine for excretion of soluble wastes, the kidneys have several vital functions in maintaining body-wide\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2350\">homeostasis<\/a>. Most of these functions are related to the\u00a0composition\u00a0or volume of urine formed by the kidneys. The kidneys must maintain the proper balance of water and salts in the body, normal\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4480\">blood pressure<\/a>, and the correct range of blood\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4330\">pH<\/a>. Through the processes of absorption and secretion by nephrons, more or less water, salt ions, acids, or bases are returned to the blood or excreted in urine, as needed, to maintain homeostasis.<\/p>\n<h2>Blood Pressure\u00a0Regulation<\/h2>\n<p>The kidneys do not control homeostasis all alone. As indicated above, endocrine hormones are also involved. Consider the regulation of\u00a0blood pressure\u00a0by the kidneys. Blood pressure is the pressure exerted by blood on the walls of the arteries. The regulation of blood pressure is part of a complex system, called the renin-angiotensin-aldosterone system. This system regulates the\u00a0concentration\u00a0of sodium in the blood to control blood pressure.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 736px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1559\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Renin_Angiotensin_System-01.jpg\" alt=\"16.4.9 Regulation of Blood Pressure\" width=\"736\" height=\"336\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.9 This diagram summarizes the processes that occur in the regulation of blood pressure by the renin-angiotensin-aldosterone system. The final step on the far right occurs in the nephrons and collecting ducts of the kidneys, where aldosterone stimulates increased reabsorption of sodium and water into the blood.<\/em><\/figcaption><\/figure>\n<p>The renin-angiotensin-aldosterone system is put into play when the\u00a0concentration\u00a0of sodium ions in the blood falls lower than normal. This causes the kidneys to secrete an\u00a0enzyme\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4762\">renin<\/a> into the blood. It also causes the liver to secrete a\u00a0protein\u00a0called angiotensinogen. Renin changes angiotensinogen into a proto-hormone\u00a0called\u00a0angiotensin I. This is converted to angiotensin II by an\u00a0enzyme\u00a0(angiotensin-converting enzyme) in lung capillaries.<\/p>\n<p>Angiotensin II is a potent hormone that causes arterioles to constrict. This, in turn, increases blood pressure. Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the kidneys to increase the reabsorption of sodium ions and water from the filtrate into the blood. This returns the\u00a0concentration\u00a0of sodium ions in the blood to normal. The increased water in the blood also increases blood volume and blood pressure.<\/p>\n<h2>Other Kidney Hormones<\/h2>\n<p>Hormones other than renin are also produced and secreted by the kidneys. These include calcitriol and erythropoietin.<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4763\">Calcitriol<\/a><\/strong>\u00a0is secreted by the kidneys in response to low levels of calcium in the blood. This hormone stimulates uptake of calcium by the intestine, thus raising blood levels of calcium.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4764\">Erythropoietin<\/a><\/strong> is secreted by the kidneys in response to low levels of oxygen in the blood. This hormone stimulates erythropoiesis, which is the production of\u00a0 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4398\">erythrocytes<\/a>\u00a0in bone marrow. Extra red blood cells increase the level of oxygen carried in the blood.<\/li>\n<\/ul>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<p>Kidney failure is a complication of common disorders including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2771\">diabetes mellitus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4231\">hypertension<\/a>. It is estimated that approximately 12.5% of Canadians have some form of kidney disease.\u00a0 If the disease is serious, the patient must either receive a donated kidney or have frequent hemodialysis, a medical procedure in which the blood is artificially filtered through a machine. Transplant generally results in better outcomes than hemodialysis, but demand for organs far outstrips the supply. The average time on the organ donation waitlist for a kidney is four years.\u00a0 There are over 3,000 Canadians on the wait list for a kidney transplant and some will die waiting for a kidney to become available.<\/p>\n<p>For the past decade, Dr. William Fissell, a kidney specialist at Vanderbilt University, has been working to create an implantable part-biological and part-artificial kidney. Using microchips like those used in computers, he has produced an artificial kidney small enough to implant in the patient\u2019s body in place of the failed kidney. According to Dr. Fissell, the artificial kidney is \u201c... a bio-hybrid device that can mimic a kidney to remove enough waste products, salt, and water to keep a patient off [hemo]dialysis.\u201d<\/p>\n<p>The filtration system in the artificial kidney consists of a stack of 15 microchips. Tiny pores in the microchips act as a scaffold for the growth of living kidney\u00a0cells\u00a0that can mimic the natural functions of the kidney. The living cells form a membrane to filter the patient\u2019s blood as a biological kidney would, but with less risk of rejection by the patient\u2019s immune system, because they are embedded within the device. The new kidney doesn\u2019t need a power source, because it uses the natural pressure of blood flowing through arteries to push the blood through the filtration system. A major part of the design of the artificial organ was devoted to fine tuning the fluid dynamics so blood flows through the device without clotting.<\/p>\n<p>Because of the potential life-saving benefits of the device, the implantable kidney was given fast-track approval for testing in people by the U.S. Food and Drug Administration. The artificial kidney is expected to be tested in pilot trials by 2018. Dr. Fissell says he has a long list of patients eager to volunteer for the trials.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The two bean-shaped kidneys are located high in the back of the abdominal cavity on either side of the spine. A renal artery connects each kidney with the aorta, and transports unfiltered blood to the kidney. A renal vein connects each kidney with the inferior vena cava and transports filtered blood back to the\u00a0circulation.<\/li>\n<li>The kidney has two main layers involved in the filtration of blood and formation of urine: the outer cortex and inner medulla. At least a million nephrons \u2014 which are the tiny functional units of the kidney \u2014 span the cortex and medulla. The entire kidney is surrounded by a fibrous capsule and protective fat layers.<\/li>\n<li>As blood flows through a nephron, many materials are filtered out of the blood, needed materials are returned to the blood, and the remaining materials are used to form urine.<\/li>\n<li>In each nephron, the glomerulus and surrounding Bowman\u2019s capsule form the unit that filters blood. From Bowman\u2019s capsule, the material filtered from blood (called filtrate) passes through the long renal tubule. As it does, some substances are reabsorbed into the blood, and other substances are secreted from the blood into the filtrate, finally forming urine. The urine empties into collecting ducts, where more water may be reabsorbed.<\/li>\n<li>The kidneys control homeostasis with the help of endocrine hormones.\u00a0The kidneys, for example, are part of the renin-angiotensin-aldosterone system that regulates the concentration of sodium in the blood to control blood pressure. In this system, the\u00a0enzyme\u00a0renin secreted by the kidneys works with hormones from the liver and adrenal gland to stimulate nephrons to reabsorb more sodium and water from urine.<\/li>\n<li>The kidneys also secrete endocrine hormones, including calcitriol \u2014 which helps control the level of calcium in the blood \u2014 and erythropoietin, which stimulates bone marrow to produce red blood\u00a0cells.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-316\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-316\" class=\"h5p-iframe\" data-content-id=\"316\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"16.4 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Contrast the renal artery and renal vein.<\/li>\n<li>Identify the functions of a nephron.\u00a0Describe in detail what happens to fluids (blood, filtrate, and urine) as they pass through the parts of a nephron.<\/li>\n<li>Identify two endocrine hormones secreted by the kidneys, along with the functions they control.<\/li>\n<li>Name two regions in the kidney where water is reabsorbed.<\/li>\n<li>Is the blood in the glomerular capillaries more or less filtered than the blood in the peritubular capillaries? Explain your answer.<\/li>\n<li>What do you think would happen if\u00a0blood flow to the kidneys is blocked?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/FN3MFhYPWWo<\/p>\n<p style=\"text-align: center\">How do your kidneys work? - Emma Bryce, TED-Ed, 2015.<\/p>\n<p>https:\/\/youtu.be\/es-t8lO1KpA<\/p>\n<p style=\"text-align: center\">Urine Formation, Hamada Abass, 2013.<\/p>\n<p>https:\/\/youtu.be\/bX3C201O4MA<\/p>\n<p style=\"text-align: center\">Printing a human kidney - Anthony Atala, TED-Ed, 2013.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 16.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/haynes\/3403969320\" rel=\"cc:attributionURL\">Steak and Kidney Pie<\/a> by <a class=\"owner-name truncate\" title=\"Go to Charles Haynes's photostream\" href=\"https:\/\/www.flickr.com\/photos\/haynes\/\" data-track=\"attributionNameClick\">Charles Haynes<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\" rel=\"license\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/p>\n<p><strong>Figure 16.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gray1120.png\" rel=\"cc:attributionURL\">Gray Kidneys<\/a> by\u00a0<a href=\"https:\/\/en.wikipedia.org\/wiki\/Henry_Vandyke_Carter\">Henry Vandyke Carter<\/a>\u00a0(1831-1897) on Wikimedia Commons is in the \u00a0<a class=\"extiw\" title=\"en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/public_domain). (<a class=\"extiw\" title=\"en:Bartleby.com\" href=\"https:\/\/en.wikipedia.org\/wiki\/Bartleby.com\">Bartleby.com<\/a>:\u00a0<a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/\" rel=\"nofollow\">Gray\u2019s Anatomy<\/a>, <a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/illus1120.html\" rel=\"nofollow\">Plate 1120<\/a>).<\/p>\n<p><strong>Figure 16.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0592_KidneyAnatomy_01.png\" rel=\"cc:attributionURL\">Blausen_0592_KidneyAnatomy_01<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_how_the_kidneys_work_CRUK_138.svg\" rel=\"cc:attributionURL\">Diagram_showing_how_the_kidneys_work_CRUK_138.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 16.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2611_Blood_Flow_in_the_Nephron.jpg\" rel=\"cc:attributionURL\">Blood_Flow_in_the_Nephron<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Physiology_of_Nephron.png\" rel=\"cc:attributionURL\">1024px-Physiology_of_Nephron<\/a> by <a title=\"User:Madhero88\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Madhero88\">Madhero88<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2618_Nephron_Secretion_Reabsorption.jpg\" rel=\"cc:attributionURL\">Nephron_Secretion_Reabsorption<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-6-tubular-reabsorption\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Weewee.JPG\" rel=\"cc:attributionURL\">Urine<\/a> by <a class=\"extiw\" title=\"en:User:Markhamilton\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Markhamilton\">User:Markhamilton<\/a> at <a class=\"extiw\" title=\"en:Main Page\" href=\"https:\/\/en.wikipedia.org\/wiki\/Main_Page\">English Wikipedia<\/a> on Wikimedia Commons is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 16.4.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2712_Renin_Angiotensin_System-01.jpg\" rel=\"cc:attributionURL\">Renin_Angiotensin_System-01<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/26-3-electrolyte-balance\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">25.10<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"4696\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">Blood flow in the nephron [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 25.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney<\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">25.17<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"26834\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text last focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">Locations of secretion and reabsorption in the nephron <span id=\"4696\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 25.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-6-tubular-reabsorption<\/span><\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">26.14<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"41702\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">The renin-angiotensin system <span id=\"26834\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text last focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\"><span id=\"4696\" class=\"os-title\" data-type=\"title\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 26.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/26-3-electrolyte-balance<\/span><\/span><\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014.\u00a0<i>WikiJournal of Medicine<\/i>\u00a0<b>1<\/b>\u00a0(2).\u00a0DOI:10.15347\/wjm\/2014.010.\u00a0ISSN\u00a02002-4436<\/p>\n<p class=\"hanging-indent\">Hamada Abass. (2013). Urine formation. YouTube. https:\/\/www.youtube.com\/watch?v=es-t8lO1KpA&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 9). How do your kidneys work? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=FN3MFhYPWWo&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, March 15). Printing a human kidney - Anthony Atala. YouTube. https:\/\/www.youtube.com\/watch?v=bX3C201O4MA&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3009\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3009\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-309\">\n<div class=\"h5p-content\" data-content-id=\"309\"><\/div>\n<\/div>\n<p><em>Figure 16.3.1 The surprising uses of pee.<\/em><\/p>\n<div>\n<h1>Surprising Uses<\/h1>\n<\/div>\n<p>What do gun powder, leather, fabric dyes and laundry service have in common?\u00a0 This may be surprising, but they all historically involved urine.\u00a0 One of the main components in gun powder, potassium nitrate, was difficult to come by pre-1900s, so ingenious gun-owners would evaporate urine to concentrate the nitrates it contains.\u00a0 The ammonium in urine was excellent in breaking down tissues, making it a prime candidate for softening leathers and removing stains in laundry.\u00a0 Ammonia in urine also helps dyes penetrate fabrics, so it was used to make colours stay brighter for longer.<\/p>\n<div>\n<h1>What is the Urinary System?<\/h1>\n<\/div>\n<p>The actual human\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2914\">urinary system<\/a><\/strong>, also known as the renal system, is shown in Figure 16.3.2. The system consists of the kidneys, ureters, bladder, and urethra. The main function of the urinary system is to eliminate the waste products of metabolism from the body by forming and excreting <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">urine<\/a>.<\/strong> Typically, between one and two litres of urine are produced every day in a healthy individual.<\/p>\n<figure id=\"attachment_1540\" aria-describedby=\"caption-attachment-1540\" style=\"width: 560px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1536\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Urinary_System_Male.png\" alt=\"16.3.2 Urinary System\" width=\"560\" height=\"560\"><figcaption id=\"caption-attachment-1540\" class=\"wp-caption-text\"><em>16.3.2 The components of the urinary system include the two kidneys, two ureters, bladder, and urethra. The urinary system is the same in males and females, except the urethra is longer in males.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Organs of the Urinary System<\/h1>\n<\/div>\n<p>The urinary system is all about urine. It includes organs that form urine, and also those that transport, store, or excrete urine.<\/p>\n<h2>Kidneys<\/h2>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">Urine<\/a> is formed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2988\">kidneys<\/a>, which filter many substances out of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2702\">blood<\/a>, allow the blood to reabsorb needed materials, and use the remaining materials to form urine. The human body normally has two paired kidneys, although it is possible to get by quite well with just one. As you can see in Figure 16.3.3, each kidney is well supplied with blood vessels by a major artery and vein. Blood to be filtered enters the kidney through the renal artery, and the filtered blood leaves the kidney through the renal vein. The kidney itself is wrapped in a fibrous capsule, and consists of a thin outer layer called the cortex, and a thicker inner layer called the medulla.<\/p>\n<figure id=\"attachment_1540\" aria-describedby=\"caption-attachment-1540\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-1538\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2610_The_Kidney.jpg\" alt=\"16.3.3 The Kidney\" width=\"1024\" height=\"585\"><figcaption id=\"caption-attachment-1540\" class=\"wp-caption-text\"><em>Figure 16.3.3 The structure of the kidney is specialized to filter blood and form and collect urine.<\/em><\/figcaption><\/figure>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2702\">Blood<\/a> is filtered and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">urine<\/a> is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephron<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. Each kidney contains at least a million nephrons, and each nephron spans the cortex and medulla layers of the kidney. After urine forms in the nephrons, it flows through a system of converging collecting ducts. The collecting ducts join together to form minor calyces (or chambers) that join together to form major calyces (see Figure 16.3.3 above). Ultimately, the major calyces join the <\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4724\">renal pelvis<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">, which is the funnel-like end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4725\">ureter<\/a> where it enters the kidney.<\/span><\/p>\n<h2>Ureters, Bladder, Urethra<\/h2>\n<p>After urine forms in the kidneys, it is transported through the ureters (one per kidney) via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2890\">peristalsis<\/a> to the sac-like urinary bladder, which stores the urine until <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4726\">urination<\/a>. <\/strong>During urination, the urine is released from the bladder and transported by the urethra to be excreted outside the body through the external urethral opening.<\/p>\n<div>\n<h1>Functions of the Urinary System<\/h1>\n<\/div>\n<p>Waste products removed from the body with the formation and elimination of urine include many water-soluble metabolic products. The main waste products are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4708\">urea<\/a> \u2014 a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2422\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2299\">catabolism<\/a> \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4709\">uric\u00a0acid<\/a>, a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4727\">nucleic acid<\/a>\u00a0catabolism. Excess\u00a0water\u00a0and mineral ions are also eliminated in urine.<\/p>\n<p>Besides the elimination of waste products such as these, the urinary system has several other vital functions. These include:<\/p>\n<ul>\n<li><strong>Maintaining<\/strong><strong>\u00a0homeostasis\u00a0of mineral ions in extracellular fluid<\/strong>: These ions are either excreted in urine or returned to the blood as needed to maintain the proper balance.<\/li>\n<li><strong>Maintaining homeostasis of blood pH<\/strong>:\u00a0When\u00a0pH\u00a0is too low (blood is too acidic), for example, the kidneys excrete less bicarbonate (which is basic) in urine. When pH is too high (blood is too basic), the opposite occurs, and more bicarbonate is excreted in urine.<\/li>\n<li><strong>Maintaining homeostasis of extracellular fluids, including the blood volume, which helps maintain<\/strong><strong>\u00a0blood pressure:<\/strong>\u00a0The kidneys control fluid volume and\u00a0blood pressure\u00a0by excreting more or less salt and\u00a0water\u00a0in urine.<\/li>\n<\/ul>\n<div>\n<h1>Control of the Urinary System<\/h1>\n<\/div>\n<p>The formation of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">urine<\/a> must be closely regulated to maintain body-wide\u00a0homeostasis. Several\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2648\">endocrine<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2218\">hormones<\/a>\u00a0help control this function of the urinary system, including antidiuretic\u00a0hormone, parathyroid hormone, and aldosterone.<\/p>\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2050\"><strong>Antidiuretic<\/strong><strong> hormone<\/strong><\/a><strong> (ADH)<\/strong>, also called vasopressin, is secreted by the\u00a0posterior\u00a0pituitary gland. One of its main roles is conserving body\u00a0water. It is released when the body is dehydrated, and it causes the kidneys to excrete less water in urine.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3467\"><strong>Parathyroid<\/strong><strong>\u00a0hormone<\/strong><\/a>\u00a0is secreted by the parathyroid glands. It works to regulate the balance of mineral ions in the body\u00a0via\u00a0its effects on several organs, including the kidneys. Parathyroid hormone stimulates the kidneys to excrete less calcium and more phosphorus in urine.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2509\">Aldosterone<\/a><\/strong> is secreted by the cortex of the adrenal glands, which rest atop the kidneys, as shown in Figure 16.3.4. Through its effect on the kidneys, it plays a central role in regulating blood pressure. It causes the kidneys to excrete less sodium and water in urine.<\/li>\n<\/ul>\n<figure id=\"attachment_1540\" aria-describedby=\"caption-attachment-1540\" style=\"width: 588px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1539 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-e1592620428819.jpg\" alt=\"16.3.4 Adrenal Glands\" width=\"588\" height=\"540\"><figcaption id=\"caption-attachment-1540\" class=\"wp-caption-text\"><em>Figure 16.3.4 The adrenal glands are located on top of the kidneys. They secrete aldosterone into the bloodstream, which carries it to the kidneys.<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_1540\" aria-describedby=\"caption-attachment-1540\" style=\"width: 428px\" class=\"wp-caption alignleft\"><img class=\" wp-image-1540\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary_Sphincter.png\" alt=\"16.3.5 Urinary sphincter\" width=\"428\" height=\"428\"><figcaption id=\"caption-attachment-1540\" class=\"wp-caption-text\"><em>Figure 16.3.5 The urinary sphincter relaxes to allow urination.<\/em><\/figcaption><\/figure>\n<p>Once urine forms, it is excreted from the body in the process of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4726\">urination<\/a>, also sometimes referred to as micturition. This process is controlled by both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3014\">somatic<\/a> nervous systems. As the bladder fills with urine, it causes the autonomic nervous system to signal smooth muscle in the bladder wall to contract (as shown in Figure 16.3.5), and the sphincter between the bladder and urethra to relax and open. This forces urine out of the bladder and through the urethra. Another sphincter at the distal end of the urethra is under <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3004\">voluntary<\/a> control. When it relaxes under the influence of the somatic nervous system, it allows urine to leave the body through the external urethral opening.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.3 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2914\">urinary system<\/a> consists of the kidneys, ureters, bladder, and urethra. The main function of the urinary system is to eliminate the waste products of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2368\">metabolism<\/a> from the body by forming and excreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4717\">urine<\/a>.<\/li>\n<li>Urine is formed by the kidneys, which filter many substances out of blood, allow the blood to reabsorb needed materials, and use the remaining materials to form urine. Blood to be filtered enters the kidney through the renal artery, and filtered blood leaves the kidney through the renal vein.<\/li>\n<li>Within each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2988\">kidney<\/a>, blood is filtered and urine is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4718\">nephrons<\/a>, of which there are at least a million in each kidney.<\/li>\n<li>After urine forms in the kidneys, it is transported through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4725\">ureters<\/a> via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2890\">peristalsis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4731\">urinary bladder<\/a>. The bladder stores the urine until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4726\">urination<\/a>, when urine is transported by the urethra to be excreted outside the body.<\/li>\n<li>Besides the elimination of waste products (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4708\">urea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4709\">uric\u00a0acid<\/a>, excess water, and mineral ions), the urinary system has other vital functions. These include maintaining\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2350\">homeostasis<\/a>\u00a0of mineral ions in extracellular fluid, regulating acid-base\u00a0balance in the blood, regulating the volume of extracellular fluids, and controlling <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4480\">blood pressure<\/a>.<\/li>\n<li>The formation of urine must be closely regulated to maintain body-wide homeostasis. Several\u00a0endocrine hormones\u00a0help control this function of the urinary system, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2526\">antidiuretic hormone<\/a> from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2938\">pituitary gland<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3467\">parathyroid hormone<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3402\">parathyroid glands<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2509\">aldosterone<\/a> from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2494\">adrenal glands<\/a>.<\/li>\n<li>The process of urination is controlled by both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3014\">somatic<\/a> nervous systems. The autonomic system causes the bladder to empty, but conscious relaxation of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4627\">sphincter<\/a> at the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4732\">urethra<\/a> allows urine to leave the body.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-310\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-310\" class=\"h5p-iframe\" data-content-id=\"310\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"16.3 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>State the main function of the urinary system.<\/li>\n<li>What are nephrons?<\/li>\n<li>Other than the elimination of waste products, identify functions of the urinary system.<\/li>\n<li>How is the formation of urine regulated?<\/li>\n<li>Explain why it is important to have voluntary control over the sphincter at the end of the urethra.<\/li>\n<li>In terms of how they affect the kidneys, compare aldosterone to antidiuretic hormone.<\/li>\n<li>If your body needed to retain more calcium, which of the hormones described in this concept is most likely to increase? Explain your reasoning.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.3 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/dxecGD0m0Xc<\/p>\n<p style=\"text-align: center\">The Urinary System - An Introduction | Physiology | Biology | FuseSchool, 2017.<\/p>\n<p>https:\/\/youtu.be\/pyMcTUQYMQw<\/p>\n<p style=\"text-align: center\">Maple Syrup Urine Disease, Alexandria Doody, 2016.<\/p>\n<p>https:\/\/youtu.be\/3z-xjfdJWAI<\/p>\n<p style=\"text-align: center\">How Accurate Are Drug Tests? Seeker, 2016.<\/p>\n<p>https:\/\/youtu.be\/xt1Tj5eeS0k<\/p>\n<p style=\"text-align: center\">Three Ways Pee Could Change the World, Gross Science, 2015.<\/p>\n<\/div>\n<\/div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Attributions<\/span><\/p>\n<\/div>\n<p><strong>Figure 16.3.1<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Pyrodex_powder_ffg.jpg\">File:Pyrodex powder ffg.jpg<\/a> by <a title=\"User:Hustvedt\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Hustvedt\">Hustvedt<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en\">CC BY SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/pFLNV4gkXsc\">Brown leather satchel bag<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@alvaroserrano\">\u00c1lvaro Serrano<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the <a href=\"https:\/\/unsplash.com\/license\">Unsplash Licence<\/a> (https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/nHhGuO-2YPw\">Laundry basket<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@andyfitz\">Andy Fitzsimon<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the <a href=\"https:\/\/unsplash.com\/license\">Unsplash Licence<\/a> (https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/pixabay.com\/photos\/wool-skeins-natural-dyed-colorful-593794\/\">Tags: Wool Skeins Natural Dyed Colorful Himalayan Weavers<\/a> by\u00a0 on <a href=\"http:\/\/pixabay.com\">Pixabay<\/a> is used under the <a href=\"https:\/\/pixabay.com\/service\/license\/\">Pixabay License<\/a> (https:\/\/pixabay.com\/service\/license\/).<\/li>\n<\/ul>\n<p><strong>Figure 16.3.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Urinary_System_(Male).png\" rel=\"cc:attributionURL\">Urinary_System_(Male)<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 16.3.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2610_The_Kidney.jpg\" rel=\"cc:attributionURL\">2610_The_Kidney<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.3.4<\/strong><\/p>\n<p><a href=\"https:\/\/visuals.nci.nih.gov\/details.cfm?imageid=4355\" rel=\"cc:attributionURL\">Adrenal glands on Kidney<\/a>\u00a0 by <a href=\"https:\/\/visuals.nci.nih.gov\/details.cfm?imageid=4355\">Alan Hoofring (Illustrator)\/ NCI Visuals Online<\/a> is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 16.3.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Urinary_Sphincter.png\" rel=\"cc:attributionURL\">Urinary_Sphincter<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Alexandria Doody. (2016, March 29). Maple syrup urine disease. YouTube. https:\/\/www.youtube.com\/watch?v=pyMcTUQYMQw&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><span class=\"os-number\">25.8<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"3662\" class=\"os-title\" data-type=\"title\">Left kidney [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 25.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney<\/span><\/p>\n<p class=\"hanging-indent\">FuseSchool. (2017, June 19). The urinary system - An introduction | Physiology | Biology | FuseSchool. YouTube. https:\/\/www.youtube.com\/watch?v=dxecGD0m0Xc&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Gross Science. (2015, September 15). Three ways pee could change the world. YouTube. https:\/\/www.youtube.com\/watch?v=xt1Tj5eeS0k&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Seeker. (2016, January 16). How accurate are drug tests? YouTube. https:\/\/www.youtube.com\/watch?v=3z-xjfdJWAI&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_2929\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_2929\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_394\" aria-describedby=\"caption-attachment-394\" style=\"width: 496px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-2482\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/loly-galina-JrHhKeQBM9A-unsplash-scaled-1.jpg\" alt=\"Image demonstrates that within a family, the offspring resemble their parents, but are slightly different from both the parents and their siblings.\" width=\"496\" height=\"744\"><figcaption id=\"caption-attachment-394\" class=\"wp-caption-text\"><em>Figure 5.12.1 Family resemblance. <\/em><\/figcaption><\/figure>\n<h1>All in the Family<\/h1>\n<p>This family photo (Figure 5.12.1) clearly illustrates an important point: children in a family resemble their parents and each other, but the children never look exactly the same, unless they are identical twins. Each of the daughters in the photo have inherited a unique combination of traits from the parents. In this concept, you will learn how this happens. It all begins with sex \u2014 sexual reproduction, that is.<\/p>\n<div>\n<h1>Sexual Reproduction<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2414\">Reproduction<\/a><\/strong>\u00a0is the process by which organisms give rise to offspring. It is one of the defining characteristics of living things. Like many other organisms, human beings reproduce sexually.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2468\">Sexual reproduction<\/a> <\/strong>involves two parents. As you can see from Figure 5.12.2, in sexual reproduction, parents produce reproductive (sex) cells \u2014 called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2694\">gametes<\/a>\u00a0<\/strong>\u2014 that unite to form an offspring. Gametes are\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2484\">haploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2485\">1N<\/a>)\u00a0cells.\u00a0This means they contain one copy of each chromosome in the\u00a0nucleus.\u00a0Gametes are produced by a type of\u00a0cell division\u00a0called\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2486\">meiosis<\/a>, which is described in detail below. The process in which two gametes unite is called\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2677\"><strong>fertilizat<\/strong><strong>i<\/strong><strong>on<\/strong><\/a>. The fertilized cell that results is referred to as a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2471\">zygote<\/a><\/strong>. A zygote is a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2103\">diploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2103\">2N<\/a>) cell,\u00a0which means it contains two copies of each chromosome. Thus, it has twice the number of\u00a0chromosomes\u00a0as a gamete.<\/p>\n<figure id=\"attachment_394\" aria-describedby=\"caption-attachment-394\" style=\"width: 555px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-388\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Human-Life-Cycle.png\" alt=\"Image illustrates the human life cycle\" width=\"555\" height=\"464\"><figcaption id=\"caption-attachment-394\" class=\"wp-caption-text\"><em>Figure 5.12.2 Sexual reproduction involves the production of haploid gametes by meiosis, followed by fertilization and the formation of a diploid zygote. The number of chromosomes in a gamete is represented by the letter N. Why does the zygote have 2N, or twice as many, chromosomes?<\/em><\/figcaption><\/figure>\n<div>\n<h1>Meiosis<\/h1>\n<\/div>\n<p>The process that produces haploid gametes is called meiosis.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2486\">Meiosis<\/a><\/strong> is a type of cell division in which the number of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2166\">chromosomes<\/a> is reduced by half. It occurs only in certain special cells of an organism. During meiosis, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2153\">homologous (paired) chromosomes<\/a> separate, and four <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2484\">haploid<\/a> cells form that have only one chromosome from each pair. The diagram (Figure 5.12.3) gives an overview of meiosis.<\/p>\n<figure id=\"attachment_394\" aria-describedby=\"caption-attachment-394\" style=\"width: 587px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-389\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/MajorEventsInMeiosis_variant_int.png\" alt=\"Image shows the major events in Meiosis\" width=\"587\" height=\"352\"><figcaption id=\"caption-attachment-394\" class=\"wp-caption-text\"><em>Figure 5.12.3 Overview of Meiosis. During meiosis, homologous chromosomes separate and go to different daughter cells. This diagram shows just the nuclei of the cells. Notice the exchange of genetic material that occurs prior to the first cell division.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>As you can see in\u00a0the meiosis diagram, two cell divisions occur during the overall process,\u00a0producing\u00a0a total of four <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2484\">haploid<\/a> cells from one parent cell. The two cell divisions are called meiosis I and meiosis II.\u00a0Meiosis I begins after\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2086\">DNA\u00a0replicates<\/a> during interphase. Meiosis II follows meiosis I without DNA replicating again. Both meiosis I and meiosis II occur in four phases, called prophase, metaphase, anaphase, and telophase. You may recognize these four phases from\u00a0mitosis, the division of the\u00a0nucleus\u00a0that takes place during routine\u00a0cell division\u00a0of eukaryotic cells.<\/p>\n<h2>Meiosis I- Increasing genetic variation<\/h2>\n<p>The phases of Meiosis I are:<\/p>\n<ol>\n<li><strong>Prophase I:<\/strong>\u00a0The nuclear envelope begins to break down, and the\u00a0chromosomes\u00a0condense. Centrioles start moving to opposite poles of the cell, and a spindle begins to form. Importantly, homologous chromosomes pair up, which is unique to prophase I. In prophase of\u00a0mitosis\u00a0and meiosis II, homologous chromosomes do not form pairs in this way. During prophase I, crossing-over occurs. The significance of crossing-over is discussed below.<\/li>\n<li><strong>Metaphase I:<\/strong> Spindle fibres attach to the paired homologous chromosomes. The paired chromosomes line up along the equator of the cell, randomly aligning in a process called independent alignment.\u00a0 The significance of independent alignment is discussed below. This occurs only in metaphase I. In metaphase of mitosis and meiosis II, it is sister chromatids that line up along the equator of the cell.<\/li>\n<li><strong>Anaphase I:<\/strong> Spindle fibres shorten, and the chromosomes of each homologous pair start to separate from each other. One chromosome of each pair moves toward one pole of the cell, and the other chromosome moves toward the opposite pole.<\/li>\n<li><strong>Telophase I and Cytokinesis:<\/strong>\u00a0The spindle breaks down, and new nuclear membranes form. The cytoplasm of the cell divides, and two haploid daughter cells result. The daughter cells each have a random assortment of chromosomes, with one from each homologous pair. Both daughter cells go on to meiosis II.<\/li>\n<\/ol>\n<figure id=\"attachment_394\" aria-describedby=\"caption-attachment-394\" style=\"width: 1052px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-390 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Meiosis-1.png\" alt=\"Illustrates the stages in Meiosis I\" width=\"1052\" height=\"582\"><figcaption id=\"caption-attachment-394\" class=\"wp-caption-text\"><em>Figure 5.12.4 Meiosis I is critical in creating genetic diversity in resulting gametes. Crossing over, in Prophase I and independent alignment in Metaphase I ensure that each resulting gamete is unique.<\/em><\/figcaption><\/figure>\n<h2>Meiosis II- Halfing the DNA<\/h2>\n<p>The phases of Meiosis II are:<\/p>\n<ol>\n<li><strong>Prophase II:<\/strong>\u00a0The nuclear envelope breaks down, and the spindle begins to form in each haploid daughter cell from meiosis I. The centrioles also start to separate.<\/li>\n<li><strong>Metaphase II:<\/strong> Spindle fibres line up the sister chromatids of each chromosome along the equator of the cell.<\/li>\n<li><strong>Anaphase II:<\/strong>\u00a0Sister chromatids separate and move to opposite poles.<\/li>\n<li><strong>Telophase II and Cytokinesis:<\/strong>\u00a0The spindle breaks down, and new nuclear membranes form. The cytoplasm of each cell divides, and four haploid cells result. Each cell has a unique combination of chromosomes.<\/li>\n<\/ol>\n<div>\n<div>\n<figure id=\"attachment_391\" aria-describedby=\"caption-attachment-391\" style=\"width: 1000px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-391 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Meiosis-2-1.png\" alt=\"Image shows the stages of Meiosis II\" width=\"1000\" height=\"582\"><figcaption id=\"caption-attachment-391\" class=\"wp-caption-text\"><em>Figure 5.12.5 In Meiosis II, dyads are separated to create four unique haploid cells.<\/em><\/figcaption><\/figure>\n<h1>Sexual Reproduction and\u00a0Genetic Variation<\/h1>\n<\/div>\n<p>\"It takes two to tango\" might be a euphemism for sexual reproduction. Requiring\u00a0<em>two<\/em>\u00a0individuals to produce offspring, however, is also the main drawback of this way of reproducing, because it requires extra steps \u2014 and often a certain amount of luck \u2014 to successfully reproduce with a partner. On the other hand, sexual reproduction greatly increases the potential for\u00a0genetic variation\u00a0in offspring,\u00a0which\u00a0increases the likelihood that the resulting offspring will have genetic advantages. In fact, each offspring produced is almost guaranteed to be genetically unique, differing from both parents and from any other offspring. Sexual reproduction increases genetic variation in a number of ways:<\/p>\n<figure id=\"attachment_393\" aria-describedby=\"caption-attachment-393\" style=\"width: 518px\" class=\"wp-caption alignright\"><img class=\"wp-image-392\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Corssing-Over-by-OpenStax.jpg\" alt=\"Image shows the process of crossing over as it occurs in Meiosis I\" width=\"518\" height=\"363\"><figcaption id=\"caption-attachment-393\" class=\"wp-caption-text\"><em>Figure 5.12.6 Crossing over results in exchange of sections of DNA between homologous pairs of chromosomes.<\/em><\/figcaption><\/figure>\n<ul>\n<li>When homologous chromosomes pair up during meiosis I, crossing-over can occur.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2500\">Crossing-over<\/a> <\/strong>is the exchange of genetic material between non-sister chromatids of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2153\">homologous chromosomes<\/a>. It results in new combinations of genes on each chromosome. This is called recombination. You can see how it happens in the figure to the right.<\/li>\n<li>When cells divide during meiosis, homologous chromosomes are randomly distributed to daughter cells, and different chromosomes segregate independently of each other. This is called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2502\">independent alignment<\/a><\/strong>. It results in gametes that have unique combinations of chromosomes.\u00a0 You can see how it happens in Figure 5.12.7.<\/li>\n<li>In sexual reproduction, two gametes unite to produce an offspring. But which two of the millions of possible gametes will it be? This is a matter of chance, and it's obviously another source of genetic variation in offspring.<\/li>\n<\/ul>\n<figure id=\"attachment_393\" aria-describedby=\"caption-attachment-393\" style=\"width: 512px\" class=\"wp-caption alignleft\"><img class=\"wp-image-393 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Independent_assortment.svg_.png\" alt=\"Image shows how independent alignment increases genetic diversity in gametes.\" width=\"512\" height=\"217\"><figcaption id=\"caption-attachment-393\" class=\"wp-caption-text\"><em>Figure 5.12.7 Independent alignment greatly increases the genetic diversity among gametes produced.\u00a0 Depending on how the homologous pairs align (with paternal or maternal DNA on the left or right side) determines which mix of genes will end up in each of the four unique haploid gametes produced.<\/em><\/figcaption><\/figure>\n<p>With all of this recombination of genes, there is a need for a new set of vocabulary.\u00a0 Remember, that sister chromatids are two\u00a0<em>identical<\/em> pieces of DNA connected at a centromere.\u00a0 Once crossing over has occured, we can no longer call them sister chromatids since they are no longer identical; we term them <strong>dyads.\u00a0 <\/strong>In addition, once crossing over has occurred, the pair of homologous chromosomes can be referred to as\u00a0<strong>tetrads.\u00a0\u00a0<\/strong><\/p>\n<p>All of these mechanisms\u00a0\u2014\u00a0crossing over, independent assortment, and the random union of gametes\u00a0\u2014\u00a0work together to result in an amazing\u00a0range\u00a0of potential genetic variation. Each human couple, for example, has the potential to produce more than 64 trillion genetically unique children. No wonder we are all different!<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=VzDMG7ke69g<\/p>\n<p style=\"text-align: center\">Meiosis (updated), Amoeba Sisters, 2017.<\/p>\n<h1>Gametogenesis<\/h1>\n<\/div>\n<p>At the end of meiosis, four haploid cells have been produced, but the cells are not yet gametes. The cells need to develop before they become mature gametes capable of\u00a0fertilization. The\u00a0development\u00a0of haploid cells into gametes is called\u00a0<strong>gametogenesis<\/strong>. It\u00a0differs between males and females.<\/p>\n<ul>\n<li>A gamete produced by a male is called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2506\">sperm<\/a><\/strong><strong>,<\/strong>\u00a0and the process that produces a mature\u00a0sperm\u00a0is\u00a0called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2507\">spermatogenesis<\/a><\/strong>. During this process, a sperm cell grows a tail and gains the ability to \u201cswim,\u201d like the human sperm cell shown in Figure 5.12.8.<\/li>\n<li>A gamete produced by a female is called an<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2467\"><strong>egg or ovum,<\/strong><\/a>\u00a0and the process that produces a mature egg is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2509\">oogenesis<\/a><\/strong>, during which just one functional egg is produced. The other three haploid cells that result from meiosis are called polar bodies, and they disintegrate. The single egg is a very large cell, as you can see from the human egg also shown in Figure 5.12.8.<\/li>\n<\/ul>\n<figure id=\"attachment_394\" aria-describedby=\"caption-attachment-394\" style=\"width: 391px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-394 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Fertilization.jpg\" alt=\"Image shows a sperm fertilizing an egg.\" width=\"391\" height=\"265\"><figcaption id=\"caption-attachment-394\" class=\"wp-caption-text\"><em>Figure 5.12.8 A human sperm is a tiny cell with a tail. A human egg is much larger. Both cells are mature haploid gametes that are capable of fertilization. What process is shown in this photograph?<\/em><\/figcaption><\/figure>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">5.12 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>In <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2468\">sexual reproduction<\/a>, two parents produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2694\">gametes<\/a> that unite in the process of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2677\">fertilization<\/a>\u00a0to form a single-celled <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2471\">zygote<\/a>. Gametes are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2484\">haploid<\/a> cells with one copy of each of the 23 chromosomes, and the zygote is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2103\">diploid<\/a> cell with two\u00a0copies of each of the 23 chromosomes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2486\">Meiosis<\/a> is the type of cell division that produces four haploid daughter cells that may become gametes. Meiosis occurs in two stages, called meiosis I and meiosis II, each of which occurs in four phases (prophase, metaphase, anaphase, and telophase).<\/li>\n<li>Meiosis is followed by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2697\">gametogenesis<\/a>, the process during which the haploid daughter cells change into mature gametes. Males produce gametes called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2506\">sperm<\/a> in a process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2507\">spermatogenesis<\/a>, and females produce gametes called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2467\">eggs<\/a> in the process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2509\">oogenesis<\/a>.<\/li>\n<li>Sexual reproduction produces genetically unique offspring. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2500\">Crossing-over<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2502\">independent alignment<\/a>, and the random union of gametes work together to result in an amazing range of potential genetic variation.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">5.12 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-72\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-72\" class=\"h5p-iframe\" data-content-id=\"72\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Sexual Reproduction, Meiosis and Gametogenesis\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain how sexual reproduction happens\u00a0at the cellular level.<\/li>\n<li>Summarize what happens during Meiosis.<\/li>\n<li>Compare and contrast gametogenesis in males and females.<\/li>\n<li>Explain the mechanisms that increase genetic variation in the offspring produced by sexual reproduction.<\/li>\n<li>Why do gametes need to be haploid? What would happen to the chromosome number after fertilization if they were diploid?<\/li>\n<li>Describe one difference between Prophase I of Meiosis and Prophase of Mitosis.<\/li>\n<li>Do all of the chromosomes that you got from your mother go into one of your gametes? Why or why not?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">5.12 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=qCLmR9-YY7o&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Meiosis: Where the Sex Starts - Crash Course Biology #13, CrashCourse, 2012.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=zrKdz93WlVk<\/p>\n<p style=\"text-align: center\">Mitosis vs Meiosis Comparison, Amoeba Sisters, 2018.<\/p>\n<\/div>\n<\/div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Attributions<\/span><\/p>\n<\/div>\n<p><strong>Figure 5.12.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/JrHhKeQBM9A\" rel=\"cc:attributionURL\">Family portrait<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@lolygalina\">loly galina<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p><strong>Figure 5.12.2<\/strong><\/p>\n<p>Human Life Cycle by Christine Miller is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" rel=\"license\">CC BY-NC-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/) license.<\/p>\n<p><strong>Figure 5.12.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:MajorEventsInMeiosis_variant_int.svg\" rel=\"cc:attributionURL\">MajorEventsInMeiosis_variant_int<\/a> by <a title=\"User:Patr\u00edciaR\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Patr%C3%ADciaR\">Patr\u00edciaR<\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0(i<span style=\"font-size: 1em\">nternationalization) on Wikimedia Commons is used and <\/span>adapted by Christine Miller. This image<\/span><span style=\"text-align: initial;font-size: 1em\">\u00a0in the <\/span><a class=\"extiw\" style=\"text-align: initial;font-size: 1em\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain.<\/a> (<span style=\"text-align: initial;font-size: 1em\">Original image from <a href=\"https:\/\/en.wikipedia.org\/wiki\/National_Center_for_Biotechnology_Information\">NCBI<\/a>; original vector version by <a title=\"User:Jakov\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Jakov\">Jakov.<\/a>)<\/span><\/p>\n<p><strong>Figure 5.12.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Meiosis_Stages.svg\" rel=\"cc:attributionURL\">Meiosis 1\/ Meiosis Stages<\/a> by <span style=\"color: #0000ff\"><a class=\"mw-redirect\" style=\"color: #0000ff\" title=\"User:Ali Zifan\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Ali_Zifan\">Ali Zifan<\/a><\/span> on Wikimedia Commons is used and adapted by Christine Miller under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\">CC <span style=\"font-size: 1em\">BY-SA 4.0<\/span><\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0 (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/span><\/p>\n<p><strong>Figure 5.12.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Meiosis_Stages.svg\" rel=\"cc:attributionURL\">Meiosis 2\/ Meiosis Stages <\/a> by <span style=\"color: #0000ff\"><a class=\"mw-redirect\" style=\"color: #0000ff\" title=\"User:Ali Zifan\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Ali_Zifan\">Ali Zifan<\/a><\/span> on Wikimedia Commons is used and adapted by Christine Miller under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\">CC <span style=\"font-size: 1em\">BY-SA 4.0<\/span><\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0 (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/span><\/p>\n<p><strong>Figure 5.12.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_17_02_01.jpg\" rel=\"cc:attributionURL\">Crossover\/ Figure 17 02 01<\/a> by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:Qq6Y1A16@5\/Mapping-Genomes\">CNX OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong>Figure 5.12.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Independent_assortment.svg\" rel=\"cc:attributionURL\">Independent_assortment<\/a> by <a class=\"new\" title=\"User:Mtian20 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Mtian20&amp;action=edit&amp;redlink=1\">Mtian20<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 5.12.8<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/81461206@N02\/7468551760\/\">sperm fertilizing egg<\/a> by <a class=\"owner-name truncate\" title=\"Go to AndreaLaurel's photostream\" href=\"https:\/\/www.flickr.com\/photos\/81461206@N02\/\" data-track=\"attributionNameClick\">AndreaLaurel<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Amoeba Sisters. (2017, July 11). Meiosis (updated). YouTube. https:\/\/www.youtube.com\/watch?v=VzDMG7ke69g&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Amoeba Sisters. (2018, May 31). Mitosis vs meiosis comparison. YouTube. https:\/\/www.youtube.com\/watch?v=zrKdz93WlVk&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">CrashCourse, (2012, April 23). Meiosis: Where the sex starts - Crash Course Biology #13. YouTube. https:\/\/www.youtube.com\/watch?v=qCLmR9-YY7o&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">OpenStax CNX. (2016, May 27). Figure 1 Crossover may occur at different locations on the chromosome<span style=\"text-align: initial;font-size: 1em\">. <\/span><span style=\"text-align: initial;font-size: 1em\">In <\/span><em style=\"text-align: initial;font-size: 1em\">OpenStax, Biology <\/em>(Section 17.2)<span style=\"text-align: initial;font-size: 1em\">. http:\/\/cnx.org\/contents\/185cbf87-c72e-48f5-b51e-f14f21b5eabd@10.53.<\/span><\/p>\n<p class=\"hanging-indent\">\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5939\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5939\"><div tabindex=\"-1\"><p>Clear fluid produced by the brain that forms a thin layer within the meninges and provides protection and cushioning for the brain and spinal cord.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5909\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5909\"><div tabindex=\"-1\"><p>A highly selective membrane formed of epithelial cells that separates circulating blood from extracellular fluid in the brain and spinal cord.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_2984\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_2984\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1103\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/stroller-fit.jpg\" alt=\"12.5.1 Stroller Fit\" width=\"400\" height=\"225\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>12.5.1 It's stroller time!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Stroller Moms<\/h1>\n<\/div>\n<p>These moms (Figure 12.5.1) are setting a great example for their children by engaging in physical exercise. Adopting a habit of regular physical exercise is one of the most important ways to maintain fitness and good health. From higher self-esteem to a healthier heart, physical exercise can have a positive effect on virtually all aspects of health, including physical, mental, and emotional health.<\/p>\n<div>\n<h1>What Is Physical Exercise?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4224\">Physical exercise<\/a><\/strong> is any bodily activity that enhances or maintains physical fitness and overall health and wellness. We generally think of physical exercise as activities that are undertaken for the main purpose of improving physical fitness and health. However, physical activities that are undertaken for other purposes may also count as physical exercise. Scrubbing a floor, raking a lawn, or playing active games with young children or a pet are all activities that can have fitness and health benefits, even though they generally are not done mainly for this purpose.<\/p>\n<p>How much physical exercise should people get? In the Canada, both the Canadian Food Guide and the Canadian Society for Exercise Physiology\u00a0 recommend that every child and\u00a0 adult who is able should participate in moderate exercise for a minimum of 60 minutes a day. This might include walking, swimming, and\/or household or yard work.<\/p>\n<div>\n<h1>Types of Physical Exercise<\/h1>\n<\/div>\n<p>Physical exercise can be classified into three types, depending on the effects it has on the body: aerobic exercise, anaerobic exercise, and flexibility exercise. Many specific examples of physical exercise (including playing soccer and rock climbing) can be classified as more than one type.<\/p>\n<h2>Aerobic Exercise<\/h2>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 276px\" class=\"wp-caption alignright\"><img class=\" wp-image-1105\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Kayaking-on-PIXNIO-53266-725x483-1.jpg\" alt=\"12.5 Kayaking Aerobic Exercise\" width=\"276\" height=\"184\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.2 Kayaking is a form of aerobic exercise.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4225\">Aerobic exercise<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">is any physical activity in which muscles are used at well below their maximum contraction strength, but for long periods of time. Aerobic exercise uses a relatively high percentage of slow-twitch muscle fibres that consume a large amount of oxygen. The main goal of aerobic exercise is to increase cardiovascular endurance, although it can have many other benefits, including muscle toning. Examples of aerobic exercise include cycling, swimming, brisk walking, jumping rope, rowing, hiking, <\/span><span style=\"font-size: 1em\">tennis, <\/span><span style=\"font-size: 1em;text-align: initial\">and kayaking as shown in Figure 12.5.2 .<\/span><\/p>\n<h2>Anaerobic Exercise<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4226\">Anaerobic exercise<\/a><\/strong> is any physical activity in which muscles are used at close to their maximum contraction strength, but for relatively short periods of time. Anaerobic exercise uses a relatively high percentage of fast-twitch muscle fibres that consume a small amount of oxygen. Goals of anaerobic exercise include building and strengthening muscles, as well as improving bone strength, balance, and coordination. Examples of anaerobic exercise include push-ups, lunges, sprinting, interval training, resistance training, and weight training (such as biceps curls with a dumbbell, as pictured in Figure 12.5.3).<\/p>\n<div>\n<figure id=\"attachment_1106\" aria-describedby=\"caption-attachment-1106\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1106\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Bicep-curls.jpg\" alt=\"12.5.3 Bicep Curls\" width=\"400\" height=\"261\"><figcaption id=\"caption-attachment-1106\" class=\"wp-caption-text\"><em>Figure 12.5.3 Pitting the biceps muscle in the upper arm against a heavy weight helps to build and strengthen this muscle.<\/em><\/figcaption><\/figure>\n<\/div>\n<h2>Flexibility Exercise<\/h2>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 232px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4229\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Flexibility-exercise-by-carl-barcelo-nqUHQkuVj3c-unsplash-scaled-1.jpg\" alt=\"12.5.4 Flexibility Exercise\" width=\"232\" height=\"155\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.4 Flexibility exercise can increase range of motion and lower risk of injury.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4228\">Flexibility exercise<\/a><\/strong> is any physical activity that stretches and lengthens muscles. Goals of flexibility exercise include increasing joint flexibility, keeping muscles limber, and improving the range of motion, all of which can reduce the risk of injury. Examples of flexibility exercise include stretching, yoga (as in Figure 12.5.4), and tai chi.<\/p>\n<div>\n<h1>Health Benefits of Physical Exercise<\/h1>\n<\/div>\n<p>Many studies have shown that physical exercise is positively correlated with a diversity of health benefits. Some of these benefits include maintaining physical fitness, losing weight and maintaining a healthy weight, regulating digestive health, building and maintaining healthy bone density, increasing muscle strength, improving joint mobility, strengthening the immune system, boosting cognitive ability, and promoting psychological well-being. Some studies have also found a significant positive correlation between exercise and both quality of life and life expectancy. People who participate in moderate to high levels of physical activity have been shown to have lower mortality rates than people of the same ages who are not physically active and daily exercise has been shown to increase life expectancy up to an average of five years.<\/p>\n<p>The underlying physiological mechanisms explaining why exercise has these positive health benefits are not completely understood. However, developing\u00a0research\u00a0suggests that many of the benefits of exercise may come about because of the role of\u00a0skeletal muscles\u00a0as endocrine organs. Contracting muscles release hormones called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4230\">myokines<\/a><\/strong>, which promote tissue repair and the growth of new tissue. Myokines also have anti-inflammatory effects, which, in turn, reduce the risk of developing inflammatory diseases. Exercise also reduces levels of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2615\">cortisol<\/a>, the adrenal cortex stress\u00a0hormone\u00a0that may cause many health problems \u2014 both physical and mental \u2014 at sustained high levels.<\/p>\n<h2>Cardiovascular Benefits of Physical Exercise<\/h2>\n<p>The beneficial effects of exercise on the\u00a0cardiovascular system\u00a0are well documented. Physical inactivity has been identified as a risk factor for the\u00a0development\u00a0of <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/coronary-artery-disease\/symptoms-causes\/syc-20350613\">coronary artery disease<\/a>. There is also a direct correlation between physical inactivity and cardiovascular disease mortality. Physical exercise, in contrast, has been demonstrated to reduce several risk factors for cardiovascular disease, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4231\">hypertension<\/a> (high blood pressure), \u201cbad\u201d cholesterol (low-density lipoproteins), high total cholesterol, and excess body weight. Physical exercise has also been shown to increase \u201cgood\u201d cholesterol (high-density lipoproteins), insulin sensitivity, the mechanical efficiency of the heart, and exercise tolerance, which is the ability to perform physical activity without undue stress and fatigue.<\/p>\n<h2>Cognitive Benefits of Physical Exercise<\/h2>\n<p>Physical exercise has been shown to help protect people from developing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2007\">neurodegenerative disorders<\/a>, such as dementia. A 30-year study of almost 2,400 men found that those who exercised regularly had a 59 per cent reduction in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4233\">dementia<\/a> when compared with those who did not exercise. Similarly, a review of cognitive enrichment therapies for the elderly found that physical activity \u2014 in particular, aerobic exercise \u2014 can enhance the cognitive function of older adults. Anecdotal evidence suggests that frequent exercise may even help reverse alcohol-induced brain damage. There are several possible reasons why exercise is so beneficial for the brain. Physical exercise:<\/p>\n<ul>\n<li>Increases blood flow and oxygen availability to the brain.<\/li>\n<li>Increases growth factors that promote new brain cells and new neuronal pathways in the brain.<\/li>\n<li>Increases levels of neurotransmitters (such as serotonin), which increase memory retention, information processing, and cognition.<\/li>\n<\/ul>\n<h2>Mental Health Benefits of Physical Exercise<\/h2>\n<p>Numerous studies suggest that regular <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4225\">aerobic exercise<\/a> works as well as pharmaceutical antidepressants in treating mild-to-moderate <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4237\">depression<\/a>. A possible reason for this effect is that exercise increases the biosynthesis of at least three <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4238\">neurochemicals <\/a>that may act as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4239\">euphoriants<\/a>. The euphoric effect of exercise is well known. Distance runners may refer to it as \u201crunner\u2019s high,\u201d and people who participate in crew (as in Figure 12.5.5) may refer to it as \u201crower\u2019s high.\u201d Because of these effects, health care providers often promote the use of aerobic exercise as a treatment for depression.<\/p>\n<div>\n<figure id=\"attachment_1110\" aria-describedby=\"caption-attachment-1110\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1110\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Canadian-womens-double-scull-silver-Rio-2016-by-Gerhard-Pratt-on-flickr-.jpg\" alt=\"12.5.5 Exercise Euphoria\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1110\" class=\"wp-caption-text\"><em>Figure 12.5.5 These rowing duos are competing in the 2016 Summer Olympics in Rio, in which Canada won a silver medal.\u00a0 They are clearly exerting themselves \u2014 and no doubt increasing their euphoriant neurochemicals in the process.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Additional mental health benefits of physical exercise include reducing stress, improving body image, and promoting positive self-esteem. Conversely, there is evidence to suggest that being sedentary is associated with increased risk of anxiety.<\/p>\n<h2>Sleep Benefits of Physical Exercise<\/h2>\n<p>A recent review of published scientific research suggests that exercise generally improves sleep for most people, and helps sleep disorders, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4241\">insomnia<\/a>. In fact, exercise is the most recommended alternative to sleeping pills for people with insomnia. For sleep benefits, the optimum time to exercise may be four to eight hours before bedtime, although exercise at any time of day seems to be beneficial. The only possible exception is heavy exercise undertaken shortly before bedtime, which may actually interfere with sleep.<\/p>\n<h2>Other Benefits of Physical Exercise<\/h2>\n<p>Some studies suggest that physical activity may benefit the immune system. For example, moderate exercise has been found to be associated with a decreased incidence of upper respiratory tract infections. Evidence from many studies has found a correlation between physical exercise and reduced death rates from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2148\">cancer<\/a>, specifically breast cancer and colon cancer. Physical exercise has also been shown to reduce the risk of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3417\">type 2 diabetes<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4243\">obesity<\/a>.<\/p>\n<div>\n<h1>Variation in Responses to Physical Exercise<\/h1>\n<\/div>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4245\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Toronto-Marathon-2012-by-Marc-Roberts-on-flickr-scaled-1.jpg\" alt=\"11.5 Marathon\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.6 This participant in the Toronto Marathon is likely to have a relatively high proportion of slow-twitch muscle fibres that increase her endurance.<\/em><\/figcaption><\/figure>\n<p>Not everyone benefits equally from physical exercise. When participating in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4225\">aerobic exercise<\/a>, most people will have a moderate increase in their endurance, but some people will as much as\u00a0<em>double<\/em> their endurance. Some people, on the other hand, will show little or no increase in endurance from aerobic exercise. Genetic differences in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4184\">slow-twitch<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4185\">fast-twitch<\/a> skeletal muscle fibres may play a role in these different results. People with more slow-twitch fibres may be able to develop greater endurance, because these muscle fibres have more capillaries, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2383\">mitochondria<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4244\">myoglobin<\/a> than fast-twitch fibres. As a result, slow-twitch fibres can carry more oxygen and sustain aerobic activity for a longer period of time than fast-twitch fibres. Studies show that endurance athletes (like the marathoner pictured in Figure 12.5.6) generally do tend to have a higher proportion of slow-twitch fibres than other people.<\/p>\n<p>There is also great variation in individual responses to muscle building as a result of anaerobic exercise. Some people have a much greater capacity to increase muscle size and strength, whereas other people never develop large muscles, no matter how much they exercise them. People who have more fast-twitch than slow-twitch muscle fibres may be able to develop bigger, stronger muscles, because fast-twitch muscle fibres contribute more to muscle strength and have greater potential to increase in mass. Evidence suggests that athletes who excel at power activities (such as throwing and jumping) tend to have a higher proportion of fast-twitch fibres than do endurance athletes.<\/p>\n<div>\n<h1>Can You \u201cOverdose\u201d on Physical Exercise?<\/h1>\n<\/div>\n<p>Is it possible to exercise too much? Can too much exercise be harmful? Evidence suggests that some adverse effects may occur if exercise is extremely intense and the body is not given proper rest between exercise sessions. Athletes who train for multiple marathons have been shown to develop scarring of the heart and heart rhythm abnormalities. Doing too much exercise without prior conditioning also increases the risk of injuries to muscles and joints. Damage to muscles due to overexertion is often seen in new military recruits (see Figure 12.5.7). Too much exercise in females may cause <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/amenorrhea\/symptoms-causes\/syc-20369299#:~:text=Amenorrhea%20(uh%2Dmen%2Do,cause%20of%20amenorrhea%20is%20pregnancy.\">amenorrhea<\/a>, which is a cessation of menstrual periods. When this occurs, it generally indicates that a woman is pushing her body too hard.<\/p>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4246\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Muscle-damage-in-military-recruits-scaled-1.jpg\" alt=\"12.5 Muscle Damage\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.7 New military recruits may suffer muscle damage from overexertion of unconditioned muscles. The drill instructor pictured here (in orange shirt) is doing his best to encourage these marine recruits to expend their maximum effort<\/em>.<\/figcaption><\/figure>\n<p>Many people develop <a href=\"https:\/\/en.wikipedia.org\/wiki\/Delayed_onset_muscle_soreness#:~:text=Delayed%20onset%20muscle%20soreness%20(DOMS,72%20hours%20after%20the%20exercise.\">delayed onset muscle soreness<\/a> (DOMS), which is pain or discomfort in muscles that is felt one to three days after exercising, and generally subsides two or three days later. DOMS was once thought to be caused by the buildup of lactic acid in the muscles. Lactic acid is a product of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2163\">anaerobic respiration<\/a> in muscle tissues. However, lactic acid disperses fairly rapidly, so it is unlikely to explain pain experienced several days after exercise. The current theory is that DOMS is caused by tiny tears in muscle fibres, which occur when muscles are used at too high a level of intensity.<\/p>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<p>Most people know that exercise is important for good health, and it\u2019s easy to find endless advice about exercise programs and fitness plans. What is not so easy to find is the motivation to start exercising \u2014 and to stick with it.\u00a0This is\u00a0the main reason why so many people fail to get regular exercise. Practical concerns like a busy schedule and bad\u00a0weather\u00a0can certainly make exercising more of a challenge, but the biggest barriers to adopting a regular exercise routine are mental. If you want to exercise but find yourself making excuses or getting discouraged and giving up, here are some tips that may help you get started and stay moving:<\/p>\n<ul>\n<li><strong>Avoid an all-or-nothing point of view.<\/strong> Don\u2019t think you need to spend hours sweating at the gym or training for a marathon to get healthy. Even a little bit of exercise is better than nothing at all. Start out with ten or 15 minutes of moderate activity each day. Taking a walk around your neighborhood is a great way to begin! From there, gradually increase the amount of time until you are exercising to at least 30 minutes a day, five days a week.\u00a0 Make it a routine.<\/li>\n<li><strong>Be kind to yourself, and reinforce positive behaviors with rewards. <\/strong>Don\u2019t be down on yourself because you are overweight or out of shape. Don\u2019t beat yourself up because of a supposed lack of willpower. Instead, look at any past failures as opportunities to learn and do better. When you do achieve even small exercise goals, treat yourself to something special. Did you just complete your first workout? Reward yourself with a relaxing bath or other treat.<\/li>\n<li><strong>Don\u2019t make excuses for not exercising.<\/strong>\u00a0Common complaints include being too busy or tired or not athletic enough. Such excuses are not valid reasons to avoid exercising, and they will sabotage any plans to improve your fitness. If you can\u2019t find a 30-minute period to work out, try to find\u00a0ten\u00a0minutes, three times a day. If you\u2019re feeling tired, know that exercise can actually reduce fatigue and boost your\u00a0energy level. If you feel clumsy and uncoordinated, remind yourself that you don\u2019t need to be athletic to take a walk or engage in vigorous house or yard work.<\/li>\n<li><strong>Find an activity that you truly enjoy doing.<\/strong>\u00a0Don\u2019t think you have to lift weights or run on a treadmill to exercise your muscles. If you find such activities boring or unpleasant, you won\u2019t stick with them. Any activity that increases your heart rate and uses large muscles can provide a workout, especially if you\u2019re not in the habit of exercising, so find something you like to do. Do you like to dance? Put on some music and dance up a sweat! Do you enjoy gardening? Get out in the yard and dig up some dirt! Still not interested? Try an activity-based video game, such as Wii or Kinect. You may find it so much fun that it doesn\u2019t seem like exercise until you realize you\u2019ve worked up a sweat.<\/li>\n<li><strong>Make yourself accountable.<\/strong>\u00a0Tell friends and family members that you\u2019re going to start exercising. You\u2019ll be letting them \u2014 as well as yourself \u2014 down if you don\u2019t follow through. Some people find that keeping an exercise log to track their progress is a good way to be accountable and stick to an exercise program. Perhaps the best way to keep at it is to find an exercise partner. If you\u2019ve got someone waiting to exercise with you, you will be less likely to make excuses for not exercising.<\/li>\n<li><strong>Add more physical activity to your daily life.<\/strong>\u00a0You don\u2019t need to follow a structured exercise program to increase your activity level. Do your house or yard work briskly for a workout. Park your car\u00a0further\u00a0than necessary from work or the mall, and walk the extra\u00a0distance. If you live close enough, leave the car at home and walk to and from your destination. Rather than taking elevators or escalators, walk up and down stairs. When you take breaks at work, take a walk instead of sitting. Every time a commercial comes on while you\u2019re watching TV, take a quick exercise break \u2014 run in place or do some curls with hand weights.<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4224\">Physical exercise<\/a> is any bodily activity that enhances or maintains physical fitness and overall health. Activities such as household chores may count as physical exercise, even if they are not done for their health benefits.\u00a0Current\u00a0recommendations for adults are 30 minutes a day of moderate exercise.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4225\">Aerobic exercise<\/a> is any physical activity that uses muscles at less than their maximum contraction strength, but for long periods of time. This type of exercise uses a relatively high percentage of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4184\">slow-twitch muscle fibres<\/a> that consume large amounts of oxygen. Aerobic exercises increase cardiovascular endurance and include cycling and brisk walking.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4226\">Anaerobic exercise<\/a> is any physical activity that uses muscles at close to their maximum contraction strength, but for short periods of time. This type of exercise uses a relatively high percentage of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4185\">fast-twitch muscle fibres<\/a> that consume small amounts of oxygen. Anaerobic exercises increase muscle and bone mass and strength, and they include push-ups and sprinting.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4228\">Flexibility exercise<\/a> is any physical activity that stretches and lengthens muscles, thereby improving range of motion and reducing risk of injury. Examples include stretching and yoga.<\/li>\n<li>Many studies have shown that physical exercise is positively correlated with a diversity of physical, mental, and emotional health benefits. Physical exercise also increases quality of life and life expectancy.<\/li>\n<li>Many of the benefits of exercise may come about because contracting muscles release hormones called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4230\">myokines<\/a>, which promote tissue repair and growth and have anti-inflammatory effects.<\/li>\n<li>Physical exercise can reduce risk factors for\u00a0cardiovascular disease, including hypertension and excess body weight. Physical exercise can also increase factors associated with\u00a0cardiovascular health, such as mechanical\u00a0efficiency\u00a0of the heart.<\/li>\n<li>Physical exercise has been shown to offer protection from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4233\">dementia<\/a> and other cognitive problems, perhaps because it increases\u00a0blood\u00a0flow or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3056\">neurotransmitters<\/a>\u00a0in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2554\">brain<\/a>, among other potential effects.<\/li>\n<li>Numerous studies suggest that regular aerobic exercise works as well as pharmaceutical antidepressants in treating mild-to-moderate depression, possibly because it increases synthesis of natural euphoriants in the brain.<\/li>\n<li>Research\u00a0shows that physical exercise generally improves sleep for most people and helps sleep disorders, such as insomnia. Other health benefits of physical exercise include better immune system function and reduced risk of type 2\u00a0diabetes\u00a0and\u00a0obesity.<\/li>\n<li>There is great variation in individual responses to exercise, partly due to genetic differences in proportions of slow-twitch and fast-twitch skeletal muscle fibres. People with more slow-twitch fibres may be able to develop greater endurance from aerobic exercise, whereas people with more fast-twitch fibres may be able to develop greater muscle size and strength from anaerobic exercise.<\/li>\n<li>Some adverse effects may occur if exercise is extremely intense and the body is not given proper rest between exercise sessions. Many people who overwork their muscles develop delayed onset muscle soreness (DOMS), which may be caused by tiny tears in muscle fibres.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>How do we define physical exercise?<\/li>\n<li>What are current recommendations for physical exercise for adults?<\/li>\n<li>\n<div id=\"h5p-227\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-227\" class=\"h5p-iframe\" data-content-id=\"227\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"12.5 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Define flexibility exercise, and state its benefits. What are two examples of flexibility exercises?<\/li>\n<li>In general, how does physical exercise affect health, quality of life, and longevity?<\/li>\n<li>What mechanism may\u00a0underlie many of the general health benefits of physical exercise?<\/li>\n<li>Relate physical exercise to\u00a0cardiovascular disease risk.<\/li>\n<li>What may explain the positive benefits of physical exercise on cognition?<\/li>\n<li>How does physical exercise compare with antidepressant drugs in the treatment of depression?<\/li>\n<li>Identify several other health benefits of physical exercise.<\/li>\n<li>Explain how genetics may influence the way individuals respond to physical exercise.<\/li>\n<li>Can too much physical exercise be harmful?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=hmFQqjMF_f0<\/p>\n<p style=\"text-align: center\">How playing sports benefits your body ... and your brain - Leah Lagos and Jaspal Ricky Singh, TED-Ed, 2016.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=rLsimrBoYXc&amp;t=12s<\/p>\n<p style=\"text-align: center\">The surprising reason our muscles get tired - Christian Moro, TED-Ed, 2019.<\/p>\n<p>https:\/\/youtu.be\/2tM1LFFxeKg<\/p>\n<p style=\"text-align: center\">What makes muscles grow? - Jeffrey Siegel, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=QeIrdqU0o9s<\/p>\n<p style=\"text-align: center\">Why some people find exercise harder than others | Emily Balcetis, TED, 2014.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Attack_of_the_stroller_Moms_(4665101120).jpg\" rel=\"cc:attributionURL\">stroller fit<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/67958110@N00\" rel=\"nofollow\">Serge Melki<\/a> from Indianapolis, USA on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\" rel=\"license\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0) license.<\/p>\n<p><strong>Figure 12.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/pixnio.com\/sport\/canoeing-and-kayaking-pictures\/children-kayaking-young-sport#\" rel=\"cc:attributionURL\">Children kayaking young sport<\/a> by <span style=\"font-size: 1em\">Hagerty Ryan, USFWS <\/span>on <a href=\"https:\/\/pixnio.com\/sport\/canoeing-and-kayaking-pictures\/children-kayaking-young-sport#\">Pixnio<\/a> is used under a <a title=\"public domain\" href=\"https:\/\/creativecommons.org\/licenses\/publicdomain\/\" target=\"_blank\" rel=\"license nofollow noopener noreferrer\">public domain (CC0) Certification<\/a> (https:\/\/creativecommons.org\/licenses\/publicdomain\/).<\/p>\n<p><strong>Figure 12.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/www.acc.af.mil\/News\/Photos\/igphoto\/2000849716\/\" rel=\"cc:attributionURL\">Bicep curls<\/a> [photo] by Senior Airman Jarrod Grammel from <a href=\"https:\/\/www.acc.af.mil\/News\/Photos\/igphoto\/2000849716\/\">U.S. Moody Air Force Base<\/a> is released into the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 12.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/nqUHQkuVj3c\" rel=\"cc:attributionURL\">Flexibility exercise by carl-barcelo-nqUHQkuVj3c<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@barcelocarl\">Carl Barcelo<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the <a href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p><strong>Figure 12.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/gerhardpratt\/29956941214\/\" rel=\"cc:attributionURL\">Canadian women\u2019s double scull silver Rio 2016 <\/a>by <a class=\"owner-name truncate\" title=\"Go to Gerhard Pratt's photostream\" href=\"https:\/\/www.flickr.com\/photos\/gerhardpratt\/\" data-track=\"attributionNameClick\">Gerhard Pratt<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 12.5.6<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/marcs-album\/8321816093\/\" rel=\"cc:attributionURL\">Toronto Marathon 2012<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/marcs-album\/\" rel=\"dc:creator\">Marc Roberts<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" rel=\"license\">CC BY-NC-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/) license.<\/p>\n<p><strong>Figure 12.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/www.mcrdsd.marines.mil\/News\/Photos\/igphoto\/2000017386\/\" rel=\"cc:attributionURL\">Muscle damage in military recruits<\/a> by Lance Cpl. Bridget M. Keane from the United States <a href=\"https:\/\/www.mcrdsd.marines.mil\/News\/Photos\/igphoto\/2000017386\/\">Marine Corps Recruit Depot<\/a> is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Elwood, P., Galante, J., Pickering, J., Palmer, S., Bayer, A., Ben-Shlomo, Y., Longley, M., &amp; Gallacher, J. (2013). Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study. <em>PloS one, 8<\/em>(12), e81877. https:\/\/doi.org\/10.1371\/journal.pone.0081877<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Amenorrhea [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/amenorrhea\/symptoms-causes\/syc-20369299#<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Coronary artery disease [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/coronary-artery-disease\/symptoms-causes\/syc-20350613<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, June 28). How playing sports benefits your body ... and your brain - Leah Lagos and Jaspal Ricky Singh. YouTube. https:\/\/www.youtube.com\/watch?v=hmFQqjMF_f0&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, April 18). The surprising reason our muscles get tired - Christian Moro. YouTube. https:\/\/www.youtube.com\/watch?v=rLsimrBoYXc&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, November 3). What makes muscles grow? - Jeffrey Siegel. YouTube https:\/\/www.youtube.com\/watch?v=2tM1LFFxeKg&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2014, November 14). Why some people find exercise harder than others | Emily Balcetis, YouTube. https:\/\/www.youtube.com\/watch?v=QeIrdqU0o9s&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, August 1). Delayed onset muscle soreness. In\u00a0<i>Wikipedia<\/i>. https:\/\/en.wikipedia.org\/w\/index.php?title=Delayed_onset_muscle_soreness&amp;oldid=970682631<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_2985\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_2985\"><div tabindex=\"-1\"><p>Image shows a diagram of locations in the body where the effects of anemia are experienced.  Some of these include: Central nervous system: fatigue, dizziness and possibly fainting.  Low blood pressure. In the heart: heart palpitations, rapid heart rate, chest palpitations, in extreme cases chest pain, angina and heart attack. Enlargement of the spleen.  Changed stool (poo) colour. Muscular weakness. Shortness of breath. Pale, cold and\/or yellowing skin.  Yellowing eyes.  <\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5451\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5451\"><div tabindex=\"-1\"><p>Glucose (also called dextrose) is a simple sugar with the molecular formula C6H12O6. Glucose is the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using energy from sunlight.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_327\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_327\"><div tabindex=\"-1\"><p>Created by:\u00a0CK-12\/Adapted by Christine Miller<\/p>\n<div>\n<h1>Case Study: Cancer in the Family<\/h1>\n<\/div>\n<figure id=\"attachment_325\" aria-describedby=\"caption-attachment-325\" style=\"width: 430px\" class=\"wp-caption alignleft\"><img class=\"wp-image-325\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Family-Tree.png\" alt=\"Image shows a family tree with three generations. The tree shows cartoon faces for each person on the tree, not names. The images show a variety of diverse faces.\" width=\"430\" height=\"396\"><figcaption id=\"caption-attachment-325\" class=\"wp-caption-text\"><em>Figure 5.1.1 Family tree - three generations.<\/em><\/figcaption><\/figure>\n<p>People tend to carry similar traits to their biological parents, as illustrated by the family tree. Beyond just appearance, you can also inherit traits from your parents that you <em>can\u2019t<\/em>\u00a0see.<\/p>\n<p>Rebecca becomes very aware of this fact when she visits her new doctor for a physical exam. Her doctor asks several questions about her family medical history, including whether Rebecca has or had relatives with cancer. Rebecca tells her that her grandmother, aunt, and uncle \u2014 who have all passed away \u2014 had cancer. They all had breast cancer, including her uncle, and her aunt\u00a0also\u00a0had ovarian cancer. Her doctor asks how old they were when they were diagnosed with cancer. Rebecca is not sure exactly, but she knows that her grandmother was fairly young at the time, probably in her forties.<\/p>\n<p>Rebecca\u2019s doctor explains that while the vast majority of cancers are not due to inherited factors, a cluster of cancers within a family may indicate that there are mutations in certain genes that increase the risk of getting certain types of cancer, particularly breast and ovarian cancer. Some signs that cancers may be due to these genetic factors are present in Rebecca\u2019s family, such as cancer with an early age of onset (e.g., breast cancer before age 50), breast cancer in men, and breast cancer and ovarian cancer within the same person or family.<\/p>\n<p>Based on her family medical history, Rebecca\u2019s doctor recommends that she see a genetic counselor, because these professionals can help determine whether the high incidence of cancers in her family could be due to inherited mutations in their genes. If so, they can test Rebecca to find out whether she has the particular variations of these genes that would increase her risk of getting cancer.<\/p>\n<p>When Rebecca sees the genetic counselor, he asks how her grandmother, aunt, and uncle with cancer are related to her. She says that these relatives are all on her mother\u2019s side \u2014 they are her mother\u2019s mother and siblings. The genetic counselor records this information in the form of a specific type of family tree, called a pedigree, indicating which relatives had which type of cancer, and how they are related to each other and to Rebecca.<\/p>\n<p>He also asks her ethnicity. Rebecca says that her family on both sides are Ashkenazi Jews (Jews whose ancestors came from central and eastern Europe). \u201cBut what does that have to do with anything?\u201d she asks. The counselor tells Rebecca that mutations in two tumor-suppressor genes called <a href=\"https:\/\/en.wikipedia.org\/wiki\/BRCA1\">BRCA1<\/a> and <a href=\"https:\/\/en.wikipedia.org\/wiki\/BRCA2\">BRCA2<\/a>, located on chromosome 17 and 13, respectively, are particularly prevalent in people of <a href=\"https:\/\/en.wikipedia.org\/wiki\/Ashkenazi_Jews\">Ashkenazi<\/a> Jewish descent and greatly increase the risk of getting cancer. About one in 40 Ashkenazi Jewish people have one of these mutations, compared to about one in 800 in the general population. Her ethnicity, along with the types of cancer, age of onset, and the specific relationships between her family members who had cancer, indicate to the counselor that she is a good candidate for genetic testing for the presence of these mutations.<\/p>\n<figure id=\"attachment_325\" aria-describedby=\"caption-attachment-325\" style=\"width: 429px\" class=\"wp-caption alignright\"><img class=\" wp-image-2096\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Rebecca-scaled-1.jpg\" alt=\"In this image, a woman looks thoughtfully out at the countryside.\" width=\"429\" height=\"286\"><figcaption id=\"caption-attachment-325\" class=\"wp-caption-text\"><em>Figure 5.1.2 Rebecca is not sure if she wants to know if she is at an increased risk of breast and ovarian cancer.<\/em><\/figcaption><\/figure>\n<p>Rebecca says that her 72-year-old mother never had cancer, nor had many other relatives on that side of the family. How could the cancers be genetic? The genetic counselor explains that the mutations in the BRCA1 and BRCA2 genes, while dominant, are not inherited by <em>everyone<\/em> in a family. Also, even people with mutations in these genes do not necessarily get cancer \u2014 the mutations simply increase their risk of getting cancer. For instance, 55 to 65 per cent of women with a harmful mutation in the BRCA1 gene will get breast cancer before age 70, compared to 12 per cent of women in the general population who will get breast cancer sometime over the course of their lives.<\/p>\n<p>Rebecca is not sure she wants to know whether she has a higher risk of cancer. The genetic counselor understands her apprehension, but explains that if she knows that she has harmful mutations in either of these genes, her doctor will screen her for cancer more often and at earlier ages. Therefore, any cancers she may develop are likely to be caught earlier when they are often much more treatable. Rebecca decides to go through with the testing, which involves taking a blood sample, and nervously waits for her results.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\">Chapter Overview: Genetics<\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>At the end of this chapter, you will find out Rebecca\u2019s test results. By then, you will have learned how traits are inherited from parents to offspring through genes, and how mutations in genes such as BRCA1 and BRCA2 can be passed down and cause disease. Specifically, you will learn about:<\/p>\n<ul>\n<li>The structure of DNA.<\/li>\n<li>How DNA replication occurs.<\/li>\n<li>How DNA was found to be the inherited genetic material.<\/li>\n<li>How genes and their different alleles are located on chromosomes.<\/li>\n<li>The 23 pairs of human chromosomes, which include autosomal and sex chromosomes.<\/li>\n<li>How genes code for proteins using codons made of the sequence of nitrogen bases within RNA and DNA.<\/li>\n<li>The central dogma of molecular biology, which describes how DNA is transcribed into RNA, and then translated into proteins.<\/li>\n<li>The structure, functions, and possible evolutionary history of RNA.<\/li>\n<li>How proteins are synthesized through the transcription of RNA from DNA and the translation of protein from RNA, including how RNA and proteins can be modified, and the roles of the different types of RNA.<\/li>\n<li>What mutations are, what causes them, different specific types of mutations, and the importance of mutations in evolution and to human health.<\/li>\n<li>How the expression of genes into proteins is regulated and why problems in this process can cause diseases, such as cancer.<\/li>\n<li>How Gregor Mendel discovered the laws of inheritance for certain types of traits.<\/li>\n<li>The science of heredity, known as genetics, and the relationship between genes and traits.<\/li>\n<li>How gametes, such as eggs and sperm, are produced through meiosis.<\/li>\n<li>How sexual reproduction works on the cellular level and how it increases genetic variation.<\/li>\n<li>Simple Mendelian and more complex non-Mendelian inheritance of some human traits.<\/li>\n<li>Human genetic disorders, such as Down syndrome, hemophilia A, and disorders involving sex chromosomes.<\/li>\n<li>How biotechnology \u2014 which is the use of technology to alter the genetic makeup of organisms \u2014 is used in medicine and agriculture, how it works, and some of the ethical issues it may raise.<\/li>\n<li>The human genome, how it was sequenced, and how it is contributing to discoveries in science and medicine.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<p>As you read this chapter, keep Rebecca\u2019s situation in mind and think about the following questions:<\/p>\n<ol>\n<li>BCRA1 and BCRA2 are also called Breast cancer type 1 and 2 susceptibility proteins.\u00a0 What do the BRCA1 and BRCA2 genes normally do? How can they cause cancer?<\/li>\n<li>Are BRCA1 and BRCA2 linked genes? Are they on autosomal or sex chromosomes?<\/li>\n<li>After learning more about pedigrees, draw the pedigree for cancer in Rebecca\u2019s family. Use the pedigree to help you think about why it is possible that her mother does not have one of the BRCA gene mutations, even if her grandmother, aunt, and uncle did have it.<\/li>\n<li>Why do you think certain gene mutations are prevalent in certain ethnic groups?<\/li>\n<\/ol>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 5.1.1<\/strong><\/p>\n<p><a href=\"http:\/\/www.clker.com\/search\/face\/12\" rel=\"cc:attributionURL\">Family Tree<\/a> [all individual face images] from <a href=\"http:\/\/www.clker.com\/\">Clker.com<\/a> used and adapted by Christine Miller under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\">CC0 1.0<\/a> public domain dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/).<\/p>\n<p><strong>Figure 5.1.2<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/P9rQn2qcEV0\" rel=\"cc:attributionURL\">Rebecca<\/a> by <a href=\"https:\/\/unsplash.com\/@kylebroad\">Kyle Broad<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 27). Ashkenazi Jews. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=Ashkenazi_Jews&amp;oldid=964691647<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 22). BRCA1. In <em>Wikipedia<\/em>. https:\/\/en.wikipedia.org\/w\/index.php?title=BRCA1&amp;oldid=963868423<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, May 25). BRCA2. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=BRCA2&amp;oldid=958722957<\/p>\n<p class=\"hanging-indent\">\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3073\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3073\"><div tabindex=\"-1\"><p>Image shows a diagram of the locations of the three major salivary glands.  The parotid glands are  at the back of the jaw just below the cheekbones, the submandibular glands are under the jaw bone on both the left and right side.  The sublingual gland is under the tongue.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5935\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5935\"><div tabindex=\"-1\"><p>The part of the brain below the cerebrum and behind the brain stem that coordinates body movements.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3075\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3075\"><div tabindex=\"-1\"><p>image shows a diagram of the location of each type of tooth on the bottom jaw.  Per side, there are three molars at the very back, just in front of the molars there are two submolars per side, and then one canine on each side.  At the very front and center of the lower jaw are four incisors.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3076\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3076\"><div tabindex=\"-1\"><p>Image shows a labelled diagram of organs of the head and neck belonging to the respiratory and digestive systems.  These include the nasal cavity, the palate, the oral cavity, the lips, the jaw, tongue, pharynx, epiglottis, larynx, and esophagus.  The pharynx is of particular note since it is the last space through which food and air travel.  The epiglottis is critical in ensuring that food only enters the esophagus of the digestive system  and not the larynx of the respiratory system.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3082\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3082\"><div tabindex=\"-1\"><p>Image shows a diagram highlighting the different sections of the small intestine.  The duodenum is the shortest portion and is the part of the small intestine that receives chyme directly from the stomch.  Next, chyme would pass through the jejenum and then finally the ileum.  The jejenum and ileum are a similar length (2.5-3 meters).<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5941\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5941\"><div tabindex=\"-1\"><p>The largest part of the brain that controls conscious functions such as reasoning and sight.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3083\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3083\"><div tabindex=\"-1\"><p>Image shows a pictomicrograph of the inside wall of the jejenum.  There are many microvilli lining the inner surface.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5955\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5955\"><div tabindex=\"-1\"><p>A thick band of nerve fibers that divides the cerebral cortex lobes into left and right hemispheres. It connects the left and right sides of the brain, allowing for communication between both hemispheres.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3085\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3085\"><div tabindex=\"-1\"><p>As per caption.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_6021\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_6021\"><div tabindex=\"-1\"><p>A part of each hemisphere of the cerebrum that controls executive functions such as reasoning and language.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3088\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3088\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4630\" aria-describedby=\"caption-attachment-4630\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4630\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/1024px-Bacteroides_biacutis_01-1.jpg\" alt=\"15.5.1 Gut Microbes\" width=\"400\" height=\"269\"><figcaption id=\"caption-attachment-4630\" class=\"wp-caption-text\"><em>Figure 15.5.1 Are you a human with bacteria, or bacteria wearing a human?<\/em><\/figcaption><\/figure>\n<div>\n<h1>What Is It?<\/h1>\n<\/div>\n<p>Figure 15.5.1 shows some of the cells of what has been called \u201cthe last human organ to be discovered.\u201d This \u201corgan\u201d weighs about 200 grams (about 7 oz) and consists of a hundred trillion cells, yet scientists are only now beginning to learn everything it does and how it varies among individuals. What is it? It\u2019s the mass of bacteria that live in our lower gastrointestinal tract.<\/p>\n<div>\n<h1>Organs of the Lower Gastrointestinal Tract<\/h1>\n<\/div>\n<p>Most of the bacteria that normally live in the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4575\">lower gastrointestinal (GI) tract<\/a><\/strong>\u00a0live in the large intestine. They have important and mutually beneficial relationships with the human organism. We provide them with a great place to live, and they provide us with many benefits, some of which you can read about below. Besides the large intestine and its complement of helpful bacteria, the lower GI tract also includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4559\">small intestine<\/a>. The latter is arguably the most important organ of the digestive system. It is where most <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4551\">chemical digestion<\/a> and virtually all absorption of nutrients take place.<\/p>\n<div>\n<h1>Small Intestine<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4559\">small intestine<\/a><\/strong> (also called the small bowel or gut) is the part of the GI tract between the stomach and large intestine. Its average length in adults is 4.6 m in females and 6.9 m in males. It is approximately 2.5 to 3.0 cm in diameter. It is called \u201csmall\u201d because it is much smaller in diameter than the large intestine. The internal surface area of the small intestine totals an average of about 30 m<sup>2<\/sup>. Structurally and functionally, the small intestine can be divided into three parts, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4605\">jejunum<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4606\">ileum<\/a>, as shown in Figure 15.5.2 and described below.<\/p>\n<figure id=\"attachment_4631\" aria-describedby=\"caption-attachment-4631\" style=\"width: 600px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4631\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0817_SmallIntestine_Anatomy-1.png\" alt=\"15.5.2\" width=\"600\" height=\"600\"><figcaption id=\"caption-attachment-4631\" class=\"wp-caption-text\"><em>Figure 15.5.2 The three parts of the small intestine are colour coded in this diagram, with yellow for the duodenum, blue for the jejunum, and pink for the ileum.<\/em><\/figcaption><\/figure>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4561\">mucosa<\/a> lining the small intestine is highly enfolded and covered with the finger-like projections called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4543\">villi<\/a>. In fact, each square inch (about 6.5 cm<sup>2<\/sup>) of mucosa contains around 20 thousand villi. The individual cells on the surface of the villi also have many finger-like projections \u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4583\">microvilli<\/a>, shown in Figure 15.5.3. There are thought to be well over 17 billion microvilli per square centimetre of intestinal mucosa! All of these folds, villi, and microvilli greatly increase the surface area for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> to come into contact with digestive enzymes, which coat the microvilli, as well as forming a tremendous <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4593\">surface area<\/a> for the absorption of nutrients. Inside each of the villi is a network of tiny <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3577\">blood<\/a> and lymph vessels that receive the absorbed nutrients and carry them away in the blood or lymph circulation. The wrinkles and projections in the intestinal mucosa also slow down the passage of chyme so there is more time for digestion and absorption to take place.<\/p>\n<figure id=\"attachment_4632\" aria-describedby=\"caption-attachment-4632\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4632\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Human_jejunum_microvilli_1_-_TEM-1.jpg\" alt=\"15.5.3 Jejenum\" width=\"640\" height=\"480\"><figcaption id=\"caption-attachment-4632\" class=\"wp-caption-text\"><em>Figure 15.5.3 The fringe-like structures in this photomicrograph are microvilli lining the inside of the small intestine.<\/em><\/figcaption><\/figure>\n<h2>Duodenum<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a><\/strong> is the first part of the small intestine, directly connected to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4558\">stomach<\/a>. It is also the shortest part of the small intestine, averaging only about 25 cm (almost 10 in) in length in adults. Its main function is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4551\">chemical digestion<\/a>, and it is where most of the chemical digestion in the entire GI tract takes place.<\/p>\n<figure id=\"attachment_4635\" aria-describedby=\"caption-attachment-4635\" style=\"width: 326px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4635\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-2422_Accessory_Organs-1.jpg\" alt=\"15.5.4 Pancreatic Duct and Common Bile Duct\" width=\"326\" height=\"406\"><figcaption id=\"caption-attachment-4635\" class=\"wp-caption-text\"><em>Figure 15.5.4 This figure shows the liver, gallbladder and pancreas, along with the ducts that carry their secretions to the duodenum (labeled small intestine).<\/em><\/figcaption><\/figure>\n<p>The duodenum receives partially digested, semi-liquid <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> from the stomach. It receives digestive enzymes and alkaline bicarbonate from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a> through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4633\">pancreatic duct<\/a>, and it receives <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">bile<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a> via the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4634\">common bile duct<\/a> (see Figure 15.5.4). In addition, the lining of the duodenum secretes digestive enzymes and contains glands \u2014 called Brunner\u2019s glands \u2014 that secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4571\">mucous<\/a> and bicarbonate. The bicarbonate from the pancreas and Brunner\u2019s glands \u2014 along with bile from the liver \u2014 neutralize the highly acidic chyme after it enters the duodenum from the stomach. This is necessary because the digestive enzymes in the duodenum require a nearly neutral environment in order to work. The three major classes of compounds that undergo chemical digestion in the duodenum are carbohydrates, proteins, and lipids.<\/p>\n<h3>Digestion of Carbohydrates in the Duodenum<\/h3>\n<p>Complex <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_288\">carbohydrates<\/a> (such as starch<span style=\"font-size: 1em\">es<\/span><span style=\"text-align: initial;font-size: 1em\"><\/span><span style=\"text-align: initial;font-size: 1em\">) are broken down by the digestive enzyme <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4578\">amylase<\/a> from the pancreas to short-chain molecules consisting of just a few saccharides (that is, simple <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_316\">sugars<\/a>). Disaccharides, including sucrose and lactose, are broken down to simple sugars by duodenal enzymes. Sucrase breaks down sucrose, and lactase (if present) breaks down lactose. Some carbohydrates are not digested in the duodenum, and they ultimately pass undigested to the large intestine, where they may be digested by intestinal bacteria.<\/span><\/p>\n<h3>Digestion of Proteins in the Duodenum<\/h3>\n<p>In the duodenum, the pancreatic enzymes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4597\">trypsin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4598\">chymotrypsin<\/a> cleave <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_297\">protein<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">\u00a0into peptides. Then, these smaller molecules are broken down into <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_305\">amino acid<\/span><span style=\"font-size: 1em\">s<\/span><span style=\"font-size: 1em;text-align: initial\"><\/a><\/span><span style=\"font-size: 1em;text-align: initial\">. Their digestion is catalyzed by pancreatic enzymes called peptidases.<\/span><\/p>\n<h3>Digestion of Lipids in the Duodenum<\/h3>\n<p>Pancreatic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4602\">lipase<\/a> breaks down triglycerides into fatty acids and glycerol. Lipase works with the help of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">bile<\/a> secreted by the liver and stored in the gallbladder. Bile salts attach to triglycerides to help them emulsify, or form smaller particles (called micelles) that can disperse through the watery contents of the duodenum. This increases access to the molecules by pancreatic lipase.<\/p>\n<h2>Jejunum<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4605\">jejunum<\/a><\/strong> is the middle part of the small intestine, connecting the duodenum and the ileum. The jejunum is about 2.5 m (about 8 ft) long. Its main function is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4553\">absorption<\/a> of the products of digestion, including sugars, amino acids, and fatty acids. Absorption occurs by simple <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1655\">diffusion<\/a> (water and fatty acids), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1658\">facilitated diffusion<\/a> (the simple sugar fructose), or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1652\">active transport<\/a> (amino acids, small peptides, water-soluble vitamins, and most glucose). All nutrients are absorbed into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2702\">blood<\/a>, except for fatty acids and fat-soluble vitamins, which are absorbed into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4552\">lymph<\/a>. Although most nutrients are absorbed in the jejunum, there are a few exceptions:<\/p>\n<ul>\n<li>Iron is absorbed in the duodenum.<\/li>\n<li>Vitamin B12 and bile salts are absorbed in the ileum.<\/li>\n<li>Water and lipids are absorbed throughout the small intestine, including the duodenum and ileum in addition to the jejunum.<\/li>\n<\/ul>\n<h2>Ileum<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4606\">ileum<\/a><\/strong> is the third and final part of the small intestine, directly connected at its distal end to the large intestine. The ileum is about 3 m (almost 10 ft) long. Some cells in the lining of the ileum secrete enzymes that catalyze the final stages of digestion of any undigested protein and carbohydrate molecules. However, the main function of the ileum is to absorb vitamin B12 and bile salts. It also absorbs any other remaining nutrients that were not absorbed in the jejunum. All substances in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> that remain undigested or unabsorbed by the time they reach the distal end of the ileum pass into the large intestine.<\/p>\n<div>\n<h1>Large Intestine<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4560\">large intestine<\/a>\u00a0<\/strong>\u2014 also called the large bowel \u2014 is the last organ of the GI tract. In adults, it averages about 1.5 m (about 5ft) in length. It is shorter than the small intestine, but at least twice as wide, averaging about 6.5 cm (about 2.5 in) in diameter. Water is absorbed from chyme as it passes through the large intestine, turning the chyme into solid <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4636\">feces<\/a>. Feces is stored in the large intestine until it leaves the body during <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4638\">defecation<\/a>.<\/p>\n<h2>Parts of the Large Intestine<\/h2>\n<p>Like the small intestine, the large intestine can be divided into several parts, as shown in Figure 15.5.5. The large intestine begins at the end of the small intestine, where a valve separates the small and large intestines and regulates the movement of chyme into the large intestine. Most of the large intestine is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4639\">colon<\/a>.<\/strong>\u00a0The first part of the colon, where chyme enters from the small intestine, is called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4640\">cecum<\/a>. From the cecum, the colon continues upward as the ascending colon, travels across the upper abdomen as the transverse colon, and then continues downward as the descending colon. It then becomes a V-shaped region called the sigmoid colon, which is attached to the rectum. The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4641\">rectum<\/a><\/strong> stores feces until elimination occurs. It\u00a0transitions to the final part of the large intestine, called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4556\">anus<\/a><\/strong>,\u00a0which has an opening to the outside of the body for feces to pass through.<\/p>\n<figure id=\"attachment_4642\" aria-describedby=\"caption-attachment-4642\" style=\"width: 600px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4642\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0603_LargeIntestine_Anatomy-1.png\" alt=\"15.5.5 Large Intestine\" width=\"600\" height=\"600\"><figcaption id=\"caption-attachment-4642\" class=\"wp-caption-text\"><em>Figure 15.5.5 The parts of the large intestine include the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anus.<\/em><\/figcaption><\/figure>\n<p>The diagram below (Figure 15.5.6) shows a projection from the cecum of the colon that is known as the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4643\">appendix<\/a>.<\/strong> The function of the appendix is somewhat uncertain, but it does not seem to be involved in digestion or absorption. It may play a role in immunity, and in the fetus, it seems to have an endocrine function, releasing hormones needed for homeostasis. Some biologists speculate that the appendix may also store a sample of the colon\u2019s normal bacteria. If so, it may be able to repopulate the colon with the bacteria if illness or antibiotic medications deplete these microorganisms. Appendicitis, or infection and inflammation of the appendix, is a fairly common medical problem, typically resolved by surgical removal of the appendix (appendectomy). People who have had their appendix surgically removed do not seem to suffer any ill effects, so the organ is considered dispensable.<\/p>\n<figure id=\"attachment_4645\" aria-describedby=\"caption-attachment-4645\" style=\"width: 339px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4645\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Ds00070_an01934_im00887_divert_s_gif.webp-1-e1592580013661-1.png\" alt=\"15.5.6 Cecum and Appendix\" width=\"339\" height=\"369\"><figcaption id=\"caption-attachment-4645\" class=\"wp-caption-text\"><em>Figure 15.5.6 The appendix is a projection of the cecum of the large intestine.<\/em><\/figcaption><\/figure>\n<h2>Functions of the Large Intestine<\/h2>\n<p>The removal of water from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> to form <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4636\">feces<\/a> starts in the ascending <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4639\">colon<\/a> and continues throughout much of the length of the organ. Salts (such as sodium) are also removed from food wastes in the large intestine before the wastes are eliminated from the body. This allows salts \u2014 as well as water \u2014 to be recycled in the body.<\/p>\n<p>The large intestine is also the site where huge numbers of beneficial bacteria ferment many unabsorbed materials in food waste. The bacterial breakdown of undigested polysaccharides produces nitrogen, carbon dioxide, methane, and other gases responsible for intestinal gas, or flatulence. These <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2588\">bacteria<\/a> are particularly prevalent in the descending colon. Some of the bacteria also produce vitamins that are absorbed from the colon. The vitamins include vitamins B1 (thiamine), B2 (riboflavin), B7 (biotin), B12, and K. Another role of bacteria in the colon is an immune function. The bacteria may stimulate the immune system to produce antibodies that are effective against similar, but pathogenic, bacteria, thereby preventing infections. Still other roles played by bacteria in the large intestine include breaking down toxins before they can poison the body, producing substances that help prevent colon cancer, and inhibiting the growth of harmful bacteria.<\/p>\n<div>\n<h1>Feature: My Human Body<\/h1>\n<\/div>\n<p>Serotonin is a neurotransmitter with a wide variety of functions in the body.\u00a0 Sometimes called the \"happy chemical,\" it is used in the central nervous system to stabilize mood by contributing to a feeling of well being and happiness.\u00a0 While this \"happy chemical\" function is important, serotonin is also important for critical brain functions, including support of learning, memory, and reward structures and regulating sleep.\u00a0 Since serotonin's main target is brain function, you may be surprised to learn that 90% of the human body's supply of this neurotransmitter is located in the gastrointestinal tract, where it regulates intestinal movements.<\/p>\n<p>The enteric nervous system (ENS), a division of the autonomic nervous system, is a mesh-like system of neurons that control GI function.\u00a0 Interestingly, the ENS can act independently from both the sympathetic\/parasympathetic nervous systems and the brain\/spinal cord, which is why some scientists refer to the ENS as the \"second brain\".\u00a0 The ENS consists of over 500 million neurons (five times as many as in the spinal cord!) and lines the GI tract from the esophagus all the way to the anus. Serotonin is made in and secreted by the gut (small and large intestine) by enterochromaffin cells (also known as Kulchitsky cells) residing in the inner lining of the lower GI tract. While the main function of serotonin in the gut is to regulate digestion, it is also suspected to play a role in brain function \u2014 meaning that your gut may actually be partly dictating your mood!\u00a0 Another piece of evidence for the gut-dictating-your-mood theory is the nature vagus nerve, a fibrous visceral nerve, in which 90% of the fibres are dedicated to sending information <em>too<\/em> the brain, and only 10% of the fibres receiving information <em>from<\/em> the brain. Some treatments for depression actually involved electrical stimulation of the vagus nerve!<\/p>\n<p>In a 2015 study by researchers at Caltech,\u00a0 it was shown that gut bacteria promote serotonin production by enterochromaffin cells.\u00a0 The study involved measuring the levels of serotonin levels in mice with normal gut bacteria, and then comparing that to the levels of serotonin in a population of mice with no gut bacteria.\u00a0 The germ-free mice were found to produce only 40% of the serotonin that the mice with normal gut flora were producing.\u00a0 Once the germ-free mice were re-colonized with normal gut flora, their production of serotonin returned to normal.\u00a0 This lead researchers to the conclusion that enterochromaffin cells depend on an interaction with gut bacterial flora to be able to produce necessary levels of serotonin.<\/p>\n<p>&nbsp;<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4575\">lower GI tract<\/a> includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4559\">small intestine<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4560\">large intestine<\/a>. The small intestine is where most <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4551\">chemical digestion<\/a> and virtually all <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4553\">absorption<\/a> of nutrients occur. The large intestine contains huge numbers of beneficial bacteria and removes water and salts from food waste before it is eliminated.<\/li>\n<li>The small intestine consists of three parts: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4605\">jejunum<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4606\">ileum<\/a>. All three parts of the small intestine are lined with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4561\">mucosa<\/a> that is highly enfolded and covered with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4543\">villi<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4583\">microvilli<\/a>, giving the small intestine a huge surface area for digestion and absorption.<\/li>\n<li>The duodenum secretes digestive enzymes, and also receives <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">bile<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a> via the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> and digestive enzymes and bicarbonate from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a>. These digestive substances neutralize acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> and allow for the chemical digestion of carbohydrates, proteins, lipids, and nucleic acids in the duodenum.<\/li>\n<li>The jejunum carries out most of the absorption of nutrients in the small intestine, including the absorption of simple sugars, amino acids, fatty acids, and many vitamins.<\/li>\n<li>The ileum carries out any remaining digestion and absorption of nutrients, but its main function is to absorb vitamin B12 and bile salts.<\/li>\n<li>The large intestine consists of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4639\">colon<\/a> (which, in turn, includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4640\">cecum<\/a>, ascending colon, transverse colon, descending colon, and sigmoid colon), rectum, and anus. The vestigial organ called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4643\">appendix<\/a> is attached to the cecum of the colon.<\/li>\n<li>The main function of the large intestine is to remove water and salts from chyme for recycling within the body and eliminating the remaining solid <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4636\">feces<\/a> from the body through the anus. The large intestine is also the site where trillions of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2588\">bacteria<\/a> help digest certain compounds, produce vitamins, stimulate the immune system, and break down toxins, among other important functions.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-186\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-186\" class=\"h5p-iframe\" data-content-id=\"186\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Plasma Membrane\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>How is the mucosa of the small intestine specialized for digestion and absorption?<\/li>\n<li>What digestive substances are secreted into the duodenum? What compounds in food do they help digest?<\/li>\n<li>What is the main function of the jejunum?<\/li>\n<li>What roles does the\u00a0ileum play?<\/li>\n<li>How do beneficial bacteria in the large intestine help the human organism?<\/li>\n<li>When diarrhea occurs, feces leaves the body in a more liquid state than normal. What part of the digestive system do you think is involved in diarrhea? Explain your answer<\/li>\n<li>What causes intestinal gas, or flatulence?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/GTvnjaUU6Xk<\/p>\n<p style=\"text-align: center\">Why do we pass gas? - Purna Kashyap, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/0IVO50DuMCs<\/p>\n<p style=\"text-align: center\">What causes constipation? - Heba Shaheed, TED-Ed, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bacteroides_biacutis_01.jpg\" rel=\"cc:attributionURL\">1024px-Bacteroides_biacutis_01<\/a> by <a href=\"https:\/\/phil.cdc.gov\/Details.aspx?pid=3087\">CDC\/Dr. V.R. Dowell, Jr. Public Health Image Library (PHIL) ID#3087)<\/a> on Wikimedia Commons is in the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 15.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0817_SmallIntestine_Anatomy.png\" rel=\"cc:attributionURL\">Blausen_0817_SmallIntestine_Anatomy<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 15.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Human_jejunum_microvilli_1_-_TEM.jpg\" rel=\"cc:attributionURL\">Human_jejunum_microvilli_1_-_TEM<\/a> by Louisa Howard, Katherine Connollly \/<a href=\"https:\/\/www.dartmouth.edu\/emlab\/\"> E. M. Facility, Dartmouth<\/a>, on Wikimedia Commons is in the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 15.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2422_Accessory_Organs.jpg\" rel=\"cc:attributionURL\">512px-2422_Accessory_Organs<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 15.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0603_LargeIntestine_Anatomy.png\" rel=\"cc:attributionURL\">1024px-Blausen_0603_LargeIntestine_Anatomy<\/a> by\u00a0<a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 15.5.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Ds00070_an01934_im00887_divert_s_gif.webp\" rel=\"cc:attributionURL\">512px-Ds00070_an01934_im00887_divert_s_gif.webp (1)<\/a> by <a class=\"new\" title=\"User:Lfreeman04 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Lfreeman04&amp;action=edit&amp;redlink=1\">Lfreeman04<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1597595846309\" data-highlight-id=\"ee98f411-eead-4047-a7fe-4767fec029a5\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text\" data-timestamp=\"1597595846309\" data-highlight-id=\"ee98f411-eead-4047-a7fe-4767fec029a5\" data-highlighted=\"true\">23.24<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"18088\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1597595846309\" data-highlight-id=\"ee98f411-eead-4047-a7fe-4767fec029a5\" data-highlighted=\"true\">Accessory organs [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 23.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder<\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436. \/<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2018, May 7). What causes constipation? - Heba Shaheed. YouTube. https:\/\/www.youtube.com\/watch?v=0IVO50DuMCs&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, September 8). Why do we pass gas? - Purna Kashyap. YouTube. https:\/\/www.youtube.com\/watch?v=GTvnjaUU6Xk&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Yano, J. M., Yu, K., Donaldson, G. P., Shastri, G. G., Ann, P., Ma, L., Nagler, C. R., Ismagilov, R. F., Mazmanian, S. K., &amp; Hsiao, E. Y. (2015). Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. <em>Cell, 161<\/em>(2), 264\u2013276. https:\/\/doi.org\/10.1016\/j.cell.2015.02.047<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3089\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3089\"><div tabindex=\"-1\"><p>Image shows a picture of a man smiling.  The whites of his eyes (the sclera) are distinctly yellow.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3090\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3090\"><div tabindex=\"-1\"><p>Image shows a diagram of the location of the liver (large organ which sits below the diaphragm), the gallbladder (small sac-like organ which is tucked under the liver) and the pancreas (long flat organ which sits in front of and just under the stomach).<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5937\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5937\"><div tabindex=\"-1\"><p>The highly folded, thin outer layer of the cerebrum where most information processing in the brain takes place.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3098\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3098\"><div tabindex=\"-1\"><p>Image shows a diagram of the large intestine.  There are multiple abnormal little pouches on the exterior of the colon.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_2937\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_2937\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-455\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Free_Awesome_Girl_With_Braces_Close_Up.jpg\" alt=\"\" width=\"400\" height=\"409\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.1 Brace yourself!\u00a0<\/em><\/figcaption><\/figure>\n<h1>Oh, the Agony!<\/h1>\n<p>Wearing braces can be very uncomfortable, but it is usually worth it. Braces and other orthodontic treatments can re-align the teeth and jaws to improve bite and appearance. Braces can change the position of the teeth and the shape of the jaws because the human body is malleable. Many phenotypic traits \u2014 even those that have a strong genetic basis \u2014 can be molded by the environment. Changing the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2477\">phenotype<\/a> in response to the environment is just one of several ways we respond to environmental stress.<\/p>\n<div>\n<h1>Types of Responses to Environmental Stress<\/h1>\n<\/div>\n<p>There are four different types of responses that humans may make to cope with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2653\">environmental stress<\/a>:<\/p>\n<ol>\n<li>Adaptation<\/li>\n<li>Developmental adjustment<\/li>\n<li>Acclimatization<\/li>\n<li>Cultural responses<\/li>\n<\/ol>\n<p>The first three types of responses are biological in nature, and the fourth type is cultural. Only adaptation involves genetic change and occurs at the level of the population or species. The other three responses do not require genetic change, and they occur at the individual level.<\/p>\n<div>\n<h1>Adaptation<\/h1>\n<\/div>\n<p>An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2486\">adaptation<\/a><\/strong>\u00a0is a genetically-based trait that has evolved because it helps living things survive and reproduce in a given environment. Adaptations generally evolve in a population over many generations in response to stresses that last for a long period of time. Adaptations come about through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2633\">natural selection<\/a>. Those individuals who inherit a trait that confers an advantage in coping with an environmental stress are likely to live longer and reproduce more. As a result, more of their genes pass on to the next generation. Over many generations, the genes and the trait they control become more frequent in the population.<\/p>\n<h2>A Classic Example: Hemoglobin S and Malaria<\/h2>\n<p>Probably the most frequently-cited example of a genetic adaptation to an environmental stress is sickle cell trait. As you read in the previous section, people with sickle cell trait have one abnormal allele (S) and one normal allele (A) for hemoglobin, the red blood cell protein that carries oxygen in the blood. Sickle cell trait is an adaptation to the environmental stress of malaria, because people with the trait have resistance to this parasitic disease. In areas where malaria is endemic (present year-round), the sickle cell trait and its <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">allele<\/a> have evolved to relatively high frequencies. \u00a0It is a classic example of natural selection favoring <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2474\">heterozygotes<\/a> for a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\">gene<\/a> with two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">alleles<\/a>. This type of selection keeps both alleles at relatively high frequencies in a population.<\/p>\n<h2>To Taste or Not to Taste<\/h2>\n<p>Another example of an adaptation in humans is the ability to taste bitter compounds. Plants produce a variety of toxic compounds in order to protect themselves from being eaten, and these toxic compounds often have a bitter taste. The ability to taste bitter compounds is thought to have evolved as an adaptation, because it prevented people from eating poisonous plants. Humans have many different genes that code for bitter taste receptors, allowing us to taste a wide variety of bitter compounds.<\/p>\n<p>A harmless bitter compound\u00a0called\u00a0<strong>phenylthiocarbamide (PTC)<\/strong>\u00a0is not found naturally in plants, but it is similar to toxic bitter compounds that\u00a0<em>are<\/em> found in plants. Humans' ability to taste this harmless substance has been tested in many different populations. In virtually every population studied, there are some people who can taste PTC (called tasters), and some people who cannot taste PTC, (called nontasters). The ratio of tasters to non-tasters varies among populations, but on average, 75 per cent of people can taste PTC and 25 per cent cannot.<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 272px\" class=\"wp-caption alignright\"><img class=\" wp-image-456\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Tongue.jpg\" alt=\"Tongue\" width=\"272\" height=\"288\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.2 The tiny red dots on the surface of the tongue consist of clumps of taste buds that contain receptor proteins for certain chemicals. We can taste those chemicals that bind strongly with any of the receptors.<\/em><\/figcaption><\/figure>\n<p>Like many scientific discoveries, human variation in PTC-taster status was discovered by chance. Around 1930, a chemist named Arthur Fox was working with powdered PTC in his lab. Some of the powder accidentally blew into the air. Another lab worker noticed that the powdered PTC tasted bitter, but Fox couldn't detect any taste at all. Fox wondered\u00a0how to explain\u00a0this difference in PTC-tasting ability. Geneticists soon determined that PTC-taster status is controlled by a single <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\">gene<\/a> with two common alleles, usually represented by the letters\u00a0<em>T<\/em>\u00a0and\u00a0<em>t<\/em>. The\u00a0<em>T<\/em> allele encodes a chemical receptor protein (found in taste buds on the tongue, as illustrated in Figure 6.4.2) that can strongly bind to PTC. The other allele, <em>t<\/em>, encodes a version of the receptor protein that cannot bind as strongly to PTC. The particular combination of these two alleles that a person inherits determines whether the person finds PTC to taste very bitter (<em>TT<\/em>), somewhat bitter\u00a0<em>(Tt),<\/em>\u00a0or not bitter at all\u00a0<em>(tt).<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>If the ability to taste bitter compounds is advantageous, why does every human population studied contain a significant percentage of people who are nontasters?\u00a0Why has the nontasting allele been preserved in human populations at all? Some scientists hypothesize that the nontaster allele actually confers the ability to taste some other, yet-to-be identified, bitter compound in plants. People who inherit both alleles would presumably be able to taste a wider range of bitter compounds, so they would have the greatest ability to avoid plant toxins. In other words, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2474\">heterozygote<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2715\">genotype<\/a> for the taster gene would be the most fit and favored by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2633\">natural selection<\/a>.<\/p>\n<p>Most people no longer have to worry whether the plants they eat contain toxins. The produce you grow in your garden or buy at the supermarket consists of known varieties that are safe to eat. However, natural selection may still be at work in human populations for the PTC-taster gene, because PTC tasters may be more sensitive than nontasters to bitter compounds in tobacco and vegetables in the cabbage family (that is, cruciferous vegetables, such as the broccoli, cauliflower, and cabbage pictured in Figure 6.4.3).<\/p>\n<ul>\n<li>People who find PTC to taste very bitter are less likely to smoke tobacco, presumably because tobacco smoke has a stronger bitter taste to these individuals. In this case, selection would favor taster genotypes, because tasters would be more likely to avoid smoking and its serious health risks.<\/li>\n<li>Strong tasters find cruciferous vegetables to taste bitter. As a result, they may avoid eating these vegetables (and perhaps other foods, as well), presumably resulting in a diet that is less varied and nutritious. In this scenario, natural selection\u00a0might\u00a0work against taster genotypes.<\/li>\n<\/ul>\n<p><span style=\"text-align: initial;font-size: 1em\"><\/p>\n<div id=\"h5p-86\">\n<div class=\"h5p-content\" data-content-id=\"86\"><\/div>\n<\/div>\n<p><\/span><\/p>\n<p><em>Figure 6.4.3 Cruciferous vegetables.<\/em><\/p>\n<div>\n<h1>Developmental Adjustment<\/h1>\n<\/div>\n<p>It takes a relatively long time for genetic change in response to environmental stress to produce a population with adaptations. Fortunately, we can adjust to some environmental stresses more quickly by changing in nongenetic ways. One type of nongenetic response to stress is\u00a0<strong>developmental adjustment.<\/strong>\u00a0This refers to phenotypic change that occurs during development in infancy or childhood, and that may persist into adulthood. This type of change may be irreversible by adulthood.<\/p>\n<h2>Phenotypic Plasticity<\/h2>\n<p>Developmental adjustment is possible because humans have a high degree of\u00a0<strong>phenotypic plasticity,<\/strong>\u00a0which is\u00a0the ability to alter\u00a0the<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2477\"> phenotype<\/a> in response to changes in the environment. Phenotypic plasticity allows us to respond to changes that occur within our lifetime, and it is particularly important for species\u00a0(like our own)\u00a0that have a long generation time. With long generations, evolution of genetic adaptations may occur too slowly to keep up with changing environmental stresses.<\/p>\n<h2>Developmental Adjustment and Cultural Practices<\/h2>\n<p>Developmental adjustment may be the result of naturally occurring environmental stresses or cultural practices, including medical or dental treatments. Like our example at the beginning of this section, using braces to change the shape of the jaw and the position of the teeth is an example of a dental practice that brings about a developmental adjustment. Another example of developmental adjustment is the use of a back brace to treat scoliosis (see images in <em>Figure 6.4.4<\/em>). Scoliosis is an abnormal curvature from side to side in the spine. If the problem is not too severe, a brace, if worn correctly, should prevent the curvature from worsening as a child grows, although it cannot straighten a curve that is already present. Surgery may be required to do that.<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 651px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-457\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg.png\" alt=\"\" width=\"651\" height=\"342\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.4 Scoliosis can be prevented from worsening by shaping the phenotype with a back brace.<\/em><\/figcaption><\/figure>\n<h2>Developmental Adjustment and Nutritional Stress<\/h2>\n<p>An important example of developmental adjustment that results from a naturally occurring environmental stress is the cessation of physical growth that occurs in children who are under nutritional stress. Children who lack adequate food to fuel both growth and basic metabolic processes are likely to slow down in their growth rate \u2014 or even to stop growing entirely. Shunting all available calories and nutrients into essential life functions may keep the child alive at the expense of increasing body size.<\/p>\n<p>Table 6.4.1 shows the effects of inadequate diet on children's' growth in several countries worldwide. For each country, the table gives the prevalence of <strong>stunting<\/strong>\u00a0in children under\u00a0the age of five. Children are considered stunted if their height is at least two standard deviations below the median height for their age in an international reference population.<\/p>\n<p><strong>Table 6.4.1<\/strong><\/p>\n<p><em>Percentage of Stunting in Young Children in Selected Countries (2011-2015)<\/em><\/p>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 53.0094%;height: 142px\" border=\"0\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 52.9369%;text-align: center\" colspan=\"2\"><strong>Percentage of Stunting in Young Children in Selected Countries (2011-2015)<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 16px\">\n<td style=\"height: 16px;width: 22.19%\"><strong>Country<\/strong><\/td>\n<td style=\"height: 16px;width: 30.7469%\"><strong>Per cent of Children Under Age 5 with Stunting<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">United States<\/td>\n<td style=\"height: 14px;width: 30.7469%\">2.1<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Turkey<\/td>\n<td style=\"height: 14px;width: 30.7469%\">9.5<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Mexico<\/td>\n<td style=\"height: 14px;width: 30.7469%\">13.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Thailand<\/td>\n<td style=\"height: 14px;width: 30.7469%\">16.3<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Iraq<\/td>\n<td style=\"height: 14px;width: 30.7469%\">22.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Philippines<\/td>\n<td style=\"height: 14px;width: 30.7469%\">33.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Pakistan<\/td>\n<td style=\"height: 14px;width: 30.7469%\">45.0<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Papua New Guinea<\/td>\n<td style=\"height: 14px;width: 30.7469%\">49.5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>After a growth slow-down occurs and if adequate food becomes available, a child may be able to make up the loss of growth. If food is plentiful, the child may grow more rapidly than normal until the original, genetically-determined growth trajectory is reached. If the inadequate diet persists, however, the failure of growth may become chronic, and the child may never reach his or her full potential adult size.<\/p>\n<p>Phenotypic plasticity of body size in response to dietary change has been observed in successive generations within populations. For example, children in Japan were taller, on average, in each successive generation\u00a0after\u00a0the end of World War II. Boys aged 14-15 years old in 1986 were an average of about 18 cm (7 in.) taller than boys of the same age in 1959, a generation earlier. This is a highly significant difference, and it occurred too quickly to be accounted for by genetic change. Instead, the increase in height is a developmental adjustment, thought to be largely attributable to changes in the Japanese diet since World War II. During this period, there was an increase in the amount of animal protein and fat, as well as in the total calories consumed.<\/p>\n<div>\n<h1>Acclimatization<\/h1>\n<\/div>\n<p>Other responses to environmental stress are reversible and not permanent, whether they occur in childhood or adulthood. The development of reversible changes to environmental stress is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2483\">acclimatization<\/a>.<\/strong>\u00a0Acclimatization generally develops over a relatively short period of time.\u00a0It may take just a few days or weeks to attain a maximum response to a stress. When the stress is no longer present, the acclimatized state declines, and the body returns to its normal baseline state. Generally, the shorter the time for acclimatization to occur, the more quickly the condition is reversed when the environmental stress is removed.<\/p>\n<h2>Acclimatization to UV Light<\/h2>\n<p>A common example of acclimatization is tanning of the skin (see Figure 6.4.5). This occurs in many people in response to exposure to ultraviolet radiation from the sun. Special pigment cells in the skin, called melanocytes, produce more of the brown pigment melanin when exposed to sunlight. The melanin collects near the surface of the skin where it absorbs UV radiation so it cannot penetrate and potentially damage deeper skin structures. Tanning is a reversible change in the phenotype that helps the body deal temporarily with the environmental stress of high levels of UV radiation. When the skin is no longer exposed to the sun\u2019s rays, the tan fades, generally over a period of a few weeks or months.<\/p>\n<div id=\"h5p-87\">\n<div class=\"h5p-content\" data-content-id=\"87\"><\/div>\n<\/div>\n<p><em>Figure 6.4.5 Tanning of the skin occurs in many people in response to exposure to ultraviolet radiation from the sun.<\/em><\/p>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Acclimatization to Heat<\/span><\/p>\n<\/div>\n<p>Another common example of acclimatization occurs in response to heat. Changes that occur with heat acclimatization include increased sweat output and earlier onset of sweat production, which helps the body stay cool because evaporation of sweat takes heat from the body\u2019s surface in a process called evaporative cooling. It generally takes a couple of weeks for maximum heat acclimatization to come about by gradually working out harder and longer at high air temperatures. The changes that occur with acclimatization just as quickly subside when the body is no longer exposed to excessive heat.<\/p>\n<h2>Acclimatization to High Altitude<\/h2>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 420px\" class=\"wp-caption alignleft\"><img class=\" wp-image-458\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nepalese-base-camp-by-Mark-Horrell-on-Flickr-CC-BY-NC-SA-.jpg\" alt=\"Base camp in Nepal\" width=\"420\" height=\"315\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.6 Mountaineers must spend 4-5 days acclimatizing to high altitude before attempting to climb to the summit of Mount Everest.<\/em><\/figcaption><\/figure>\n<p>Short term acclimatization to high altitude occurs as a response to low levels of oxygen in the blood.\u00a0 This reduced level of oxygen is detected by carotid bodies, which will trigger in increase in breathing and heart rate.\u00a0 Over a period of weeks the body will compensate by increasing red blood cell production, thereby improving the oxygen-carrying capacity of the blood.\u00a0 This is why mountaineers wishing to climb to the peak of Mount Everest must complete the full climb in portions; it is recommended that climbers spend 2-3 days acclimatizing for every 600 metres of elevation increase.\u00a0 In addition, the higher to altitude, the longer it make take to acclimatize; climbers are advised to spend 4-5 days acclimatizing at base camp (whether the base camp in Nepal or China) before completing the final leg of the climb to the peak.\u00a0 The concentration of red blood cells gradually decreases to normal levels once a climber returns to their normal elevation.<\/p>\n<div>\n<h1>Cultural Responses<\/h1>\n<\/div>\n<p>More than any other species, humans respond to environmental stresses with learned behaviors and technology. These cultural responses allow us to change our environments to control stresses, rather than changing our bodies genetically or physiologically to cope with the stresses. Even archaic humans responded to some environmental stresses in this way. For example, Neanderthals used shelters, fires, and animal hides as clothing to stay warm in the cold climate in Europe during the last ice age. Today, we use more sophisticated technologies to stay warm in cold climates while retaining our essentially tropical-animal anatomy and physiology. We also use technology (such as furnaces and air conditioners) to avoid temperature stress and stay comfortable in hot or cold climates.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Humans may respond to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2653\">environmental stress <\/a>in four different ways: adaptation, developmental adjustment, acclimatization, and cultural responses.<\/li>\n<li>An adaptation is a genetically based trait that has evolved because it helps living things survive and reproduce in a given environment. Adaptations evolve by natural selection in populations over a relatively long period to time. Examples of adaptations include sickle cell trait as an adaptation to the stress of endemic malaria and the ability to taste bitter compounds as an adaptation to the stress of bitter-tasting toxins in plants.<\/li>\n<li>A developmental adjustment is a non-genetic response to stress that occurs during infancy or childhood, and that may persist into adulthood. This type of change may be irreversible. Developmental adjustment is possible because humans have a high degree of phenotypic plasticity. It may be the result of environmental stresses (such as inadequate food), which may stunt growth, or cultural practices (such as orthodontic treatments), which re-align the teeth and jaws.<\/li>\n<li>Acclimatization is the development of reversible changes to environmental stress that develop over a relatively short period of time. The changes revert to the normal baseline state after the stress is removed. Examples of acclimatization include tanning of the skin and physiological changes (such as increased sweating) that occur with heat acclimatization.<\/li>\n<li>More than any other species, humans respond to environmental stress with learned behaviors and technology, which are cultural responses. These responses allow us to change our environment to control stress, rather than changing our bodies genetically or physiologically to cope with stress. Examples include using shelter, fire, and clothing to cope with a cold climate.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>List four different types of responses that humans may make to cope with environmental stress.<\/li>\n<li>Define adaptation.<\/li>\n<li>\n<div id=\"h5p-88\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-88\" class=\"h5p-iframe\" data-content-id=\"88\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Human Responses to Environmental Stress\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain how natural selection may have resulted in most human populations having people who can and people who cannot taste PTC.<\/li>\n<li>What is a developmental adjustment?<\/li>\n<li>Define phenotypic plasticity.<\/li>\n<li>Explain why phenotypic plasticity may be particularly important in a species with a long generation time.<\/li>\n<li>Why may stunting of growth occur in children who have an inadequate diet? Why is stunting preferable to the alternative?<\/li>\n<li>What is acclimatization?<\/li>\n<li>How does acclimatization to heat come about, and what are two physiological changes that occur in heat acclimatization?<\/li>\n<li>Give an example of a cultural response to heat stress.<\/li>\n<li>Which is more likely to be reversible \u2014 a change due to acclimatization, or a change due to developmental adjustment? Explain your answer.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=upp9-w6GPhU<\/p>\n<p style=\"text-align: center\">Could we survive prolonged space travel? - Lisa Nip, TED-Ed, 2016.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=hRnrIpUMyZQ&amp;t=182s<\/p>\n<p style=\"text-align: center\">How this disease changes the shape of your cells - Amber M. Yates, TED-Ed, 2019.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 6.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Free_Awesome_Girl_With_Braces_Close_Up.jpg\" rel=\"cc:attributionURL\">Free_Awesome_Girl_With_Braces_Close_Up<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/40645538@N00\" rel=\"nofollow\">D. Sharon Pruitt<\/a> from Hill Air Force Base, Utah, USA on Wikimedia Commons is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\" rel=\"license\">CC BY 2.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en) license.<\/p>\n<p><strong>Figure 6.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:%D8%B2%D8%A8%D8%A7%D9%86_tongue.jpg\" rel=\"cc:attributionURL\">Tongue<\/a> by <a class=\"new\" title=\"User:Mahdiabbasinv (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Mahdiabbasinv&amp;action=edit&amp;redlink=1\">Mahdiabbasinv<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en) license.<\/p>\n<p><strong>Figure 6.4.3<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/unsplash.com\/photos\/PT-GXFtQj-s\">White cauliflower on brown wooden chopping board<\/a> by <a href=\"https:\/\/unsplash.com\/@louishansel\">Louis Hansel @shotsoflouis<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/LpHYbY6Qu_o\">Broccoli on wooden chopping board<\/a> by <a href=\"https:\/\/unsplash.com\/@louishansel\">Louis Hansel @shotsoflouis<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/knGwkn2j4ro\">Green cabbage close up<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@photoliphecjd\">Craig Dimmick<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/2Qzk3EJLNGE\">Cabbage hybrid\/ brussel sprouts<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@darkersolstice\">Solstice Hannan<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/_zV74zUnwmc\">Kale<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@lauramakoj\">Laura Johnston<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/v25z8P-CPB4\">Tiny bok choy at the Asian market<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@twoluckyspoons\">Jodie Morgan<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<\/ul>\n<p><strong>Figure 6.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg.png\" rel=\"cc:attributionURL\">Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg<\/a> by Weiss H.R. from <a href=\"https:\/\/scoliosisjournal.biomedcentral.com\/articles\/10.1186\/1748-7161-2-19\">Scoliosis Journal\/BioMed Central Ltd<\/a>. on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\" rel=\"license\">CC BY 2.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/2.0) license.<\/p>\n<p><strong>Figure 6.4.5<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/21077319@N02\/3667901661\">Tan Lines<\/a> by <a class=\"owner-name truncate\" title=\"Go to k.steudel's photostream\" href=\"https:\/\/www.flickr.com\/photos\/snaks\/\" data-track=\"attributionNameClick\">k.steudel<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/3760162521\/sizes\/l\/\">Twin tan lines (all sizes)<\/a> by <a class=\"owner-name truncate\" title=\"Go to Quinn Dombrowski's photostream\" href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/\" data-track=\"attributionNameClick\">Quinn Dombrowski<\/a>\u00a0on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/14518898810\">Wedding ring tan line<\/a> by <a class=\"owner-name truncate\" title=\"Go to Quinn Dombrowski's photostream\" href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/\" data-track=\"attributionNameClick\">Quinn Dombrowski<\/a>\u00a0on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/29333334@N06\/3792695572\">Tan<\/a> by <a class=\"owner-name truncate\" title=\"Go to Evil Erin's photostream\" href=\"https:\/\/www.flickr.com\/photos\/evilerin\/\" data-track=\"attributionNameClick\">Evil Erin<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/li>\n<\/ul>\n<p><strong style=\"text-align: initial;font-size: 1em\">Figure 6.4.6<\/strong><\/p>\n<p><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.flickr.com\/photos\/markhorrell\/18787430274\/in\/photostream\/\" rel=\"cc:attributionURL\">Nepalese base camp<\/a> by <a class=\"owner-name truncate\" title=\"Go to Mark Horrell's photostream\" href=\"https:\/\/www.flickr.com\/photos\/markhorrell\/\" data-track=\"attributionNameClick\">Mark Horrell<\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a\u00a0<\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" rel=\"license\">CC BY-NC-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">TED-Ed. (2016, October 4). Could we survive prolonged space travel? - Lisa Nip. YouTube. https:\/\/www.youtube.com\/watch?v=upp9-w6GPhU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, May 6). How this disease changes the shape of your cells - Amber M. Yates. YouTube. https:\/\/www.youtube.com\/watch?v=hRnrIpUMyZQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Weiss, H. (2007). Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS)? [Figure 2 - digital photograph],\u00a0 <i>Scoliosis, <\/i>2(19).\u00a0https:\/\/doi.org\/10.1186\/1748-7161-2-19<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5899\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5899\"><div tabindex=\"-1\"><p>division of the peripheral nervous system that controls involuntary activities<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3093\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3093\"><div tabindex=\"-1\"><p>Image shows a diagram of the gallbladder and it's connection to the cystic duct and then the common bile duct.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_5893\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_5893\"><div tabindex=\"-1\"><p>A hormone made by the hypothalamus in the brain and stored in the posterior pituitary gland. It tells your kidneys how much water to conserve. ADH constantly regulates and balances the amount of water in your blood. Higher water concentration increases the volume and pressure of your blood.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_2938\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_2938\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 602px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-461\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Blood-Donation-by-USA-Department-of-Defence-Public-Domain.jpg\" alt=\"Blood donation\" width=\"602\" height=\"401\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.1 A phlebotomist draws blood from a blood donor.<\/em><\/figcaption><\/figure>\n<h1>Giving the Gift of Life<\/h1>\n<p>Did you ever donate blood? If you did, then you probably know that your blood type is an important factor in blood transfusions. People vary in the type of blood they inherit, and this determines which type(s) of blood they can safely receive in a transfusion. Do you know your blood type?<\/p>\n<div>\n<h1>What Are Blood Types?<\/h1>\n<\/div>\n<p style=\"text-align: left\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2702\">Blood<\/a> is composed of cells suspended in a liquid called plasma. There are three types of cells in blood: red blood cells, which carry oxygen; white blood cells, which fight infections and other threats; and platelets, which are cell fragments that help blood clot.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2703\">Blood type<\/a><\/strong>\u00a0(or blood group) is a genetic characteristic associated with the presence or absence of certain molecules, called antigens, on the surface of red blood cells. These molecules may help maintain the integrity of the cell membrane, act as receptors, or have other biological functions. A\u00a0<strong>blood group system<\/strong>\u00a0refers to all of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\">gene<\/a>(s), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">alleles<\/a>, and possible <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2715\">genotypes<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2477\">phenotypes<\/a>\u00a0that exist for a particular set of blood type antigens. Human blood group systems include the well-known ABO and Rhesus (Rh) systems, as well as at least 33 others that are less well known.<\/p>\n<h2>Antigens and Antibodies<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2704\">Antigens<\/a><\/strong>\u00a0\u2014<strong>\u00a0<\/strong>such as those on the red blood cells \u2014 are molecules that the immune system identifies as either self (produced by your own body) or non-self (not produced by your own body). Blood group antigens may be proteins, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2210\">carbohydrates<\/a>, glycoproteins (proteins attached to chains of sugars), or glycolipids (lipids attached to chains of sugars), depending on the particular blood group system. If antigens are identified as non-self, the immune system responds by forming antibodies that are specific to the non-self antigens. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2215\">Antibodies<\/a><\/strong> are large, Y-shaped proteins produced by the immune system that recognize and bind to non-self antigens. The analogy of a lock and key is often used to represent how an antibody and antigen fit together, as shown in the illustration below (Figure 6.5.2). When antibodies bind to antigens, it marks them for destruction by other immune system cells. Non-self antigens may enter your body on pathogens (such as bacteria or viruses), on foods, or on red blood cells in a blood transfusion from someone with a different blood type than your own. The last way is virtually impossible nowadays because of effective blood typing and screening protocols.<\/p>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 492px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-462\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Antibody.svg_.png\" alt=\"Antibody Lock and Key model\" width=\"492\" height=\"694\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.2 Model of antigen and matching antibody. Antibodies will detect antigens based on a match in 3-dimensional shape, as per the lock and key model.<\/em><\/figcaption><\/figure>\n<h2>Genetics of Blood Type<\/h2>\n<p>An individual\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2703\">blood type<\/a> depends on which <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">alleles<\/a> for a blood group system were inherited from their parents. Generally, blood type is controlled by alleles for a single <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\">gene<\/a>, or for two or more very closely linked genes. Closely linked genes are almost always inherited together, because there is little or no recombination between them. Like other genetic traits, a person\u2019s blood type is generally fixed for life, but there are rare instances in which blood type can change. This could happen, for example, if an individual receives a bone marrow transplant to treat a disease, such as leukemia. If the bone marrow comes from a donor who has a different blood type, the patient\u2019s blood type may eventually convert to the donor\u2019s blood type, because red blood cells are produced in bone marrow.<\/p>\n<div>\n<h1>ABO Blood Group System<\/h1>\n<\/div>\n<p>The\u00a0<strong>ABO blood group system<\/strong> is the best known human blood group system. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2704\">Antigens<\/a> in this system are glycoproteins. These antigens are shown in the list below. There are four common blood types for the ABO system:<\/p>\n<ol>\n<li>Type A, in which only the A antigen is present.<\/li>\n<li>Type B, in which only the B antigen is present.<\/li>\n<li>Type AB, in which both the A and B antigens are present.<\/li>\n<li>Type O, in which neither the A nor the B antigen is present.<\/li>\n<\/ol>\n<h2>Genetics of the ABO System<\/h2>\n<p>The ABO blood group system is controlled by a single<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\"> gene<\/a> on <a href=\"https:\/\/en.wikipedia.org\/wiki\/Chromosome_9\">chromosome 9<\/a>. There are three common <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">alleles<\/a> for the gene, often represented by the letters A , B , and O. With three alleles, there are six possible genotypes for ABO blood group. Alleles A and B, however, are both dominant to allele O and codominant to each other. This results in just four possible phenotypes (blood types) for the ABO system. These genotypes and phenotypes are shown in Table 6.5.1.<\/p>\n<p><strong>Table 6.5.1<\/strong><\/p>\n<p><em>ABO Blood Group System: Genotypes and Phenotypes<\/em><\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 49.9637%\" border=\"0\">\n<tbody>\n<tr>\n<td style=\"width: 35.8231%;text-align: center\" colspan=\"2\"><strong>ABO Blood Group System<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\"><strong>Genotype<\/strong><\/td>\n<td style=\"width: 20.8122%\"><strong>Phenotype (Blood Type, or Group)<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">AA<\/td>\n<td style=\"width: 20.8122%\">A<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">AO<\/td>\n<td style=\"width: 20.8122%\">A<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">BB<\/td>\n<td style=\"width: 20.8122%\">B<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">BO<\/td>\n<td style=\"width: 20.8122%\">B<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">OO<\/td>\n<td style=\"width: 20.8122%\">O<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 15.0109%\">AB<\/td>\n<td style=\"width: 20.8122%\">AB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The diagram below (Figure 6.5.3) shows an example of how ABO blood type is inherited. In this particular example, the father has blood type A (genotype AO) and the mother has blood type B (genotype BO). This mating type can produce children with each of the four possible ABO <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2477\">phenotypes<\/a>, although in any given family, not all phenotypes may be present in the children.<\/p>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 590px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-463\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/ABO_system_codominance.svg_.png\" alt=\"Example of the ABO system codominance\" width=\"590\" height=\"588\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.3 Example of ABO blood group inheritance.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Medical Significance of ABO Blood Type<\/span><\/p>\n<\/div>\n<p>The ABO system is the most important blood group system in blood transfusions. If red blood cells containing a particular ABO antigen are transfused into a person who lacks that antigen, the person\u2019s immune system will recognize the antigen on the red blood cells as non-self. Antibodies specific to that antigen will attack the red blood cells, causing them to agglutinate (or clump) and break apart. If a unit of incompatible blood were to be accidentally transfused into a patient, a severe reaction (called <a href=\"https:\/\/medlineplus.gov\/ency\/article\/001303.htm\">acute hemolytic transfusion reaction<\/a>) is likely to occur, in which many red blood cells are destroyed. This may result in kidney failure, shock, and even death. Fortunately, such medical accidents virtually never occur today.<\/p>\n<p>These antibodies are often spontaneously produced in the first years of life, after exposure to common microorganisms in the environment that have antigens similar to blood antigens. Specifically, a person with type A blood will produce anti-B antibodies, while a person with type B blood will produce anti-A antibodies. A person with type AB blood does not produce either antibody, while a person with type O blood produces both anti-A and anti-B antibodies. Once the antibodies have been produced, they circulate in the plasma. The relationship between ABO red blood cell antigens and plasma antibodies is shown in Figure 6.5.4.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 1016px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-412\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/ABO_blood_type.svg_.png\" alt=\"Image shows a table of each blood type, which antigens and antibodies are present, and acceptable blood donor types.\" width=\"1016\" height=\"653\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.4 The relationship between ABO red blood cell antigens and plasma antibodies.<\/em><\/figcaption><\/figure>\n<div>\n<p><em>The antibodies that circulate in the plasma are for different antigens than those on red blood cells, which are recognized as self antigens.<\/em><\/p>\n<\/div>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 273px\" class=\"wp-caption alignright\"><img class=\"wp-image-464 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blood-Donor-and-recipient-ABO-e1588625024858.png\" alt=\"Blood donors and recipients\" width=\"273\" height=\"272\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.5 You can always donate blood to someone who has the same blood type as yours, but you may or may not be able to donate to people who have other blood types, as indicated in this diagram.<\/em><\/figcaption><\/figure>\n<p>Which blood types are compatible and which are not? Type O blood contains both anti-A and anti-B antibodies, so people with type O blood can only receive type O blood. However, they can\u00a0<em>donate<\/em>\u00a0blood to people of\u00a0<em>any<\/em>\u00a0ABO blood type, which is why individuals with type O blood are called\u00a0<strong>universal donors.<\/strong>\u00a0Type AB blood contains neither anti-A nor anti-B antibodies, so people with type AB blood can receive blood from people of any ABO blood type. That\u2019s why individuals with type AB blood are called\u00a0<strong>universal recipients.<\/strong>\u00a0They can donate blood, however,\u00a0<em>only<\/em> to people who also have type AB blood. These and other relationships between blood types of donors and recipients are summarized in the simple diagram to the right.<\/p>\n<h3>Geographic Distribution of ABO Blood Groups<\/h3>\n<p>The frequencies of blood groups for the ABO system vary around the world. You can see how the A and B alleles and the blood group O are distributed geographically on the maps in Figure 6.5.6.<\/p>\n<ul>\n<li>Worldwide, B is the rarest ABO allele, so type B blood is the least common ABO blood type. Only about 16 per cent of all people have the B allele. Its highest frequency is in Asia. Its lowest frequency is among the indigenous people of Australia and the Americas.<\/li>\n<li>The A allele is somewhat more common around the world than the B allele, so type A blood is also more common than type B blood. The highest frequencies of the A allele are in Australian Aborigines, the Lapps (Sami) of Northern Scandinavia, and Blackfoot Native Americans in North America. The allele is nearly absent among Native Americans in Central and South America.<\/li>\n<li>The O allele is the most common ABO allele around the world, and type O blood is the most common ABO blood type. Almost two-thirds of people have at least one copy of the O allele. It is especially common in Native Americans in Central and South America, where it reaches frequencies close to 100 per cent. It also has relatively high frequencies in Australian Aborigines and Western Europeans. Its frequencies are lowest in Eastern Europe and Central Asia.<\/li>\n<\/ul>\n<div>\n<div id=\"h5p-89\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-89\" class=\"h5p-iframe\" data-content-id=\"89\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Global Distribution or Blood Groups\"><\/iframe><\/div>\n<\/div>\n<p><em>Figure 6.5.6 Maps of populations that have the A, B and O alleles.\u00a0<\/em><\/p>\n<\/div>\n<h2>Evolution of the ABO Blood Group System<\/h2>\n<p>The geographic distribution of ABO blood type alleles provides indirect evidence for the evolutionary history of these alleles. Evolutionary biologists hypothesize that the allele for blood type A evolved first, followed by the allele for blood type O, and then by the allele for blood type B. This chronology accounts for the percentages of people worldwide with each blood group, and is also consistent with known patterns of early population movements.<\/p>\n<p>The evolutionary forces of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2686\">founder effect<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2710\">genetic drift<\/a> have no doubt played a significant role in the current distribution of ABO blood types worldwide. Geographic variation in ABO blood groups is also likely to be influenced by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2633\">natural selection<\/a>, because different blood types are thought to vary in their susceptibility to certain diseases. For example:<\/p>\n<ul>\n<li>People with type O blood may be more susceptible to cholera and plague. They are also more likely to develop gastrointestinal ulcers.<\/li>\n<li>People with type A blood may be more susceptible to smallpox and more likely to develop certain cancers.<\/li>\n<li>People with types A, B, and AB blood appear to be less likely to form blood clots that can cause strokes. However, early in our history, the ability of blood to form clots \u2014 which appears greater in people with type O blood \u2014 may have been a survival advantage.<\/li>\n<li>Perhaps the greatest natural selective force associated with ABO blood types is malaria. There is considerable evidence to suggest that people with type O blood are somewhat resistant to malaria, giving them a selective advantage where malaria is endemic.<\/li>\n<\/ul>\n<div>\n<h1>Rhesus Blood Group System<\/h1>\n<\/div>\n<p>Another well-known blood group system is the\u00a0<strong>Rhesus (Rh) blood group system<\/strong>. The Rhesus system has dozens of different antigens, but only five main antigens (called\u00a0D, C, c, E, and e). The major Rhesus antigen is the D antigen. People with the D antigen are called Rh positive (Rh+), and people who lack the D antigen are called Rh negative (Rh-). Rhesus antigens are thought to play a role in transporting ions across cell membranes by acting as channel proteins.<\/p>\n<p>The Rhesus blood group system is controlled by two linked genes on <a href=\"https:\/\/en.wikipedia.org\/wiki\/Chromosome_1\">chromosome 1<\/a>. One gene, called RHD, produces a single antigen, antigen D. The other gene, called RHCE, produces the other four relatively common Rhesus antigens (C, c, E, and e), depending on which alleles for this gene are inherited.<\/p>\n<h2>Rhesus Blood Group and Transfusions<\/h2>\n<p>After the ABO system, the Rhesus system is the second most important blood group system in blood transfusions. The D antigen is the one most likely to provoke an immune response in people who lack the antigen. People who have the D antigen (Rh+) can be safely transfused with either Rh+ or Rh- blood, whereas people who lack the D antigen (Rh-) can be safely transfused only with Rh- blood.<\/p>\n<p>Unlike anti-A and anti-B antibodies to ABO antigens, anti-D antibodies for the Rhesus system are not usually produced by sensitization to environmental substances.\u00a0People who lack the D antigen (Rh-), however, may produce anti-D antibodies if exposed to Rh+ blood. This may happen accidentally in a blood transfusion, although this is extremely unlikely today. It may also happen during pregnancy with an Rh+ fetus if some of the fetal blood cells pass into the mother\u2019s blood circulation.<\/p>\n<h2>Hemolytic Disease of the Newborn<\/h2>\n<p>If a woman who is Rh- is carrying an Rh+ fetus, the fetus may be at risk. This is especially likely if the mother has formed anti-D antibodies during a prior pregnancy because of a mixing of maternal and fetal blood during childbirth. Unlike antibodies against ABO antigens, antibodies against the Rhesus D antigen can cross the placenta and enter the blood of the fetus. This may cause\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK2266\/\"><strong>hemolytic disease of the newborn (HDN)<\/strong><\/a>, also called erythroblastosis fetalis, an illness in which fetal red blood cells are destroyed by maternal antibodies, causing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2061\">anemia<\/a>. This illness may range from mild to severe. If it is severe, it may cause brain damage and is sometimes fatal for the fetus or newborn. Fortunately, HDN can be prevented by preventing the formation of anti-D antibodies in the Rh- mother. This is achieved\u00a0by injecting the\u00a0mother\u00a0with\u00a0a medication called Rho(D) immune globulin.<\/p>\n<h2>Geographic Distribution of Rhesus Blood Types<\/h2>\n<p>The majority of people worldwide are Rh+, but there is regional variation in this blood group system, as there is with the ABO system. The aboriginal inhabitants of the Americas and Australia originally had very close to 100 per cent Rh+ blood. The frequency of the Rh+ blood type is also very high in African populations, at about 97 to 99 per cent. In East Asia, the frequency of Rh+ is slightly lower, at about 93 to 99 per cent. Europeans have the lowest frequency of the Rh+ blood type at about 83 to 85 per cent.<\/p>\n<p>What explains the population variation in Rhesus blood types? Prior to the advent of modern medicine, Rh+ positive children conceived by Rh- women were at risk of fetal or newborn death or impairment from HDN. This\u00a0was\u00a0an enigma, because presumably, natural selection would work to\u00a0<em>remove<\/em>\u00a0the rarer phenotype (Rh-) from populations. However, the frequency of this phenotype is relatively high in many populations.<\/p>\n<p>Recent studies have found evidence that natural selection may actually favor heterozygotes for the Rhesus D antigen. The selective agent in this case is thought to be\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2718\">toxoplasmosis<\/a>,<\/strong>\u00a0a parasitic disease caused by the protozoan\u00a0<em>Toxoplasma gondii,<\/em> which is very common worldwide. You can see a life cycle diagram of the parasite in Figure 6.5.7. Infection by this parasite often causes no symptoms at all, or it may cause flu-like symptoms for a few days or weeks. Exposure to the parasite has been linked, however, to increased risk of mental disorders (such as schizophrenia), neurological disorders (such as Alzheimer\u2019s), and other neurological problems, including delayed reaction times. One study found that people who tested positive for antibodies to the parasite were more than twice as likely to be involved in traffic accidents.<\/p>\n<figure id=\"attachment_465\" aria-describedby=\"caption-attachment-465\" style=\"width: 627px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-465\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Toxoplasma_gondii_Life_cycle_PHIL_3421_lores.jpg\" alt=\"Toxoplasmosis Life Cycle\" width=\"627\" height=\"822\"><figcaption id=\"caption-attachment-465\" class=\"wp-caption-text\"><em>Figure 6.5.7 Toxoplasmosis (toxoplasma gondii): Infective and diagnostic stages.\u00a0<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"text-align: initial;font-size: 1em\">People who are heterozygous for the D antigen appear less likely to develop the negative neurological and mental effects of <em style=\"text-align: initial;font-size: 1em\">Toxoplasma gondii <\/em>infection<\/span><span style=\"text-align: initial;font-size: 1em\">. This could help explain why both phenotypes (Rh+ and Rh-) are maintained in most populations. There are also striking geographic differences in the prevalence of <a href=\"https:\/\/www.cdc.gov\/parasites\/toxoplasmosis\/gen_info\/faqs.html\">toxoplasmosis<\/a> worldwide, ranging from zero to 95 per cent in different regions. This could explain geographic variation in the D antigen worldwide, because its strength as a selective agent would vary with its prevalence.<\/span><\/p>\n<\/div>\n<div>\n<h1>Feature: Myth vs. Reality<\/h1>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%;height: 140px\" border=\"0\">\n<tbody>\n<tr style=\"height: 98px\">\n<td style=\"width: 33.1116%;height: 98px\">\n<h2><span style=\"color: #ff0000\">Myth<\/span><\/h2>\n<\/td>\n<td style=\"width: 66.8884%;height: 98px\">\n<h2><span style=\"color: #339966\">Reality<\/span><\/h2>\n<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 33.1116%;height: 14px\"><em><span style=\"font-size: 16px\">\"Your nutritional needs can be determined by your ABO blood type. Knowing your blood type allows you to choose the appropriate foods that will help you lose weight, increase your energy, and live a longer, healthier life.\"<\/span><\/em><\/td>\n<td style=\"width: 66.8884%;height: 14px\"><strong><span style=\"font-size: 16px\">This idea was proposed in 1996 in a\u00a0<\/span><em style=\"font-size: 16px\">New York Times<\/em><span style=\"font-size: 16px\">\u00a0bestseller\u00a0<\/span><em style=\"font-size: 16px\">Eat Right for Your Type<\/em><span style=\"font-size: 16px\">, by Peter D\u2019Adamo, a naturopath. Naturopathy is a method of treating disorders that involves the use of herbs, sunlight, fresh air, and other natural substances. Some medical doctors consider naturopathy a pseudoscience. A major scientific review of the blood type diet could find no evidence to support it. In one study, adults eating the diet designed for blood type A showed improved health \u2014 but this occurred in everyone, regardless of their blood type. Because the blood type diet is based solely on blood type, it fails to account for other factors that might require dietary adjustments or restrictions. For example, people with diabetes \u2014 but different blood types \u2014 would follow different diets, and one or both of the diets might conflict with standard diabetes dietary recommendations and be dangerous.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 33.1116%;height: 14px\"><em><span style=\"font-size: 16px\">\"ABO blood type is associated with certain personality traits. People with blood type A, for example, are patient and responsible, but may also be stubborn and tense, whereas people with blood type B are energetic and creative, but may also be irresponsible and unforgiving. In selecting a spouse, both your own and your potential mate\u2019s blood type should be taken into account to ensure compatibility of your personalities.\"<\/span><\/em><\/td>\n<td style=\"width: 66.8884%;height: 14px\"><strong><span style=\"font-size: 16px\">The belief that blood type is correlated with personality is widely held in Japan and other East Asian countries. The idea was originally introduced in the 1920s in a study commissioned by the Japanese government, but it was later shown to have no scientific support. The idea was revived in the 1970s by a Japanese broadcaster, who wrote popular books about it. There is no scientific basis for the idea, and it is generally dismissed as pseudoscience by the scientific community. Nonetheless, it remains popular in East Asian countries, just as astrology is popular in many other countries.<\/span><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Blood type (or blood group) is a genetic characteristic associated with the presence or absence of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2704\">antigens<\/a> on the surface of red blood cells. A blood group system refers to all of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2035\">gene<\/a>(s), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_1942\">alleles<\/a>, and possible <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2715\">genotypes<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2477\">phenotype<\/a>s that exist for a particular set of blood type antigens.<\/li>\n<li>Antigens are molecules that the immune system identifies as either self or non-self. If antigens are identified as non-self, the immune system responds by forming antibodies that are specific to the non-self antigens, leading to the destruction of cells bearing the antigens.<\/li>\n<li>The ABO blood group system is a system of red blood cell antigens controlled by a single gene with three common alleles on chromosome 9. There are four possible ABO blood types: A, B, AB, and O. The ABO system is the most important blood group system in blood transfusions. People with type O blood are universal donors, and people with type AB blood are universal recipients.<\/li>\n<li>The frequencies of ABO blood type alleles and blood groups vary around the world. The allele for the B antigen is least common, and blood type O is the most common. The evolutionary forces of founder effect, genetic drift, and natural selection are responsible for the geographic distribution of ABO alleles and blood types.\u00a0People with type O blood, for example, may be somewhat resistant to malaria, possibly giving them a selective advantage where malaria is endemic.<\/li>\n<li>The Rhesus blood group system is a system of red blood cell antigens controlled by two genes with many alleles on chromosome 1. There are five common Rhesus antigens, of which antigen D is most significant. Individuals who have antigen D are called Rh+, and individuals who lack antigen D are called Rh-. Rh- mothers of Rh+ fetuses may produce antibodies against the D antigen in the fetal blood, causing hemolytic disease of the newborn (HDN).<\/li>\n<li>The majority of people worldwide are Rh+, but there is regional variation in this blood group system. This variation may be explained by natural selection that favors heterozygotes for the D antigen, because this genotype seems to be protected against some of the neurological\u00a0consequences\u00a0of the common parasitic infection toxoplasmosis.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Define blood type and blood group system.<\/li>\n<li>Explain the relationship between antigens and antibodies.<\/li>\n<li>Identify the alleles, genotypes, and phenotypes in the ABO blood group system.<\/li>\n<li>Discuss the medical significance of the ABO blood group system.<\/li>\n<li>Compare the relative worldwide frequencies of the three ABO alleles.<\/li>\n<li>Give examples of how different ABO blood types vary in their susceptibility to diseases.<\/li>\n<li>Describe the Rhesus blood group system.<\/li>\n<li>Relate Rhesus blood groups to blood transfusions.<\/li>\n<li>What causes hemolytic disease of the newborn?<\/li>\n<li>Describe\u00a0how toxoplasmosis may explain the persistence of the Rh- blood type in human populations.<\/li>\n<li>A woman is blood type O and Rh-, and her husband is blood type AB and Rh+. Answer the following questions about this couple and their offspring.\n<ol type=\"a\">\n<li>What are the possible genotypes of their offspring in terms of ABO blood group?<\/li>\n<li>What are the possible phenotypes of their offspring in terms of ABO blood group?<\/li>\n<li>Can the woman donate blood to her husband? Explain your answer.<\/li>\n<li>Can the man donate blood to his wife? Explain your answer.<\/li>\n<\/ol>\n<\/li>\n<li>Type O blood is characterized by the presence of O antigens \u2014 explain why this statement is false.<\/li>\n<li>Explain why newborn hemolytic disease may be more likely to occur in a second pregnancy than in a first.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=xfZhb6lmxjk<\/p>\n<p style=\"text-align: center\">Why do blood types matter? - Natalie S. Hodge, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=qcZKbjYyOfE<\/p>\n<p class=\"title style-scope ytd-video-primary-info-renderer\" style=\"text-align: center\">How do blood transfusions work? - Bill Schutt, TED-Ed, 2020.<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributes<\/h2>\n<p><strong>Figure 6.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.defense.gov\/Explore\/News\/Article\/Article\/604005\/\" rel=\"cc:attributionURL\">Following the Blood Donation Trail<\/a> by <i>EJ Hersom\/<\/i> USA Department of Defense is in the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a>. [<a href=\"https:\/\/www.dimoc.mil\/resources\/limitations\/\">Disclaimer<\/a>: The appearance of U.S. Department of Defense (DoD) visual information does not imply or constitute DoD endorsement.]<\/p>\n<p><strong>Figure 6.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Antibody.svg\" rel=\"cc:attributionURL\">Antibody<\/a> by <a title=\"User:Fvasconcellos\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fvasconcellos\">Fvasconcellos<\/a>\u00a0 on Wikimedia Commons is released into\u00a0the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 6.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:ABO_system_codominance.svg\">ABO system codominance.svg<\/a>, adapted by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:YassineMrabet\">YassineMrabet<\/a> (original \"Codominant\" image from <a href=\"https:\/\/ghr.nlm.nih.gov\/primer\/inheritance\/riskassessment\">US National Library of Medicine)<\/a>\u00a0<i>on Wikimedia Commons is in the\u00a0<\/i><a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 6.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:ABO_blood_type.svg\" rel=\"cc:attributionURL\">ABO_blood_type.svg<\/a> by <a class=\"new\" title=\"User:InvictaHOG (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:InvictaHOG&amp;action=edit&amp;redlink=1\">InvictaHOG<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 6.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/8.6\/\" rel=\"cc:attributionURL\">Blood Donor and recipient ABO<\/a>\u00a0by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/8.6\/\">CK-12 Foundation<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\">CC BY-NC 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/) license.<\/p>\n<div><img src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/logo_ck12.png\" alt=\"\"> <span style=\"font-size: 1em\">\u00a9<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/\">CK-12 Foundation<\/a> <span style=\"font-size: 1em\">Licensed under\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\"><img class=\"alignnone size-full wp-image-8217\" title=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/icon_licence.png\" alt=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\"><\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/terms-of-use\/\">Terms of Use<\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/attribution\/\">Attribution<\/a><\/div>\n<p><strong>Figure 6.5.6<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Map_of_blood_group_a.gif\">Map of Blood Group A<\/a> by <a class=\"extiw\" title=\"en:User:Muntuwandi\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Muntuwandi\">Muntuwandi<\/a>\u00a0at\u00a0<a class=\"external text\" href=\"https:\/\/en.wikipedia.org\/\">en.wikipedia<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Map_of_blood_group_b.gif\">Map of Blood Group B<\/a> by <a class=\"extiw\" title=\"en:User:Muntuwandi\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Muntuwandi\">Muntuwandi<\/a>\u00a0at\u00a0<a class=\"external text\" href=\"https:\/\/en.wikipedia.org\/\">en.wikipedia<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license.<\/li>\n<li><a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Map_of_blood_group_o.gif\">Map of Blood Group O<\/a> by anthro palomar at\u00a0<a class=\"external text\" href=\"https:\/\/en.wikipedia.org\/\">en.wikipedia<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license.<\/li>\n<\/ul>\n<p><strong>Figure 6.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Toxoplasma_gondii_Life_cycle_PHIL_3421_lores.jpg\" rel=\"cc:attributionURL\">Toxoplasma_gondii_Life_cycle_PHIL_3421_lores<\/a> by Alexander J. da Silva, PhD\/Melanie Moser, <a class=\"extiw\" title=\"w:Centers for Disease Control and Prevention\" href=\"https:\/\/en.wikipedia.org\/wiki\/Centers_for_Disease_Control_and_Prevention\">Centers for Disease Control and Prevention<\/a>'s\u00a0<a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/\" rel=\"nofollow\">Public Health Image Library<\/a> (PHIL<b><a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/details.aspx?pid=3421\" rel=\"nofollow\">#3421<\/a><\/b>) on Wikimedia Commons is in the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Table 6.5.1\u00a0<\/strong><\/p>\n<p><em>ABO Blood Group System: Genotypes and Phenotypes<\/em> was created by Christine Miller.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 1.424em;font-weight: bold;text-align: initial\">References<\/span><\/p>\n<p class=\"hanging-indent\">Dean, L. (2005). Chapter 4 Hemolytic disease of the newborn. In <em>Blood Groups and Red Cell Antigens<\/em> [Internet]. National Center for Biotechnology Information (US). https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK2266\/<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Toxoplasmosis [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/toxoplasmosis\/symptoms-causes\/syc-20356249<\/p>\n<p class=\"hanging-indent\">MedlinePlus. (2019, January 29). Hemolytic transfusion reaction [online article]. U.S. National Library of Medicine. https:\/\/en.wikipedia.org\/w\/index.php?title=Chromosome_9&amp;oldid=946440619<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, June 29). Why do blood types matter? - Natalie S. Hodge. YouTube. https:\/\/www.youtube.com\/watch?v=xfZhb6lmxjk&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2020, February 18). How do blood transfusions work? - Bill Schutt. YouTube. https:\/\/www.youtube.com\/watch?v=qcZKbjYyOfE&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, May 10). Chromosome 1. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=Chromosome_1&amp;oldid=955942444<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, March 20). Chromosome 9. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=Chromosome_9&amp;oldid=946440619<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3095\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3095\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4656\" aria-describedby=\"caption-attachment-4656\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4656\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Scleral_Icterus-1.jpg\" alt=\"15.6.1 Jaundiced eye\" width=\"400\" height=\"223\"><figcaption id=\"caption-attachment-4656\" class=\"wp-caption-text\"><em>Figure 15.6.1 \"Look deep into my eyes.\"<\/em><\/figcaption><\/figure>\n<div>\n<h1>Jaundiced Eyes<\/h1>\n<\/div>\n<p>Did you ever hear of a person looking at something or someone with a \u201cjaundiced eye\u201d? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.<\/p>\n<div>\n<h1>What Are\u00a0Accessory Organs of Digestion?<\/h1>\n<\/div>\n<figure id=\"attachment_4657\" aria-describedby=\"caption-attachment-4657\" style=\"width: 438px\" class=\"wp-caption alignright\"><img class=\" wp-image-4657\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-1-1.png\" alt=\"15.6.2 Accessory Organs of the Digestive System\" width=\"438\" height=\"876\"><figcaption id=\"caption-attachment-4657\" class=\"wp-caption-text\"><em>Figure 15.6.2 The liver, gallbladder, and pancreas are the major accessory organs of digestion. In this figure, the pink tubular structure that starts at the lower stomach and wraps around the pancreas is the duodenum of the small intestine. This is where the accessory organs secrete their digestive substances.<\/em><\/figcaption><\/figure>\n<p>Accessory organs of digestion\u00a0are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a>. These organs secrete or store substances that are needed for digestion in the first part of the\u00a0small intestine\u00a0\u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a> \u2014 where most chemical digestion takes place. You can see the three organs and their locations in Figure 15.6.2.<\/p>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Liver<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a><\/strong>\u00a0is a vital organ located in the upper right part of the abdomen. It lies just below the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4558\">stomach<\/a>. The liver plays an important role in digestion by secreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">bile<\/a>, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.<\/p>\n<h2>Structure of the Liver<\/h2>\n<p>The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.<\/p>\n<p>As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.<\/p>\n<figure id=\"attachment_4658\" aria-describedby=\"caption-attachment-4658\" style=\"width: 495px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4658\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg_-1.png\" alt=\"15.6.3 Hepatic and Portal vessels\" width=\"495\" height=\"502\"><figcaption id=\"caption-attachment-4658\" class=\"wp-caption-text\"><em>Figure 15.6.3 The portal vein supplies the liver with wastes filtered out of the blood in the spleen, as well as nutrients from the gastrointestinal tract. Oxygen-rich blood enters the liver via the hepatic artery.<\/em><\/figcaption><\/figure>\n<h2>Functions of the Liver<\/h2>\n<p>The main digestive function of the liver is the production of bile.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">Bile<\/a><\/strong>\u00a0is a yellowish alkaline\u00a0liquid\u00a0that consists of\u00a0water, electrolytes, bile salts, and cholesterol, among other substances, many of which are waste products. Some of the components of bile are synthesized by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4659\">hepatocyte<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. The rest are extracted from the\u00a0blood.<\/span><\/p>\n<p>As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.<\/p>\n<figure id=\"attachment_4660\" aria-describedby=\"caption-attachment-4660\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4660\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder-by-NIH-Image-Gallery-on-Flickr-CC-BY-NC-24312875104_e6ab50150b_h-1.jpg\" alt=\"15.6.4\" width=\"789\" height=\"526\"><figcaption id=\"caption-attachment-4660\" class=\"wp-caption-text\"><em>Figure 15.6.4 The common bile duct carries bile from the liver and gallbladder to the duodenum.<\/em><\/figcaption><\/figure>\n<p>Besides its roles in digestion, the liver has many other vital functions:<\/p>\n<ul>\n<li>The liver synthesizes glycogen from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3359\">glucose<\/a> and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.<\/li>\n<li>The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the\u00a0minerals\u00a0iron and copper.<\/li>\n<li>The liver synthesizes numerous <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3721\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3615\">amino acids<\/a>\u00a0needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.<\/li>\n<li>The liver synthesizes many important\u00a0lipids, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3439\">cholesterol<\/a>,\u00a0triglycerides, and lipoproteins.<\/li>\n<li>The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the\u00a0kidneys, which excrete them in urine.<\/li>\n<\/ul>\n<p>The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic\u00a0location\u00a0and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.<\/p>\n<div>\n<h1>Gallbladder<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a><\/strong> is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.<\/p>\n<figure id=\"attachment_4662\" aria-describedby=\"caption-attachment-4662\" style=\"width: 563px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4662\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder_organ-1-1.png\" alt=\"15.6.5 Gallbladder\" width=\"563\" height=\"563\"><figcaption id=\"caption-attachment-4662\" class=\"wp-caption-text\"><em>Figure 15.6.5 The gallbladder is connected to the common duct by the cystic duct. It stores bile secreted by the liver.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Pancreas<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a><\/strong> is a glandular organ that is part of both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3877\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3893\">endocrine system<\/a>. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.<\/p>\n<figure id=\"attachment_4665\" aria-describedby=\"caption-attachment-4665\" style=\"width: 519px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4665\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0698_PancreasAnatomy-1.png\" alt=\"15.6.6\" width=\"519\" height=\"519\"><figcaption id=\"caption-attachment-4665\" class=\"wp-caption-text\"><em>Figure 15.6.6 Pancreatic digestive enzymes and bicarbonate travel to the duodenum through the pancreatic ducts. The main pancreatic duct joins with the common bile duct before the latter enters the duodenum.<\/em><\/figcaption><\/figure>\n<p>As an endocrine gland, the pancreas secretes several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3569\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3951\">glucagon<\/a>, which circulate in the blood. The\u00a0endocrine hormones\u00a0are secreted by clusters of\u00a0cells\u00a0called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive\u00a0enzymes\u00a0and also bicarbonate, which helps neutralize acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a>. The pancreas is stimulated to secrete its digestive substances when food in the stomach and duodenum triggers the release of endocrine hormones into the blood that reach the pancreas via the bloodstream. The pancreatic digestive enzymes are secreted by clusters of cells called acini, and they travel through the pancreatic ducts to the duodenum. In the duodenum, they help to chemically break down\u00a0carbohydrates,\u00a0proteins,\u00a0lipids, and\u00a0nucleic acids\u00a0in chyme. The pancreatic digestive enzymes include:<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4578\">Amylase<\/a><\/strong>, which helps digest starch and other carbohydrates.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4602\">Lipase<\/a><\/strong>, which helps digest lipids.<\/li>\n<li><strong>Deoxyribonucleases<\/strong>\u00a0and\u00a0<strong>ribonucleases<\/strong>, which help digest nucleic acids.<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Accessory organs of digestion are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. The accessory organs include the liver, gallbladder, and pancreas. These organs secrete or store substances that are carried to the duodenum of the\u00a0small intestine\u00a0as needed for digestion.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a> is a large organ in the abdomen that is divided into lobes and smaller lobules, which consist of metabolic\u00a0cells\u00a0called hepatic cells, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4413\">aorta<\/a> through the hepatic artery. It receives\u00a0nutrients\u00a0in blood from the GI tract and wastes in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4497\">spleen<\/a> through the portal vein.<\/li>\n<li>The main digestive function of the liver is the production of the alkaline\u00a0liquid\u00a0called bile. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">Bile<\/a> is carried directly to the duodenum by the common bile duct or to the gallbladder first for storage. Bile neutralizes acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> that enters the duodenum from the stomach, and also emulsifies fat globules into smaller particles (micelles) that are easier to digest chemically.<\/li>\n<li>Other vital functions of the liver include regulating blood sugar levels by storing excess sugar as glycogen, storing many\u00a0vitamins and minerals, synthesizing numerous proteins and lipids, and breaking down waste products and toxic substances.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> is a small pouch-like organ near the liver. It stores and concentrates bile from the liver until it is needed in the duodenum to neutralize chyme and help digest lipids.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a> is a glandular organ that secretes both\u00a0endocrine hormones\u00a0and digestive\u00a0enzymes. As an endocrine gland, the pancreas secretes insulin and glucagon to regulate blood sugar. As a digestive organ, the pancreas secretes digestive enzymes into the duodenum through ducts. Pancreatic digestive enzymes include amylase (starches) trypsin and chymotrypsin (proteins), lipase (lipids), and ribonucleases and deoxyribonucleases (RNA\u00a0and DNA).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Name three accessory organs of digestion. How do these organs differ from digestive organs that are part of the GI tract?<\/li>\n<li>\n<div id=\"h5p-407\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-407\" class=\"h5p-iframe\" data-content-id=\"407\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Describe the liver and its blood supply.<\/li>\n<li>Explain the main digestive function of the liver and describe the components of bile and it's importance in the digestive process.<\/li>\n<li>What type of secretions does the pancreas release as part of each body system?<\/li>\n<li>List pancreatic enzymes that work in the duodenum, along with the substances they help digest.<\/li>\n<li>What are two substances produced by accessory organs of digestion that help neutralize chyme in the small intestine? Where are they produced?<\/li>\n<li>People who have their gallbladder removed sometimes have digestive problems after eating high-fat meals. Why do you think this happens?<\/li>\n<li>Which accessory organ of digestion synthesizes cholesterol?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/8dgoeYPoE-0<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed. 2015.<\/p>\n<p>https:\/\/youtu.be\/wbh3SjzydnQ<\/p>\n<p style=\"text-align: center\">What does the liver do? - Emma Bryce, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/a0d1yvGcfzQ<\/p>\n<p style=\"text-align: center\">Scar wars: Repairing the liver, nature video, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scleral_Icterus.jpg\" rel=\"cc:attributionURL\">Scleral_Icterus<\/a> by <a class=\"new\" title=\"User:Sedooka (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sedooka&amp;action=edit&amp;redlink=1\">Sheila J. Toro<\/a> on Wikimedia Commons is used under a \u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0428_Gallbladder-Liver-Pancreas_Location.png\" rel=\"cc:attributionURL\">Blausen_0428_Gallbladder-Liver-Pancreas_Location<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> \u00a0(https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 15.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/D3rQHN\" rel=\"cc:attributionURL\">Gallbladder<\/a> by <a class=\"owner-name truncate\" title=\"Go to NIH Image Gallery's photostream\" href=\"https:\/\/www.flickr.com\/photos\/nihgov\/\" data-track=\"attributionNameClick\">NIH Image Gallery<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 15.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gallbladder_(organ).png\" rel=\"cc:attributionURL\">Gallbladder_(organ) (1)<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license. (See a\u00a0<a class=\"external text\" href=\"http:\/\/blausen.com\/?Topic=1252\" rel=\"nofollow\">full animation<\/a> of this medical topic at blausen.com.)<\/p>\n<p><strong>Figure 15.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0698_PancreasAnatomy.png\" rel=\"cc:attributionURL\">Blausen_0698_PancreasAnatomy<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https:\/\/www.youtube.com\/watch?v=a0d1yvGcfzQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=wbh3SjzydnQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;feature=youtu.be<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3096\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3096\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4656\" aria-describedby=\"caption-attachment-4656\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4656\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Scleral_Icterus-1.jpg\" alt=\"15.6.1 Jaundiced eye\" width=\"400\" height=\"223\"><figcaption id=\"caption-attachment-4656\" class=\"wp-caption-text\"><em>Figure 15.6.1 \"Look deep into my eyes.\"<\/em><\/figcaption><\/figure>\n<div>\n<h1>Jaundiced Eyes<\/h1>\n<\/div>\n<p>Did you ever hear of a person looking at something or someone with a \u201cjaundiced eye\u201d? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.<\/p>\n<div>\n<h1>What Are\u00a0Accessory Organs of Digestion?<\/h1>\n<\/div>\n<figure id=\"attachment_4657\" aria-describedby=\"caption-attachment-4657\" style=\"width: 438px\" class=\"wp-caption alignright\"><img class=\" wp-image-4657\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-1-1.png\" alt=\"15.6.2 Accessory Organs of the Digestive System\" width=\"438\" height=\"876\"><figcaption id=\"caption-attachment-4657\" class=\"wp-caption-text\"><em>Figure 15.6.2 The liver, gallbladder, and pancreas are the major accessory organs of digestion. In this figure, the pink tubular structure that starts at the lower stomach and wraps around the pancreas is the duodenum of the small intestine. This is where the accessory organs secrete their digestive substances.<\/em><\/figcaption><\/figure>\n<p>Accessory organs of digestion\u00a0are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a>. These organs secrete or store substances that are needed for digestion in the first part of the\u00a0small intestine\u00a0\u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a> \u2014 where most chemical digestion takes place. You can see the three organs and their locations in Figure 15.6.2.<\/p>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Liver<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a><\/strong>\u00a0is a vital organ located in the upper right part of the abdomen. It lies just below the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4558\">stomach<\/a>. The liver plays an important role in digestion by secreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">bile<\/a>, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.<\/p>\n<h2>Structure of the Liver<\/h2>\n<p>The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.<\/p>\n<p>As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.<\/p>\n<figure id=\"attachment_4658\" aria-describedby=\"caption-attachment-4658\" style=\"width: 495px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4658\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg_-1.png\" alt=\"15.6.3 Hepatic and Portal vessels\" width=\"495\" height=\"502\"><figcaption id=\"caption-attachment-4658\" class=\"wp-caption-text\"><em>Figure 15.6.3 The portal vein supplies the liver with wastes filtered out of the blood in the spleen, as well as nutrients from the gastrointestinal tract. Oxygen-rich blood enters the liver via the hepatic artery.<\/em><\/figcaption><\/figure>\n<h2>Functions of the Liver<\/h2>\n<p>The main digestive function of the liver is the production of bile.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">Bile<\/a><\/strong>\u00a0is a yellowish alkaline\u00a0liquid\u00a0that consists of\u00a0water, electrolytes, bile salts, and cholesterol, among other substances, many of which are waste products. Some of the components of bile are synthesized by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4659\">hepatocyte<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. The rest are extracted from the\u00a0blood.<\/span><\/p>\n<p>As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.<\/p>\n<figure id=\"attachment_4660\" aria-describedby=\"caption-attachment-4660\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4660\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder-by-NIH-Image-Gallery-on-Flickr-CC-BY-NC-24312875104_e6ab50150b_h-1.jpg\" alt=\"15.6.4\" width=\"789\" height=\"526\"><figcaption id=\"caption-attachment-4660\" class=\"wp-caption-text\"><em>Figure 15.6.4 The common bile duct carries bile from the liver and gallbladder to the duodenum.<\/em><\/figcaption><\/figure>\n<p>Besides its roles in digestion, the liver has many other vital functions:<\/p>\n<ul>\n<li>The liver synthesizes glycogen from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_317\">glucose<\/a> and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.<\/li>\n<li>The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the\u00a0minerals\u00a0iron and copper.<\/li>\n<li>The liver synthesizes numerous <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_297\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_305\">amino acids<\/a>\u00a0needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.<\/li>\n<li>The liver synthesizes many important\u00a0lipids, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4661\">cholesterol<\/a>,\u00a0triglycerides, and lipoproteins.<\/li>\n<li>The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the\u00a0kidneys, which excrete them in urine.<\/li>\n<\/ul>\n<p>The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic\u00a0location\u00a0and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.<\/p>\n<div>\n<h1>Gallbladder<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a><\/strong> is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.<\/p>\n<figure id=\"attachment_4662\" aria-describedby=\"caption-attachment-4662\" style=\"width: 563px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4662\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder_organ-1-1.png\" alt=\"15.6.5 Gallbladder\" width=\"563\" height=\"563\"><figcaption id=\"caption-attachment-4662\" class=\"wp-caption-text\"><em>Figure 15.6.5 The gallbladder is connected to the common duct by the cystic duct. It stores bile secreted by the liver.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Pancreas<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a><\/strong> is a glandular organ that is part of both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2913\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2909\">endocrine system<\/a>. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.<\/p>\n<figure id=\"attachment_4665\" aria-describedby=\"caption-attachment-4665\" style=\"width: 519px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4665\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0698_PancreasAnatomy-1.png\" alt=\"15.6.6\" width=\"519\" height=\"519\"><figcaption id=\"caption-attachment-4665\" class=\"wp-caption-text\"><em>Figure 15.6.6 Pancreatic digestive enzymes and bicarbonate travel to the duodenum through the pancreatic ducts. The main pancreatic duct joins with the common bile duct before the latter enters the duodenum.<\/em><\/figcaption><\/figure>\n<p>As an endocrine gland, the pancreas secretes several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_377\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3405\">glucagon<\/a>, which circulate in the blood. The\u00a0endocrine hormones\u00a0are secreted by clusters of\u00a0cells\u00a0called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive\u00a0enzymes\u00a0and also bicarbonate, which helps neutralize acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4576\">duodenum<\/a>. The pancreas is stimulated to secrete its digestive substances when food in the stomach and duodenum triggers the release of endocrine hormones into the blood that reach the pancreas via the bloodstream. The pancreatic digestive enzymes are secreted by clusters of cells called acini, and they travel through the pancreatic ducts to the duodenum. In the duodenum, they help to chemically break down\u00a0carbohydrates,\u00a0proteins,\u00a0lipids, and\u00a0nucleic acids\u00a0in chyme. The pancreatic digestive enzymes include:<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4578\">Amylase<\/a><\/strong>, which helps digest starch and other carbohydrates.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4602\">Lipase<\/a><\/strong>, which helps digest lipids.<\/li>\n<li><strong>Deoxyribonucleases<\/strong>\u00a0and\u00a0<strong>ribonucleases<\/strong>, which help digest nucleic acids.<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Accessory organs of digestion are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. The accessory organs include the liver, gallbladder, and pancreas. These organs secrete or store substances that are carried to the duodenum of the\u00a0small intestine\u00a0as needed for digestion.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_2989\">liver<\/a> is a large organ in the abdomen that is divided into lobes and smaller lobules, which consist of metabolic\u00a0cells\u00a0called hepatic cells, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4413\">aorta<\/a> through the hepatic artery. It receives\u00a0nutrients\u00a0in blood from the GI tract and wastes in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4497\">spleen<\/a> through the portal vein.<\/li>\n<li>The main digestive function of the liver is the production of the alkaline\u00a0liquid\u00a0called bile. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4599\">Bile<\/a> is carried directly to the duodenum by the common bile duct or to the gallbladder first for storage. Bile neutralizes acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4582\">chyme<\/a> that enters the duodenum from the stomach, and also emulsifies fat globules into smaller particles (micelles) that are easier to digest chemically.<\/li>\n<li>Other vital functions of the liver include regulating blood sugar levels by storing excess sugar as glycogen, storing many\u00a0vitamins and minerals, synthesizing numerous proteins and lipids, and breaking down waste products and toxic substances.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_4586\">gallbladder<\/a> is a small pouch-like organ near the liver. It stores and concentrates bile from the liver until it is needed in the duodenum to neutralize chyme and help digest lipids.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4774_3197\">pancreas<\/a> is a glandular organ that secretes both\u00a0endocrine hormones\u00a0and digestive\u00a0enzymes. As an endocrine gland, the pancreas secretes insulin and glucagon to regulate blood sugar. As a digestive organ, the pancreas secretes digestive enzymes into the duodenum through ducts. Pancreatic digestive enzymes include amylase (starches) trypsin and chymotrypsin (proteins), lipase (lipids), and ribonucleases and deoxyribonucleases (RNA\u00a0and DNA).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Name three accessory organs of digestion. How do these organs differ from digestive organs that are part of the GI tract?<\/li>\n<li>\n<div id=\"h5p-187\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-187\" class=\"h5p-iframe\" data-content-id=\"187\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Describe the liver and its blood supply.<\/li>\n<li>Explain the main digestive function of the liver and describe the components of bile and it's importance in the digestive process.<\/li>\n<li>What type of secretions does the pancreas release as part of each body system?<\/li>\n<li>List pancreatic enzymes that work in the duodenum, along with the substances they help digest.<\/li>\n<li>What are two substances produced by accessory organs of digestion that help neutralize chyme in the small intestine? Where are they produced?<\/li>\n<li>People who have their gallbladder removed sometimes have digestive problems after eating high-fat meals. Why do you think this happens?<\/li>\n<li>Which accessory organ of digestion synthesizes cholesterol?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/8dgoeYPoE-0<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed. 2015.<\/p>\n<p>https:\/\/youtu.be\/wbh3SjzydnQ<\/p>\n<p style=\"text-align: center\">What does the liver do? - Emma Bryce, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/a0d1yvGcfzQ<\/p>\n<p style=\"text-align: center\">Scar wars: Repairing the liver, nature video, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scleral_Icterus.jpg\" rel=\"cc:attributionURL\">Scleral_Icterus<\/a> by <a class=\"new\" title=\"User:Sedooka (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sedooka&amp;action=edit&amp;redlink=1\">Sheila J. Toro<\/a> on Wikimedia Commons is used under a \u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0428_Gallbladder-Liver-Pancreas_Location.png\" rel=\"cc:attributionURL\">Blausen_0428_Gallbladder-Liver-Pancreas_Location<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> \u00a0(https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 15.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/D3rQHN\" rel=\"cc:attributionURL\">Gallbladder<\/a> by <a class=\"owner-name truncate\" title=\"Go to NIH Image Gallery's photostream\" href=\"https:\/\/www.flickr.com\/photos\/nihgov\/\" data-track=\"attributionNameClick\">NIH Image Gallery<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 15.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gallbladder_(organ).png\" rel=\"cc:attributionURL\">Gallbladder_(organ) (1)<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license. (See a\u00a0<a class=\"external text\" href=\"http:\/\/blausen.com\/?Topic=1252\" rel=\"nofollow\">full animation<\/a> of this medical topic at blausen.com.)<\/p>\n<p><strong>Figure 15.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0698_PancreasAnatomy.png\" rel=\"cc:attributionURL\">Blausen_0698_PancreasAnatomy<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https:\/\/www.youtube.com\/watch?v=a0d1yvGcfzQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=wbh3SjzydnQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;feature=youtu.be<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3102\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3102\"><div tabindex=\"-1\"><p>Images show a pictomicrograph as per the caption.  All the viruses are round, with spiky-looking surfaces.  <\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4774_3103\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4774_3103\"><div tabindex=\"-1\"><p>Image shows a pictomicrograph of a protozoan parasite of the Giardia lamblia species.  It is roughly cone-shaped, with several flagella trailing from the narrow end of it.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":32,"menu_order":5,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[48],"contributor":[],"license":[55],"class_list":["post-4774","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by-nc"],"part":4740,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4774","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/users\/32"}],"version-history":[{"count":4,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4774\/revisions"}],"predecessor-version":[{"id":6438,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4774\/revisions\/6438"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/parts\/4740"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4774\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/media?parent=4774"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapter-type?post=4774"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/contributor?post=4774"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/license?post=4774"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}