{"id":4782,"date":"2019-06-24T14:51:04","date_gmt":"2019-06-24T14:51:04","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-6-peripheral-nervous-system-3\/"},"modified":"2023-11-30T18:51:02","modified_gmt":"2023-11-30T18:51:02","slug":"10-6-peripheral-nervous-system-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-6-peripheral-nervous-system-3\/","title":{"raw":"8.6\u00a0Peripheral Nervous System","rendered":"8.6\u00a0Peripheral Nervous System"},"content":{"raw":"&nbsp;\r\n\r\n[caption id=\"attachment_3106\" align=\"aligncenter\" width=\"400\"]<img class=\"wp-image-3106\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Kids-piant-duet-by-PJMixer-on-Unsplash-2.jpg\" alt=\"\" width=\"400\" height=\"268\" \/> <em>Figure 8.6.1 A duet with the peripheral nervous system.\u00a0<\/em>[\/caption]\r\n<h1>One Piano, Four Hands<\/h1>\r\nDid you ever see two people play the same piano? How do they coordinate all the movements of their own fingers \u2014 let alone synchronize them with those of their partner? The peripheral nervous system plays an important part in this challenge.\r\n<div>\r\n<h1>What Is the Peripheral Nervous System?<\/h1>\r\n<\/div>\r\nThe\u00a0<strong>[pb_glossary id=\"3009\"]peripheral nervous system[\/pb_glossary] (PNS)<\/strong>\u00a0consists of all the nervous tissue that lies outside of the\u00a0[pb_glossary id=\"5933\"]central nervous system[\/pb_glossary]\u00a0(CNS). The main function of the PNS is to connect the CNS to the rest of the organism. It serves as a\u00a0communication\u00a0relay, going back and forth between the CNS and\u00a0muscles, organs, and glands throughout the body.\r\n\r\n[caption id=\"attachment_3107\" align=\"aligncenter\" width=\"421\"]<img class=\"size-full wp-image-3107\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nervous_system_diagram-2.png\" alt=\"Peripheral Nervous System\" width=\"421\" height=\"695\" \/> <em>Figure 8.6.2 The nerves of the peripheral nervous system are shown in blue in this diagram.<\/em>[\/caption]\r\n\r\n<div><\/div>\r\n<div>\r\n<h1>Tissues of the Peripheral Nervous System<\/h1>\r\n<\/div>\r\nThe PNS is mostly made up of cable-like bundles of axons called\u00a0<strong>[pb_glossary id=\"3011\"]nerves[\/pb_glossary]<\/strong>,\u00a0as well as\u00a0clusters of neuronal cell bodies called\u00a0<strong>[pb_glossary id=\"6027\"]ganglia[\/pb_glossary]<\/strong>\u00a0(singular,\u00a0<strong>[pb_glossary id=\"6029\"]ganglion[\/pb_glossary]<\/strong>). Nerves are generally classified\u00a0as sensory, motor, or mixed nerves\u00a0based on\u00a0the direction in which they carry\u00a0nerve impulses.\r\n<ul>\r\n \t<li><strong>[pb_glossary id=\"3110\"]Sensory nerves[\/pb_glossary]<\/strong>\u00a0transmit information from sensory receptors in the body to the CNS. Sensory nerves are also called afferent nerves. You can see an example in the figure\u00a0below.<\/li>\r\n \t<li><strong>[pb_glossary id=\"3111\"]Motor nerves[\/pb_glossary]<\/strong>\u00a0transmit information from the CNS to\u00a0muscles, organs, and glands. Motor nerves are also called efferent nerves. You can see one in the figure\u00a0below.<\/li>\r\n \t<li><strong>[pb_glossary id=\"3112\"]Mixed nerves[\/pb_glossary]<\/strong>\u00a0contain both sensory and motor neurons, so they can transmit information in both directions. They have both afferent and efferent functions.<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<div>\r\n\r\n[caption id=\"attachment_3113\" align=\"aligncenter\" width=\"868\"]<img class=\" wp-image-3113\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Afferent_and_efferent_neurons_en.svg_-2.png\" alt=\"Afferent and Efferent Neurons\" width=\"868\" height=\"533\" \/> <em>Figure 8.6.3 In this diagram, each nerve is depicted as a single neuron for simplicity. This afferent neuron sends nerve impulses from sensory receptors in the skin to the CNS. The efferent neuron is a motor neuron that sends nerve impulses from the CNS to a muscle. The cell body of the afferent neuron is located in a ganglion (not pictured), while the cell body of the motor neuron is located in the spinal cord.<\/em>[\/caption]\r\n\r\n<\/div>\r\n<div>\r\n<h1>Divisions of the Peripheral Nervous System<\/h1>\r\n<\/div>\r\nThe PNS is divided into two major systems, called the [pb_glossary id=\"5899\"]autonomic nervous system[\/pb_glossary] and the [pb_glossary id=\"3014\"]somatic nervous system[\/pb_glossary]. In the diagram\u00a0below, the autonomic system is shown on the left, and the somatic system on the right. Both systems of the PNS interact with the CNS and include sensory and motor neurons, but they use different\u00a0circuits\u00a0of nerves and ganglia.\r\n\r\n[caption id=\"attachment_3114\" align=\"aligncenter\" width=\"1075\"]<img class=\" wp-image-3114\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Autonomic-and-Somatic-Nervous-System-2.png\" alt=\"Autonomic and Somatic Nervous System\" width=\"1075\" height=\"510\" \/> <em>Figure 8.6.4 The two major divisions of the PNS are the autonomic and sensory nervous systems.<\/em>[\/caption]\r\n<h2>Somatic Nervous System<\/h2>\r\nThe\u00a0<strong>[pb_glossary id=\"3014\"]somatic nervous system[\/pb_glossary]<\/strong>\u00a0primarily\u00a0senses\u00a0the external environment and controls voluntary activities about which decisions and commands come from the cerebral cortex of the brain. When you feel too warm, for example, you decide to turn on the air conditioner. As you walk across the room to the thermostat, you are using your somatic nervous system. In general, the somatic nervous system is responsible for all of your\u00a0<em>conscious<\/em>\u00a0perceptions of the outside world, as well as all of the voluntary motor activities you perform in response. Whether it\u2019s playing a piano, driving a car, or playing basketball, you can thank your somatic nervous system for making it possible.\r\n\r\nSomatic sensory and motor information is transmitted through\u00a012 pairs of cranial nerves and 31 pairs of spinal nerves. Cranial nerves are in the head and neck and connect directly to the brain. Sensory components of cranial nerves\u00a0transmit information about\u00a0smells, tastes, light, sounds, and body position. Motor components of cranial nerves control\u00a0skeletal muscles\u00a0of the face, tongue, eyeballs, throat, head, and shoulders. Motor components of cranial nerves also control the salivary glands and swallowing. Four of the 12 cranial nerves participate in both sensory and motor functions as mixed nerves, having both sensory and motor neurons.\r\n\r\nSpinal nerves emanate from the spinal column between vertebrae. All of the spinal nerves are mixed nerves, containing both sensory and motor neurons. The areas of skin innervated by the 31 pairs of spinal nerves are shown in the figure\u00a0below. These include sensory nerves in the skin that sense pressure,\u00a0temperature, vibrations, and pain. Other sensory nerves are in the\u00a0muscles, and they sense stretching and tension. Spinal nerves also include motor nerves that stimulate\u00a0skeletal muscles\u00a0to contract, allowing for voluntary body movements.\r\n\r\n[caption id=\"attachment_3115\" align=\"aligncenter\" width=\"550\"]<img class=\" wp-image-3115\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Dermatoms.svg_-2.png\" alt=\"Nerves\" width=\"550\" height=\"778\" \/> <em>Figure 8.6.5 This drawing shows the areas of the skin innervated by sensory spinal nerves of the somatic nervous system. The left half of the figure shows the nerves in the front of the body, and the right half shows the nerves in the back of the body. The area that each spinal nerve innervates is shown in a different colour.<\/em>[\/caption]\r\n<h2>Autonomic Nervous System<\/h2>\r\nThe\u00a0<strong>[pb_glossary id=\"5899\"]autonomic nervous system[\/pb_glossary]<\/strong>\u00a0primarily\u00a0senses\u00a0the internal environment and controls involuntary activities. It is responsible for monitoring conditions in the internal environment and bringing about appropriate changes in them. In general, the\u00a0autonomic\u00a0nervous system is responsible for all the activities that go on inside your body\u00a0<em>without<\/em>\u00a0your conscious awareness or voluntary participation.\r\n\r\nStructurally, the autonomic nervous system consists of sensory and motor nerves that run between the CNS (especially the hypothalamus in the brain), internal organs (such as the\u00a0heart, lungs, and digestive organs), and glands (such as the\u00a0pancreas\u00a0and sweat glands). [pb_glossary id=\"3030\"]Sensory neurons[\/pb_glossary] in the autonomic system detect internal body conditions and send messages to the brain. Motor nerves in the autonomic system affect appropriate responses by controlling contractions of smooth or cardiac muscle, or glandular tissue. For example, when sensory nerves of the autonomic system detect a rise in body\u00a0temperature, motor nerves signal smooth muscles in\u00a0blood vessels\u00a0near the body surface to undergo vasodilation, and the sweat glands in the skin to secrete more sweat to cool the body.\r\n\r\nThe autonomic nervous system, in turn, has three subdivisions: the [pb_glossary id=\"3015\"]sympathetic division[\/pb_glossary], [pb_glossary id=\"3016\"]parasympathetic division[\/pb_glossary], and [pb_glossary id=\"5987\"]enteric division[\/pb_glossary]. The first two subdivisions of the autonomic system are summarized in the figure\u00a0below. Both affect the same organs and glands, but they generally do so in opposite ways.\r\n<ul>\r\n \t<li>The\u00a0<strong>sympathetic division<\/strong>\u00a0controls the fight-or-flight response. Changes occur in organs and glands throughout the body that prepare the body to fight or flee in response to a perceived danger. For example, the\u00a0heart\u00a0rate speeds up, air passages in the lungs become wider, more\u00a0blood\u00a0flows to the\u00a0skeletal muscles, and the\u00a0digestive system temporarily shuts down.<\/li>\r\n \t<li>The\u00a0<strong>parasympathetic division<\/strong>\u00a0returns the body to normal after the fight-or-flight response has occurred. For example, it slows down the\u00a0heart\u00a0rate, narrows air passages in the lungs, reduces\u00a0blood\u00a0flow to the skeletal muscles, and stimulates the\u00a0digestive system\u00a0to start working again. The parasympathetic division also maintains internal\u00a0homeostasis\u00a0of the body at other times.<\/li>\r\n \t<li>The\u00a0<strong>enteric division<\/strong> is made up of nerve fibres that supply the organs of the digestive system. This division allows for the local control of many digestive functions.<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_3116\" align=\"aligncenter\" width=\"597\"]<img class=\" wp-image-3116\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/The_Autonomic_Nervous_System-2.jpg\" alt=\"The autonomic nervous system\" width=\"597\" height=\"598\" \/> <em>Figure 8.6.6 This diagram summarizes the structures and functions controlled by the parasympathetic and sympathetic divisions of the autonomic nervous system.<\/em>[\/caption]\r\n\r\n<span style=\"font-size: 1.602em; font-weight: bold;\">Disorders of the Peripheral Nervous System<\/span>\r\n\r\nUnlike the CNS \u2014 which is protected by\u00a0[pb_glossary id=\"5913\"]bone[\/pb_glossary]s, [pb_glossary id=\"2929\"]meninges[\/pb_glossary], and [pb_glossary id=\"5939\"]cerebrospinal fluid[\/pb_glossary] \u2014 the PNS has no such protections. The PNS also has no blood-brain barrier to protect it from toxins and pathogens in the\u00a0blood. Therefore, the PNS is more subject to injury and disease than is the CNS. Causes of nerve injury include\u00a0<a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/diabetes\/symptoms-causes\/syc-20371444\">diabetes<\/a>,\u00a0infectious diseases\u00a0(such as <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/shingles\/symptoms-causes\/syc-20353054\">shingles<\/a>), and poisoning by toxins (such as heavy metals). PNS disorders often have symptoms\u00a0like\u00a0loss of feeling, tingling, burning sensations, or muscle weakness. If a traumatic injury results in a nerve being transected (cut all the way through), it may regenerate, but this is a very slow process and may take many months.\r\n\r\nTwo other diseases of the PNS are Guillain-Barre syndrome and Charcot-Marie-Tooth disease.\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/guillain-barre-syndrome\/symptoms-causes\/syc-20362793\">Guillain-Barre syndrome<\/a> is a rare disease in which the immune system attacks nerves of the PNS, leading to muscle weakness and even paralysis. The exact cause of Guillain-Barre syndrome is unknown, but it often occurs after a viral or bacterial infection. There is no known cure for the syndrome, but most people eventually make a full recovery. Recovery can be slow, however, lasting anywhere from several weeks to several years.<\/li>\r\n \t<li><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/charcot-marie-tooth-disease\/symptoms-causes\/syc-20350517\">Charcot-Marie-Tooth disease<\/a> is a hereditary disorder of the nerves, and one of the most common inherited neurological disorders. It affects predominantly the nerves in the feet and legs,\u00a0and often\u00a0in the hands and arms, as well. The disease is characterized by loss of muscle tissue and sense of touch. It is presently incurable.<\/li>\r\n<\/ul>\r\n<div>\r\n<h1>Feature: My\u00a0Human Body<\/h1>\r\n<\/div>\r\nThe autonomic nervous system is considered to be involuntary because it doesn't require conscious input. However, it\u00a0<em>is<\/em>\u00a0possible to exert some voluntary control over it. People who practice yoga or other so-called mind-body techniques, for example,\u00a0can\u00a0reduce their heart rate and certain other autonomic functions. Slowing down these otherwise involuntary responses is a good way to relieve stress and reduce the wear-and-tear that stress can place on the body. Such techniques may also be useful for controlling post-traumatic stress disorder and chronic pain. Three types of integrative practices for these purposes\u00a0are\u00a0breathing exercises, body-based tension modulation exercises, and mindfulness techniques.\r\n\r\nBreathing exercises can help control the rapid, shallow breathing that often occurs when you are anxious or under stress. These exercises can be learned quickly, and they provide immediate feelings of relief. Specific breathing exercises include paced breath, diaphragmatic breathing, and Breathe2Relax or Chill Zone on MindShift\u2122 CBT, which are downloadable breathing practice mobile applications, or \"Apps\". Try syncing your breathing with Eric Klassen's \"Triangle breathing, 1 minute\" video:\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=u9Q8D6n-3qw\r\n<p style=\"text-align: center;\">Triangle breathing, 1 minute, Erin Klassen, 2015.<\/p>\r\nBody-based tension modulation exercises include yoga postures (also known as \u201casanas\u201d) and tension manipulation exercises. The latter include the Trauma\/Tension Release\u00a0Exercise\u00a0(TRE) and the Trauma Resiliency Model (TRM). Watch this video for a brief \u2014 but informative \u2014 introduction to the TRE program:\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=67R974D8swM&amp;feature=youtu.be\r\n<p style=\"text-align: center;\">TRE\u00ae : Tension and Trauma Releasing Exercises, an Introduction with Jessica Schaffer, Jessica Schaffer Nervous System RESET, 2015.<\/p>\r\nMindfulness techniques have been shown to reduce symptoms of depression, as well as those of anxiety and stress. They have also been shown to be useful for pain management and performance enhancement. Specific mindfulness programs include Mindfulness Based Stress Reduction (MBSR) and Mindfulness Mind-Fitness Training (MMFT). You can learn more about MBSR by watching the video below.\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=0TA7P-iCCcY&amp;feature=youtu.be\r\n<p style=\"text-align: center;\">Mindfulness-Based Stress Reduction (UMass Medical School, Center for Mindfulness), Palouse Mindfulness, 2017.<\/p>\r\n\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.6 Summary<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ul>\r\n \t<li>The [pb_glossary id=\"3009\"]peripheral nervous system[\/pb_glossary] (PNS) consists of all the nervous tissue that lies outside the\u00a0[pb_glossary id=\"5933\"]central nervous system[\/pb_glossary] (CNS). Its main function is to connect the CNS to the rest of the organism.<\/li>\r\n \t<li>The PNS is made up of [pb_glossary id=\"3011\"]nerves[\/pb_glossary] and [pb_glossary id=\"6027\"]ganglia[\/pb_glossary]. Nerves are bundles of [pb_glossary id=\"5901\"]axons[\/pb_glossary], and ganglia are groups of [pb_glossary id=\"5931\"]cell bodies[\/pb_glossary]. Nerves are classified as sensory, motor, or a mix of the two.<\/li>\r\n \t<li>The PNS is divided into the [pb_glossary id=\"3014\"]somatic[\/pb_glossary] and [pb_glossary id=\"5899\"]autonomic nervous systems[\/pb_glossary]. The somatic system controls [pb_glossary id=\"3004\"]voluntary[\/pb_glossary] activities, whereas the autonomic system controls [pb_glossary id=\"3005\"]involuntary[\/pb_glossary] activities.<\/li>\r\n \t<li>The autonomic nervous system is further divided into [pb_glossary id=\"3015\"]sympathetic[\/pb_glossary], [pb_glossary id=\"3016\"]parasympathetic[\/pb_glossary], and [pb_glossary id=\"5987\"]enteric divisions[\/pb_glossary]. The sympathetic division controls [pb_glossary id=\"6013\"]fight-or-flight responses[\/pb_glossary]\u00a0during emergencies, the parasympathetic system controls routine body functions the rest of the time, and the enteric division provides local control over the [pb_glossary id=\"5969\"]digestive system[\/pb_glossary].<\/li>\r\n \t<li>The PNS is not as well protected physically or chemically as the CNS, so it is more prone to injury and disease. PNS problems include injury from\u00a0diabetes, shingles, and heavy metal poisoning. Two disorders of the PNS are Guillain-Barre syndrome and Charcot-Marie-Tooth disease.<\/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;\">8.6 Review Questions<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>Describe the general structure of the peripheral nervous system. State its primary function.<\/li>\r\n \t<li>What are ganglia?<\/li>\r\n \t<li>Identify three types of nerves based on the direction in which they carry\u00a0nerve impulses.<\/li>\r\n \t<li>Outline all of the divisions of the peripheral nervous system.<\/li>\r\n \t<li>Compare and contrast the somatic and autonomic nervous systems.<\/li>\r\n \t<li>When and how does the sympathetic division of the autonomic nervous system affect the body?<\/li>\r\n \t<li>What is the function of the parasympathetic division of the autonomic nervous system?\u00a0Specifically, how does it affect the body?<\/li>\r\n \t<li>Name and describe two peripheral nervous system disorders.<\/li>\r\n \t<li>Give one example of how the CNS interacts with the PNS to control a function in the body.<\/li>\r\n \t<li>For each of the following types of information, identify whether the neuron carrying it is sensory or motor, and whether it is most likely in the somatic or autonomic nervous system:\r\n<ol type=\"a\">\r\n \t<li>Visual information<\/li>\r\n \t<li>Blood pressure information<\/li>\r\n \t<li>Information that causes muscle contraction in digestive organs after eating<\/li>\r\n \t<li>Information that causes muscle contraction in skeletal muscles based on the person\u2019s decision to make a movement<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>[h5p id=\"564\"]<\/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\" style=\"text-align: left;\"><span style=\"color: #ffffff;\">8.6 Explore More<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=ySIDMU2cy0Y&amp;feature=emb_logo\r\n<p style=\"text-align: center;\">Phantom Limbs Explained, Plethrons, 2015.<\/p>\r\nhttps:\/\/www.youtube.com\/watch?time_continue=1&amp;v=73yo5nJne6c&amp;feature=emb_logo\r\n<p style=\"text-align: center;\">Why Do Hot Peppers Cause Pain? Reactions, 2015.<\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<h2>Attributions<\/h2>\r\n<strong>Figure 8.6.1<\/strong>\r\n\r\n<a href=\"https:\/\/www.flickr.com\/photos\/pjmixer\/4460758776\" rel=\"cc:attributionURL\">Kid\u2019s piant duet<\/a> by\u00a0<a href=\"https:\/\/www.flickr.com\/photos\/pjmixer\/\" rel=\"dc:creator\">PJMixer<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/\" rel=\"license\">CC BY-NC-ND 2.0<\/a>\u00a0(https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/) license.\r\n\r\n<strong>Figure 8.6.2<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Nervous_system_diagram.png\" rel=\"cc:attributionURL\">Nervous_system_diagram<\/a> by <a class=\"extiw\" title=\"en:User:Persian Poet Gal\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Persian_Poet_Gal\"><span style=\"font-family: comic sans ms;\"><span style=\"color: purple;\">\u00a4~Persian Poet Gal<\/span><\/span><\/a>\u00a0 on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/en:public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).\r\n\r\n<strong style=\"text-align: initial; font-size: 1em;\">\r\nFigure 8.6.3<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Afferent_and_efferent_neurons_en.svg\" rel=\"cc:attributionURL\">Afferent_and_efferent_neurons_en.svg<\/a> by <a title=\"User:Helixitta\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Helixitta\">Helixitta<\/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.\r\n\r\n<strong>Figure 8.6.4<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Autonomic_and_Somatic_Nervous_System.png\" rel=\"cc:attributionURL\">Autonomic and Somatic Nervous System<\/a> by <a title=\"User:Christinelmiller\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Christinelmiller\">Christinelmiller<\/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 8.6.5<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Dermatoms.svg\" rel=\"cc:attributionURL\">Dermatoms.svg<\/a> by Ralf Stephan (mailto:ralf@ark.in-berlin.de) on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/en:public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).\r\n\r\n<strong>Figure 8.6.6<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:The_Autonomic_Nervous_System.jpg\" rel=\"cc:attributionURL\">The_Autonomic_Nervous_System<\/a> by <a title=\"User:Geo-Science-International\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Geo-Science-International\">Geo-Science-International<\/a> on Wikimedia Commons is used and adapted by Christine Miller under a\u00a0<a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> Universal\r\nPublic Domain Dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/).\r\n<h2>References<\/h2>\r\n<p class=\"hanging-indent\">Erin Klassen. (2015, December 15). Triangle breathing, 1 minute. YouTube. https:\/\/www.youtube.com\/watch?v=u9Q8D6n-3qw&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">Jessica Schaffer Nervous System RESET. (2015, January 15). TRE\u00ae : Tension and trauma releasing exercises, an Introduction with Jessica Schaffer. YouTube. https:\/\/www.youtube.com\/watch?v=67R974D8swM&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Charcot-Marie-Tooth disease [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/charcot-marie-tooth-disease\/symptoms-causes\/syc-20350517<\/p>\r\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Diabetes [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/diabetes\/symptoms-causes\/syc-20371444<\/p>\r\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Guillain-Barre syndrome [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/guillain-barre-syndrome\/symptoms-causes\/syc-20362793<\/p>\r\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Shingles [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/shingles\/symptoms-causes\/syc-20353054<\/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\">Palouse Mindfulness. (2017, March 25).\u00a0 Mindfulness-based stress reduction (UMass Medical School, Center for Mindfulness), YouTube. https:\/\/www.youtube.com\/watch?v=0TA7P-iCCcY&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">Plethrons, (2015, March 23). Phantom limbs explained. YouTube. https:\/\/www.youtube.com\/watch?v=ySIDMU2cy0Y&amp;feature=youtu.be<\/p>\r\n<p class=\"hanging-indent\">Reactions. (2015, December 1). Why do hot peppers cause pain? YouTube. https:\/\/www.youtube.com\/watch?v=73yo5nJne6c&amp;feature=youtu.be<\/p>\r\n&nbsp;\r\n\r\n&nbsp;\r\n\r\n&nbsp;","rendered":"<p>&nbsp;<\/p>\n<figure id=\"attachment_3106\" aria-describedby=\"caption-attachment-3106\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3106\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Kids-piant-duet-by-PJMixer-on-Unsplash-2.jpg\" alt=\"\" width=\"400\" height=\"268\" \/><figcaption id=\"caption-attachment-3106\" class=\"wp-caption-text\"><em>Figure 8.6.1 A duet with the peripheral nervous system.\u00a0<\/em><\/figcaption><\/figure>\n<h1>One Piano, Four Hands<\/h1>\n<p>Did you ever see two people play the same piano? How do they coordinate all the movements of their own fingers \u2014 let alone synchronize them with those of their partner? The peripheral nervous system plays an important part in this challenge.<\/p>\n<div>\n<h1>What Is the Peripheral Nervous System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3009\">peripheral nervous system<\/a> (PNS)<\/strong>\u00a0consists of all the nervous tissue that lies outside of the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5933\">central nervous system<\/a>\u00a0(CNS). The main function of the PNS is to connect the CNS to the rest of the organism. It serves as a\u00a0communication\u00a0relay, going back and forth between the CNS and\u00a0muscles, organs, and glands throughout the body.<\/p>\n<figure id=\"attachment_3107\" aria-describedby=\"caption-attachment-3107\" style=\"width: 421px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-3107\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nervous_system_diagram-2.png\" alt=\"Peripheral Nervous System\" width=\"421\" height=\"695\" \/><figcaption id=\"caption-attachment-3107\" class=\"wp-caption-text\"><em>Figure 8.6.2 The nerves of the peripheral nervous system are shown in blue in this diagram.<\/em><\/figcaption><\/figure>\n<div><\/div>\n<div>\n<h1>Tissues of the Peripheral Nervous System<\/h1>\n<\/div>\n<p>The PNS is mostly made up of cable-like bundles of axons called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3011\">nerves<\/a><\/strong>,\u00a0as well as\u00a0clusters of neuronal cell bodies called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_6027\">ganglia<\/a><\/strong>\u00a0(singular,\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_6029\">ganglion<\/a><\/strong>). Nerves are generally classified\u00a0as sensory, motor, or mixed nerves\u00a0based on\u00a0the direction in which they carry\u00a0nerve impulses.<\/p>\n<ul>\n<li><strong>Sensory nerves<\/strong>\u00a0transmit information from sensory receptors in the body to the CNS. Sensory nerves are also called afferent nerves. You can see an example in the figure\u00a0below.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3111\">Motor nerves<\/a><\/strong>\u00a0transmit information from the CNS to\u00a0muscles, organs, and glands. Motor nerves are also called efferent nerves. You can see one in the figure\u00a0below.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3112\">Mixed nerves<\/a><\/strong>\u00a0contain both sensory and motor neurons, so they can transmit information in both directions. They have both afferent and efferent functions.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<div>\n<figure id=\"attachment_3113\" aria-describedby=\"caption-attachment-3113\" style=\"width: 868px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3113\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Afferent_and_efferent_neurons_en.svg_-2.png\" alt=\"Afferent and Efferent Neurons\" width=\"868\" height=\"533\" \/><figcaption id=\"caption-attachment-3113\" class=\"wp-caption-text\"><em>Figure 8.6.3 In this diagram, each nerve is depicted as a single neuron for simplicity. This afferent neuron sends nerve impulses from sensory receptors in the skin to the CNS. The efferent neuron is a motor neuron that sends nerve impulses from the CNS to a muscle. The cell body of the afferent neuron is located in a ganglion (not pictured), while the cell body of the motor neuron is located in the spinal cord.<\/em><\/figcaption><\/figure>\n<\/div>\n<div>\n<h1>Divisions of the Peripheral Nervous System<\/h1>\n<\/div>\n<p>The PNS is divided into two major systems, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5899\">autonomic nervous system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3014\">somatic nervous system<\/a>. In the diagram\u00a0below, the autonomic system is shown on the left, and the somatic system on the right. Both systems of the PNS interact with the CNS and include sensory and motor neurons, but they use different\u00a0circuits\u00a0of nerves and ganglia.<\/p>\n<figure id=\"attachment_3114\" aria-describedby=\"caption-attachment-3114\" style=\"width: 1075px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3114\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Autonomic-and-Somatic-Nervous-System-2.png\" alt=\"Autonomic and Somatic Nervous System\" width=\"1075\" height=\"510\" \/><figcaption id=\"caption-attachment-3114\" class=\"wp-caption-text\"><em>Figure 8.6.4 The two major divisions of the PNS are the autonomic and sensory nervous systems.<\/em><\/figcaption><\/figure>\n<h2>Somatic Nervous System<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3014\">somatic nervous system<\/a><\/strong>\u00a0primarily\u00a0senses\u00a0the external environment and controls voluntary activities about which decisions and commands come from the cerebral cortex of the brain. When you feel too warm, for example, you decide to turn on the air conditioner. As you walk across the room to the thermostat, you are using your somatic nervous system. In general, the somatic nervous system is responsible for all of your\u00a0<em>conscious<\/em>\u00a0perceptions of the outside world, as well as all of the voluntary motor activities you perform in response. Whether it\u2019s playing a piano, driving a car, or playing basketball, you can thank your somatic nervous system for making it possible.<\/p>\n<p>Somatic sensory and motor information is transmitted through\u00a012 pairs of cranial nerves and 31 pairs of spinal nerves. Cranial nerves are in the head and neck and connect directly to the brain. Sensory components of cranial nerves\u00a0transmit information about\u00a0smells, tastes, light, sounds, and body position. Motor components of cranial nerves control\u00a0skeletal muscles\u00a0of the face, tongue, eyeballs, throat, head, and shoulders. Motor components of cranial nerves also control the salivary glands and swallowing. Four of the 12 cranial nerves participate in both sensory and motor functions as mixed nerves, having both sensory and motor neurons.<\/p>\n<p>Spinal nerves emanate from the spinal column between vertebrae. All of the spinal nerves are mixed nerves, containing both sensory and motor neurons. The areas of skin innervated by the 31 pairs of spinal nerves are shown in the figure\u00a0below. These include sensory nerves in the skin that sense pressure,\u00a0temperature, vibrations, and pain. Other sensory nerves are in the\u00a0muscles, and they sense stretching and tension. Spinal nerves also include motor nerves that stimulate\u00a0skeletal muscles\u00a0to contract, allowing for voluntary body movements.<\/p>\n<figure id=\"attachment_3115\" aria-describedby=\"caption-attachment-3115\" style=\"width: 550px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3115\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Dermatoms.svg_-2.png\" alt=\"Nerves\" width=\"550\" height=\"778\" \/><figcaption id=\"caption-attachment-3115\" class=\"wp-caption-text\"><em>Figure 8.6.5 This drawing shows the areas of the skin innervated by sensory spinal nerves of the somatic nervous system. The left half of the figure shows the nerves in the front of the body, and the right half shows the nerves in the back of the body. The area that each spinal nerve innervates is shown in a different colour.<\/em><\/figcaption><\/figure>\n<h2>Autonomic Nervous System<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5899\">autonomic nervous system<\/a><\/strong>\u00a0primarily\u00a0senses\u00a0the internal environment and controls involuntary activities. It is responsible for monitoring conditions in the internal environment and bringing about appropriate changes in them. In general, the\u00a0autonomic\u00a0nervous system is responsible for all the activities that go on inside your body\u00a0<em>without<\/em>\u00a0your conscious awareness or voluntary participation.<\/p>\n<p>Structurally, the autonomic nervous system consists of sensory and motor nerves that run between the CNS (especially the hypothalamus in the brain), internal organs (such as the\u00a0heart, lungs, and digestive organs), and glands (such as the\u00a0pancreas\u00a0and sweat glands). <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3030\">Sensory neurons<\/a> in the autonomic system detect internal body conditions and send messages to the brain. Motor nerves in the autonomic system affect appropriate responses by controlling contractions of smooth or cardiac muscle, or glandular tissue. For example, when sensory nerves of the autonomic system detect a rise in body\u00a0temperature, motor nerves signal smooth muscles in\u00a0blood vessels\u00a0near the body surface to undergo vasodilation, and the sweat glands in the skin to secrete more sweat to cool the body.<\/p>\n<p>The autonomic nervous system, in turn, has three subdivisions: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3015\">sympathetic division<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3016\">parasympathetic division<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5987\">enteric division<\/a>. The first two subdivisions of the autonomic system are summarized in the figure\u00a0below. Both affect the same organs and glands, but they generally do so in opposite ways.<\/p>\n<ul>\n<li>The\u00a0<strong>sympathetic division<\/strong>\u00a0controls the fight-or-flight response. Changes occur in organs and glands throughout the body that prepare the body to fight or flee in response to a perceived danger. For example, the\u00a0heart\u00a0rate speeds up, air passages in the lungs become wider, more\u00a0blood\u00a0flows to the\u00a0skeletal muscles, and the\u00a0digestive system temporarily shuts down.<\/li>\n<li>The\u00a0<strong>parasympathetic division<\/strong>\u00a0returns the body to normal after the fight-or-flight response has occurred. For example, it slows down the\u00a0heart\u00a0rate, narrows air passages in the lungs, reduces\u00a0blood\u00a0flow to the skeletal muscles, and stimulates the\u00a0digestive system\u00a0to start working again. The parasympathetic division also maintains internal\u00a0homeostasis\u00a0of the body at other times.<\/li>\n<li>The\u00a0<strong>enteric division<\/strong> is made up of nerve fibres that supply the organs of the digestive system. This division allows for the local control of many digestive functions.<\/li>\n<\/ul>\n<figure id=\"attachment_3116\" aria-describedby=\"caption-attachment-3116\" style=\"width: 597px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3116\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/The_Autonomic_Nervous_System-2.jpg\" alt=\"The autonomic nervous system\" width=\"597\" height=\"598\" \/><figcaption id=\"caption-attachment-3116\" class=\"wp-caption-text\"><em>Figure 8.6.6 This diagram summarizes the structures and functions controlled by the parasympathetic and sympathetic divisions of the autonomic nervous system.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em; font-weight: bold;\">Disorders of the Peripheral Nervous System<\/span><\/p>\n<p>Unlike the CNS \u2014 which is protected by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5913\">bone<\/a>s, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2929\">meninges<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5939\">cerebrospinal fluid<\/a> \u2014 the PNS has no such protections. The PNS also has no blood-brain barrier to protect it from toxins and pathogens in the\u00a0blood. Therefore, the PNS is more subject to injury and disease than is the CNS. Causes of nerve injury include\u00a0<a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/diabetes\/symptoms-causes\/syc-20371444\">diabetes<\/a>,\u00a0infectious diseases\u00a0(such as <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/shingles\/symptoms-causes\/syc-20353054\">shingles<\/a>), and poisoning by toxins (such as heavy metals). PNS disorders often have symptoms\u00a0like\u00a0loss of feeling, tingling, burning sensations, or muscle weakness. If a traumatic injury results in a nerve being transected (cut all the way through), it may regenerate, but this is a very slow process and may take many months.<\/p>\n<p>Two other diseases of the PNS are Guillain-Barre syndrome and Charcot-Marie-Tooth disease.<\/p>\n<ul>\n<li><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/guillain-barre-syndrome\/symptoms-causes\/syc-20362793\">Guillain-Barre syndrome<\/a> is a rare disease in which the immune system attacks nerves of the PNS, leading to muscle weakness and even paralysis. The exact cause of Guillain-Barre syndrome is unknown, but it often occurs after a viral or bacterial infection. There is no known cure for the syndrome, but most people eventually make a full recovery. Recovery can be slow, however, lasting anywhere from several weeks to several years.<\/li>\n<li><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/charcot-marie-tooth-disease\/symptoms-causes\/syc-20350517\">Charcot-Marie-Tooth disease<\/a> is a hereditary disorder of the nerves, and one of the most common inherited neurological disorders. It affects predominantly the nerves in the feet and legs,\u00a0and often\u00a0in the hands and arms, as well. The disease is characterized by loss of muscle tissue and sense of touch. It is presently incurable.<\/li>\n<\/ul>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<p>The autonomic nervous system is considered to be involuntary because it doesn&#8217;t require conscious input. However, it\u00a0<em>is<\/em>\u00a0possible to exert some voluntary control over it. People who practice yoga or other so-called mind-body techniques, for example,\u00a0can\u00a0reduce their heart rate and certain other autonomic functions. Slowing down these otherwise involuntary responses is a good way to relieve stress and reduce the wear-and-tear that stress can place on the body. Such techniques may also be useful for controlling post-traumatic stress disorder and chronic pain. Three types of integrative practices for these purposes\u00a0are\u00a0breathing exercises, body-based tension modulation exercises, and mindfulness techniques.<\/p>\n<p>Breathing exercises can help control the rapid, shallow breathing that often occurs when you are anxious or under stress. These exercises can be learned quickly, and they provide immediate feelings of relief. Specific breathing exercises include paced breath, diaphragmatic breathing, and Breathe2Relax or Chill Zone on MindShift\u2122 CBT, which are downloadable breathing practice mobile applications, or &#8220;Apps&#8221;. Try syncing your breathing with Eric Klassen&#8217;s &#8220;Triangle breathing, 1 minute&#8221; video:<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=u9Q8D6n-3qw<\/p>\n<p style=\"text-align: center;\">Triangle breathing, 1 minute, Erin Klassen, 2015.<\/p>\n<p>Body-based tension modulation exercises include yoga postures (also known as \u201casanas\u201d) and tension manipulation exercises. The latter include the Trauma\/Tension Release\u00a0Exercise\u00a0(TRE) and the Trauma Resiliency Model (TRM). Watch this video for a brief \u2014 but informative \u2014 introduction to the TRE program:<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=67R974D8swM&#38;feature=youtu.be<\/p>\n<p style=\"text-align: center;\">TRE\u00ae : Tension and Trauma Releasing Exercises, an Introduction with Jessica Schaffer, Jessica Schaffer Nervous System RESET, 2015.<\/p>\n<p>Mindfulness techniques have been shown to reduce symptoms of depression, as well as those of anxiety and stress. They have also been shown to be useful for pain management and performance enhancement. Specific mindfulness programs include Mindfulness Based Stress Reduction (MBSR) and Mindfulness Mind-Fitness Training (MMFT). You can learn more about MBSR by watching the video below.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Mindfulness-Based Stress Reduction (UMass Medical School, Center for Mindfulness)\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/0TA7P-iCCcY?feature=oembed&#38;rel=0&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">Mindfulness-Based Stress Reduction (UMass Medical School, Center for Mindfulness), Palouse Mindfulness, 2017.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">8.6 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_4782_3009\">peripheral nervous system<\/a> (PNS) consists of all the nervous tissue that lies outside the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5933\">central nervous system<\/a> (CNS). Its main function is to connect the CNS to the rest of the organism.<\/li>\n<li>The PNS is made up of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3011\">nerves<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_6027\">ganglia<\/a>. Nerves are bundles of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5901\">axons<\/a>, and ganglia are groups of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5931\">cell bodies<\/a>. Nerves are classified as sensory, motor, or a mix of the two.<\/li>\n<li>The PNS is divided into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3014\">somatic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5899\">autonomic nervous systems<\/a>. The somatic system controls <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3004\">voluntary<\/a> activities, whereas the autonomic system controls <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3005\">involuntary<\/a> activities.<\/li>\n<li>The autonomic nervous system is further divided into <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3015\">sympathetic<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3016\">parasympathetic<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5987\">enteric divisions<\/a>. The sympathetic division controls <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_6013\">fight-or-flight responses<\/a>\u00a0during emergencies, the parasympathetic system controls routine body functions the rest of the time, and the enteric division provides local control over the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5969\">digestive system<\/a>.<\/li>\n<li>The PNS is not as well protected physically or chemically as the CNS, so it is more prone to injury and disease. PNS problems include injury from\u00a0diabetes, shingles, and heavy metal poisoning. Two disorders of the PNS are Guillain-Barre syndrome and Charcot-Marie-Tooth disease.<\/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;\">8.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Describe the general structure of the peripheral nervous system. State its primary function.<\/li>\n<li>What are ganglia?<\/li>\n<li>Identify three types of nerves based on the direction in which they carry\u00a0nerve impulses.<\/li>\n<li>Outline all of the divisions of the peripheral nervous system.<\/li>\n<li>Compare and contrast the somatic and autonomic nervous systems.<\/li>\n<li>When and how does the sympathetic division of the autonomic nervous system affect the body?<\/li>\n<li>What is the function of the parasympathetic division of the autonomic nervous system?\u00a0Specifically, how does it affect the body?<\/li>\n<li>Name and describe two peripheral nervous system disorders.<\/li>\n<li>Give one example of how the CNS interacts with the PNS to control a function in the body.<\/li>\n<li>For each of the following types of information, identify whether the neuron carrying it is sensory or motor, and whether it is most likely in the somatic or autonomic nervous system:\n<ol type=\"a\">\n<li>Visual information<\/li>\n<li>Blood pressure information<\/li>\n<li>Information that causes muscle contraction in digestive organs after eating<\/li>\n<li>Information that causes muscle contraction in skeletal muscles based on the person\u2019s decision to make a movement<\/li>\n<\/ol>\n<\/li>\n<li>\n<div id=\"h5p-564\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-564\" class=\"h5p-iframe\" data-content-id=\"564\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"8.6 Peripheral Nervous System\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\" style=\"text-align: left;\"><span style=\"color: #ffffff;\">8.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"Phantom Limbs Explained\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ySIDMU2cy0Y?feature=oembed&#38;rel=0&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">Phantom Limbs Explained, Plethrons, 2015.<\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-3\" title=\"Why Do Hot Peppers Cause Pain?\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/73yo5nJne6c?start=1&#38;feature=oembed\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: center;\">Why Do Hot Peppers Cause Pain? Reactions, 2015.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 8.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/pjmixer\/4460758776\" rel=\"cc:attributionURL\">Kid\u2019s piant duet<\/a> by\u00a0<a href=\"https:\/\/www.flickr.com\/photos\/pjmixer\/\" rel=\"dc:creator\">PJMixer<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/\" rel=\"license\">CC BY-NC-ND 2.0<\/a>\u00a0(https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/) license.<\/p>\n<p><strong>Figure 8.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Nervous_system_diagram.png\" rel=\"cc:attributionURL\">Nervous_system_diagram<\/a> by <a class=\"extiw\" title=\"en:User:Persian Poet Gal\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Persian_Poet_Gal\"><span style=\"font-family: comic sans ms;\"><span style=\"color: purple;\">\u00a4~Persian Poet Gal<\/span><\/span><\/a>\u00a0 on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/en:public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong style=\"text-align: initial; font-size: 1em;\"><br \/>\nFigure 8.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Afferent_and_efferent_neurons_en.svg\" rel=\"cc:attributionURL\">Afferent_and_efferent_neurons_en.svg<\/a> by <a title=\"User:Helixitta\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Helixitta\">Helixitta<\/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 8.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Autonomic_and_Somatic_Nervous_System.png\" rel=\"cc:attributionURL\">Autonomic and Somatic Nervous System<\/a> by <a title=\"User:Christinelmiller\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Christinelmiller\">Christinelmiller<\/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 8.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Dermatoms.svg\" rel=\"cc:attributionURL\">Dermatoms.svg<\/a> by Ralf Stephan (mailto:ralf@ark.in-berlin.de) on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/en:public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 8.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:The_Autonomic_Nervous_System.jpg\" rel=\"cc:attributionURL\">The_Autonomic_Nervous_System<\/a> by <a title=\"User:Geo-Science-International\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Geo-Science-International\">Geo-Science-International<\/a> on Wikimedia Commons is used and adapted by Christine Miller under a\u00a0<a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> Universal<br \/>\nPublic Domain Dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Erin Klassen. (2015, December 15). Triangle breathing, 1 minute. YouTube. https:\/\/www.youtube.com\/watch?v=u9Q8D6n-3qw&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Jessica Schaffer Nervous System RESET. (2015, January 15). TRE\u00ae : Tension and trauma releasing exercises, an Introduction with Jessica Schaffer. YouTube. https:\/\/www.youtube.com\/watch?v=67R974D8swM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Charcot-Marie-Tooth disease [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/charcot-marie-tooth-disease\/symptoms-causes\/syc-20350517<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Diabetes [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/diabetes\/symptoms-causes\/syc-20371444<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Guillain-Barre syndrome [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/guillain-barre-syndrome\/symptoms-causes\/syc-20362793<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Shingles [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/shingles\/symptoms-causes\/syc-20353054<\/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\">Palouse Mindfulness. (2017, March 25).\u00a0 Mindfulness-based stress reduction (UMass Medical School, Center for Mindfulness), YouTube. https:\/\/www.youtube.com\/watch?v=0TA7P-iCCcY&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Plethrons, (2015, March 23). Phantom limbs explained. YouTube. https:\/\/www.youtube.com\/watch?v=ySIDMU2cy0Y&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Reactions. (2015, December 1). Why do hot peppers cause pain? YouTube. https:\/\/www.youtube.com\/watch?v=73yo5nJne6c&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_4782_3009\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_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_4782_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_4782_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_4782_4717\">Urine<\/a> is formed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2988\">kidneys<\/a>, which filter many substances out of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_2702\">Blood<\/a> is filtered and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4717\">urine<\/a> is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_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_4782_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_4782_4708\">urea<\/a> \u2014 a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2422\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2299\">catabolism<\/a> \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4709\">uric\u00a0acid<\/a>, a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_2648\">endocrine<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_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_4782_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_4782_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_2368\">metabolism<\/a> from the body by forming and excreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_4725\">ureters<\/a> via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2890\">peristalsis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4731\">urinary bladder<\/a>. The bladder stores the urine until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_4708\">urea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_2526\">antidiuretic hormone<\/a> from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2938\">pituitary gland<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3467\">parathyroid hormone<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3402\">parathyroid glands<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2509\">aldosterone<\/a> from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_4627\">sphincter<\/a> at the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_5933\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_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_4782_3011\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3011\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1570\" aria-describedby=\"caption-attachment-1570\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1564\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Cliche.jpg\" alt=\"16.5.1 Dog peeing on fire hydrant\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-1570\" class=\"wp-caption-text\"><em>Figure 16.5.1 Just leaving a message.....<\/em><\/figcaption><\/figure>\n<div>\n<h1>Communicating with Urine<\/h1>\n<\/div>\n<p>Why do dogs pee on fire hydrants? Besides \u201chaving to go,\u201d they are marking their territory with chemicals in their urine called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4768\">pheromone<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\">. It\u2019s a form of communication, in which they are \u201csaying\u201d with odors that the yard is <\/span><em style=\"text-align: initial;font-size: 1em\">theirs<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0and other dogs should stay away. In addition to fire hydrants, dogs may urinate on fence posts, trees, car tires, and many other objects. Urination in dogs, as in people, is usually a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3004\">voluntary<\/a> process controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2554\">brain<\/a>. The process of forming urine \u2014 which occurs in the kidneys \u2014 occurs constantly, and is not under voluntary control. What happens to all the urine that forms in the kidneys? It passes from the kidneys through the other organs of the urinary system, starting with the ureters.<\/span><\/p>\n<div>\n<h1>Ureters<\/h1>\n<\/div>\n<p>As shown in Figure 16.5.2, <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4725\">ureter<\/strong><strong style=\"font-size: 1em\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a><\/strong><span style=\"text-align: initial;font-size: 1em\"> are tube-like structures that connect the kidneys with the urinary bladder. They are paired structures, with one ureter for each kidney. In adults, ureters are between 25 and 30 cm (about 10\u201312 in) long and about 3 to 4 mm in diameter.<\/span><\/p>\n<figure id=\"attachment_1570\" aria-describedby=\"caption-attachment-1570\" style=\"width: 446px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1565\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary-System-Male.jpg\" alt=\"16.5.2 Urinary System - Ureters\" width=\"446\" height=\"449\"><figcaption id=\"caption-attachment-1570\" class=\"wp-caption-text\"><em>16.5.2 Besides the kidneys, the urinary system includes two ureters, the urinary bladder, and the urethra.<\/em><\/figcaption><\/figure>\n<p>Each ureter arises in the pelvis of a kidney (the renal pelvis in Figure 16.5.3). It then passes down the side of the kidney, and finally enters the back of the bladder. At the entrance to the bladder, the ureters have sphincters that prevent the backflow of urine.<\/p>\n<figure id=\"attachment_1570\" aria-describedby=\"caption-attachment-1570\" style=\"width: 388px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1567\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-1.jpg\" alt=\"16.5.3 Renal Pelvis and Ureter\" width=\"388\" height=\"357\"><figcaption id=\"caption-attachment-1570\" class=\"wp-caption-text\"><em>16.5.3 Urine collects in the renal pelvis, which is continuous with the ureter. The ureter then carries the urine from the kidney to the urinary bladder.<\/em><\/figcaption><\/figure>\n<p>The walls of the ureters are composed of multiple layers of different types of tissues.\u00a0 The innermost layer is a special type of epithelium, called transitional epithelium. Unlike the epithelium lining most organs, transitional epithelium is capable of stretching and does not produce mucus. It lines much of the urinary system, including the renal pelvis, bladder, and much of the urethra, in addition to the ureters. Transitional epithelium allows these organs to stretch and expand as they fill with urine or allow urine to pass through. The next layer of the ureter walls is made up of loose connective tissue containing elastic fibres, nerves, and blood and lymphatic vessels. After this layer are two layers of smooth muscles, an inner circular layer, and an outer longitudinal layer. The smooth muscle layers can contract in waves of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2890\">peristalsis<\/a> to propel urine down the ureters from the kidneys to the urinary bladder. The outermost layer of the ureter walls consists of fibrous tissue.<\/p>\n<div>\n<h1>Urinary Bladder<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4731\">urinary bladder<\/a><\/strong>\u00a0is a hollow, muscular, and stretchy organ that rests on the pelvic floor. It collects and stores <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4717\">urine<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2988\">kidney<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\">\u00a0before the urine is eliminated through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4726\">urination<\/a>. As shown in Figure 16.5.4, urine enters the urinary bladder from the ureters through two ureteral openings on either side of the back wall of the bladder. Urine leaves the bladder through a sphincter called the internal urethral sphincter. When the sphincter relaxes and opens, it allows urine to flow out of the bladder and into the urethra.<\/span><\/p>\n<figure id=\"attachment_1570\" aria-describedby=\"caption-attachment-1570\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1568\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2605_The_Bladder.jpg\" alt=\"16.5.4 Urinary Bladder\" width=\"1024\" height=\"627\"><figcaption id=\"caption-attachment-1570\" class=\"wp-caption-text\"><em>Figure 16.5.4 This diagram of the urinary bladder shows (a) a cross-sectional drawing of the entire bladder and (b) a microscopic cross-section of the tissues in the wall of the bladder.<\/em><\/figcaption><\/figure>\n<p>Like the ureters, the bladder is lined with transitional epithelium, which can flatten out and stretch as needed as the bladder fills with urine. The next layer (lamina propria) is a layer of loose connective tissue, nerves, and blood and lymphatic vessels. This is followed by a submucosa layer, which connects the lining of the bladder with the detrusor muscle in the walls of the bladder. The outer covering of the bladder is peritoneum, which is a smooth layer of epithelial cells that lines the abdominal cavity and covers most abdominal organs.<\/p>\n<p>The detrusor muscle in the wall of the bladder is made of smooth muscle fibres controlled by both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2533\">autonomic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3014\">somatic<\/a> nervous systems. As the bladder fills, the detrusor muscle automatically relaxes to allow it to hold more urine. When the bladder is about half full, the stretching of the walls triggers the sensation of needing to urinate. When the individual is ready to void, conscious nervous signals cause the detrusor muscle to contract, and the internal urethral sphincter to relax and open. As a result, urine is forcefully expelled out of the bladder and into the urethra.<\/p>\n<div>\n<h1>Urethra<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4732\">urethra<\/a><\/strong> is a tube that connects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4731\">urinary bladder<\/a> to the external urethral orifice, which is the opening of the urethra on the surface of the body. As shown in Figure 16.5.5, the urethra in males travels through the penis, so it is much longer than the urethra in females. In males, the urethra averages about 20 cm (about 7.8 in) long, whereas in females, it averages only about 4.8 cm (about 1.9 in) long. In males, the urethra carries semen (as well as urine), but in females, it carries only urine.\u00a0 In addition, in males, the urethra passes through the prostate gland (part of the reproductive system) which is absent in women.<\/p>\n<figure id=\"attachment_1570\" aria-describedby=\"caption-attachment-1570\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1570\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Male_and_female_urethral_openings.svg_.png\" alt=\"16.5.5\" width=\"512\" height=\"355\"><figcaption id=\"caption-attachment-1570\" class=\"wp-caption-text\"><em>Figure 16.5.5 The male pelvis on the left and the female pelvis on the right. Notice how much longer the male urethra is because it travels through the length of the penis to reach the external urethral orifice.<\/em><\/figcaption><\/figure>\n<p>Like the ureters and bladder, the proximal (closer to the bladder) two-thirds of the urethra are lined with transitional epithelium. The distal (farther from the bladder) third of the urethra is lined with mucus-secreting epithelium. The mucus helps protect the epithelium from urine, which is corrosive. Below the epithelium is loose connective tissue, and below that are layers of smooth muscle that are continuous with the muscle layers of the urinary bladder. When the bladder contracts to forcefully expel urine, the smooth muscle of the urethra relaxes to allow the urine to pass through.<\/p>\n<p>In order for urine to leave the body through the external urethral orifice, the external urethral sphincter must relax and open. This sphincter is a striated muscle that is controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3014\">somatic nervous system<\/a>, so it is under conscious, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3004\">voluntary<\/a> control in most people (exceptions are infants, some elderly people, and patients with certain injuries or disorders). The muscle can be held in a contracted state and hold in the urine until the person is ready to urinate. Following urination, the smooth muscle lining the urethra automatically contracts to re-establish muscle tone, and the individual consciously contracts the external urethral sphincter to close 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\">16.5 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_4782_4725\">Ureters<\/a>\u00a0are tube-like structures that connect the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2988\">kidneys<\/a>\u00a0with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4731\">urinary bladder<\/a>. Each ureter arises at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4724\">renal pelvis<\/a> of a kidney and travels down through the abdomen to the urinary bladder. The walls of the ureter contain <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2982\">smooth muscle<\/a> that can contract to push <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4717\">urine<\/a> through the ureter by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2890\">peristalsis<\/a>. The walls are lined with transitional epithelium that can expand and stretch.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4731\">urinary bladder<\/a> is a hollow, muscular organ that rests on the pelvic floor. It is also lined with transitional epithelium. The function of the bladder is to collect and store urine from the kidneys before the urine is eliminated through urination. Filling of the bladder triggers the sensation of needing to urinate. When a conscious decision to urinate is made, the detrusor muscle in the bladder wall contracts and forces urine out of the bladder and into the urethra.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4732\">urethra<\/a> is a tube that connects the urinary bladder to the external urethral orifice. Somatic nerves control the sphincter at the distal end of the urethra. This allows the opening of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4627\">sphincter<\/a> for urination to be under <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3004\">voluntary<\/a> control.<\/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\">16.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What are ureters?\u00a0 Describe the location of the ureters relative to other urinary tract organs.<\/li>\n<li>Identify layers in the walls of a ureter. How do they contribute to the ureter\u2019s function?<\/li>\n<li>Describe the urinary bladder. What is the function of the urinary bladder?<\/li>\n<li>\n<div id=\"h5p-318\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-318\" class=\"h5p-iframe\" data-content-id=\"318\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"16.5 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>How does the nervous system control the urinary bladder?<\/li>\n<li>What is the urethra?<\/li>\n<li>How does the nervous system control urination?<\/li>\n<li>Identify the sphincters that are located along the pathway from the ureters to the external urethral orifice.<\/li>\n<li>What are two differences between the male and female urethra?<\/li>\n<li>When the bladder muscle contracts, the smooth muscle in the walls of the urethra _________ .<\/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\">16.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/2Brajdazp1o<\/p>\n<p style=\"text-align: center\">The taboo secret to better health | Molly Winter, TED. 2016.<\/p>\n<p>https:\/\/youtu.be\/dg4_deyHLvQ<\/p>\n<p style=\"text-align: center\">What Happens When You Hold Your Pee? SciShow, 2016.<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 16.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Cliche.jpg\" rel=\"cc:attributionURL\">Cliche<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/27735730@N00\" rel=\"nofollow\">Jackie<\/a> on Wikimedia Common s 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 16.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:UrinarySystemMale.jpg\" 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 16.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Kidney_and_adrenal_gland.jpg\" rel=\"cc:attributionURL\">Adrenal glands on Kidney by NCI Public Domain<\/a>\u00a0by Alan Hoofring (Illustrator) \/<a class=\"extiw\" title=\"en:National Cancer Institute\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Cancer_Institute\">National Cancer Institute<\/a> (<a href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=4355\">photo ID 4355<\/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 16.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2605_The_Bladder.jpg\" rel=\"cc:attributionURL\">2605_The_Bladder<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-2-gross-anatomy-of-urine-transport\">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. <span class=\"os-caption\"><span class=\"search-highlight text last\" data-timestamp=\"1597636975236\" data-highlight-id=\"b46f272f-e324-486a-9b46-6607817bb903\" data-highlighted=\"true\">(Micrograph originally provided by <span class=\"search-highlight first text last\" data-timestamp=\"1597636975280\" data-highlight-id=\"fda2d69c-8a26-4beb-b12b-daf80f2c011d\" data-highlighted=\"true\">the<\/span>\u00a0Regents of\u00a0<span class=\"search-highlight first text last\" data-timestamp=\"1597636975286\" data-highlight-id=\"855d8b77-088b-43c9-81b4-0e0ff4f489e1\" data-highlighted=\"true\">the<\/span> University of Michigan Medical School \u00a9 2012.)<\/span><\/span><\/p>\n<p><strong>Figure 16.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Male_and_female_urethral_openings.svg\" rel=\"cc:attributionURL\">512px-Male_and_female_urethral_openings.svg<\/a>\u00a0by <a title=\"User:Andrybak\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Andrybak\">andrybak<\/a> (derivative work) on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\" rel=\"license\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0) license. (Original: <a title=\"File:Male anatomy blank.svg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Male_anatomy_blank.svg\">Male anatomy blank.svg<\/a>:\u00a0<a class=\"external text\" href=\"http:\/\/www.luckymojo.com\/faqs\/altsex\/penis.html\" rel=\"nofollow\">alt.sex FAQ<\/a>, derivative work:\u00a0<a title=\"User:Tsaitgaist\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Tsaitgaist\">Tsaitgaist<\/a>\u00a0<a title=\"File:Female anatomy with g-spot.svg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Female_anatomy_with_g-spot.svg\">Female anatomy with g-spot.svg<\/a>:\u00a0<a title=\"User:Tsaitgaist\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Tsaitgaist\">Tsaitgaist<\/a>.)<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1597636975236\" data-highlight-id=\"b46f272f-e324-486a-9b46-6607817bb903\" 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=\"1597636975236\" data-highlight-id=\"b46f272f-e324-486a-9b46-6607817bb903\" data-highlighted=\"true\">25.4<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"3366\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1597636975236\" data-highlight-id=\"b46f272f-e324-486a-9b46-6607817bb903\" data-highlighted=\"true\">Bladder\u00a0<\/span><\/span><span class=\"os-caption\"><span class=\"search-highlight text last\" data-timestamp=\"1597636975236\" data-highlight-id=\"b46f272f-e324-486a-9b46-6607817bb903\" data-highlighted=\"true\">(a) Anterior cross section of the bladder. (b)\u00a0<span class=\"search-highlight first text last\" data-timestamp=\"1597636975256\" data-highlight-id=\"b7b616c9-437f-4937-a7f5-c1b47387a77e\" data-highlighted=\"true\">The<\/span>\u00a0detrusor muscle of\u00a0<span class=\"search-highlight first text last\" data-timestamp=\"1597636975257\" data-highlight-id=\"31417372-bff6-4d54-941d-580ae31d2bcf\" data-highlighted=\"true\">the bladder<\/span> (source: monkey tissue) LM \u00d7 448 [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 7.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-2-gross-anatomy-of-urine-transport\u00a0<\/span><\/span><\/p>\n<p class=\"hanging-indent\">SciShow. (2016, January 22). What happens when you hold your pee? YouTube. https:\/\/www.youtube.com\/watch?v=dg4_deyHLvQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2016, September 2). The taboo secret to better health | Molly Winter. YouTube. https:\/\/www.youtube.com\/watch?v=2Brajdazp1o&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_4782_6027\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_6027\"><div tabindex=\"-1\"><p>A structure containing neuronal cell bodies in the peripheral 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_4782_6029\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_6029\"><div tabindex=\"-1\"><p>Structures containing neuronal cell bodies in the peripheral 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_4782_3110\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3110\"><div tabindex=\"-1\"><\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_3111\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3111\"><div tabindex=\"-1\"><p>image shows the signs for mens and women's washroom.  <\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_3112\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3112\"><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_4782_5899\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_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_4782_3014\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3014\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1610\" aria-describedby=\"caption-attachment-1610\" style=\"width: 405px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1602\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/nci-vol-1762-300.jpg\" alt=\"17.2.1 Schistosome Parasite\" width=\"405\" height=\"500\"><figcaption id=\"caption-attachment-1610\" class=\"wp-caption-text\"><em>Figure 17.2.1 From your nightmares...the\u00a0Schistosoma worm.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Worm Attack!<\/h1>\n<\/div>\n<p>Does the organism in Figure 17.2.1 look like a space alien? A scary creature from a nightmare? In fact, it\u2019s a 1-cm long worm in the genus <em>Schistosoma.<\/em>\u00a0It may invade and take up residence in the human body, causing a very serious illness known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4811\">schistosomiasis<\/a>. The worm gains access to the human body while it is in a microscopic life stage. It enters through a hair follicle when the skin comes into contact with contaminated water. The worm then grows and matures inside the human organism, causing disease.<\/p>\n<div>\n<h1>Host vs. Pathogen<\/h1>\n<\/div>\n<p>The\u00a0<em>Schistosoma<\/em>\u00a0worm has a parasitic relationship with humans. In this type of relationship, one organism, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4812\">parasite<\/a>, lives on or in another organism, called the host. The parasite always benefits from the relationship, and the host is always harmed. The human host of the\u00a0<em>Schistosoma<\/em>\u00a0worm is clearly harmed by the parasite when it invades the host\u2019s tissues. The urinary tract or intestines may be infected, and signs and symptoms may include abdominal pain, diarrhea, bloody stool, or blood in the urine. Those who have been infected for a long time may experience <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2989\">liver<\/a> damage, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4782\">kidney failure<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4813\">infertility<\/a>, or bladder <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2148\">cancer<\/a>. In children,\u00a0<em>Schistosoma<\/em>\u00a0infection may cause poor growth and difficulty learning.<\/p>\n<p>Like the\u00a0<em>Schistosoma<\/em>\u00a0worm, many other organisms can make us sick if they manage to enter our body. Any such agent that can cause disease is called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2405\">pathogen<\/a>.<\/strong>\u00a0Most pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2371\">microorganism<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\">, although some \u2014 such as the\u00a0<\/span><em style=\"text-align: initial;font-size: 1em\">Schistosoma<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0worm \u2014 are much larger. In addition to worms, common types of pathogens of human hosts include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2588\">bacteria<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4283\">virus<\/span><span style=\"font-size: 1em\">es<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a>, fungi, and single-celled organisms called protists. You can see examples of each of these types of pathogens in Table 17.1.1. Fortunately for us, our immune system is able to keep most potential pathogens out of the body, or quickly destroy them if they do manage to get in. When you read this chapter, you\u2019ll learn how your immune system usually keeps you safe from harm \u2014 including from scary creatures like the <\/span><em style=\"text-align: initial;font-size: 1em\">Schistosoma<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0worm!<\/span><\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%\" border=\"0\">\n<caption>Table 17.1.1: Types of Disease-Causing Pathogens<\/caption>\n<tbody>\n<tr>\n<th style=\"width: 25%\" colspan=\"2\" scope=\"col\">Type of Pathogen<\/th>\n<th style=\"width: 25%\" scope=\"col\">Description<\/th>\n<th style=\"width: 25%\" scope=\"col\">Disease Caused<\/th>\n<\/tr>\n<tr>\n<td style=\"width: 25%\"><strong>Bacteria:<\/strong><\/p>\n<p>Example shown: Escherichia coli<\/td>\n<td style=\"width: 25%\"><img class=\"alignnone wp-image-1605 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/EscherichiaColi_NIAID-1-e1592703123663.jpg\" alt=\"17.2a E. Coli\" width=\"235\" height=\"177\"><\/td>\n<td style=\"width: 25%\">Single celled organisms without a nucleus<\/td>\n<td style=\"width: 25%\">Strep throat, staph infections, tuberculosis, food poisoning, tetanus, pneumonia, syphillis<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 25%\"><strong>Viruses:<\/strong><\/p>\n<p>Example shown:<\/p>\n<p>Herpes simplex<\/td>\n<td style=\"width: 25%\"><img class=\"alignnone size-full wp-image-1606\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Herpes_simplex_virus_TEM_B82-0474_lores.jpg\" alt=\"17.2b\" width=\"639\" height=\"500\"><\/td>\n<td style=\"width: 25%\">Non-living particles that reproduce by taking over living cells<\/td>\n<td style=\"width: 25%\">Common cold, flu, genital herpes, cold sores, measles, AIDS, genital warts, chicken pox, small pox<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 25%\"><strong>Fungi:<\/strong><\/p>\n<p>Example shown:<\/p>\n<p>Death cap mushroom<\/td>\n<td style=\"width: 25%\"><img class=\"alignnone size-full wp-image-1607\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Red_death_cap_mushroom.jpg\" alt=\"17.2c Red Death cap mushroom\" width=\"256\" height=\"192\"><\/td>\n<td style=\"width: 25%\">Simple organisms, including mushrooms and yeast, that grow as single cells or thread-like filaments<\/td>\n<td style=\"width: 25%\">Ringworm, athletes foot, tineas, candidias, histoplasmomis, mushroom poisoning<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 25%\"><strong>Protozoa:<\/strong><\/p>\n<p>Example shown:<\/p>\n<p>Giardia lamblia<\/td>\n<td style=\"width: 25%\"><img class=\"alignnone wp-image-1608 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/256px-Giardia_lamblia_SEM_8698_lores-e1592706174288.jpg\" alt=\"17.2d Giardia lamblia\" width=\"256\" height=\"274\"><\/td>\n<td style=\"width: 25%\">Single celled organisms with a nucleus<\/td>\n<td style=\"width: 25%\">Malaria, \"traveller's diarrhea\", giardiasis, typano somiasis (\"sleeping sickness\")<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">What is the Immune System?<\/span><\/p>\n<p>The\u00a0<strong>immune system<\/strong> is a host defense system. It comprises many biological structures \u2014ranging from individual leukocytes to entire organs \u2014 as well as many complex biological processes. The function of the immune system is to protect the host from pathogens and other causes of disease, such as tumor (cancer) cells. To function properly, the immune system must be able to detect a wide variety of pathogens. It also must be able to distinguish the cells of pathogens from the host\u2019s own cells, and also to distinguish cancerous or damaged host cells from healthy cells. In humans and most other vertebrates, the immune system consists of layered defenses that have increasing specificity for particular pathogens or tumor cells. The layered defenses of the human immune system are usually classified into two subsystems, called the innate immune system and the adaptive immune system.<\/p>\n<h2>Innate Immune System<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4820\">innate immune system<\/a> <\/strong>(sometimes referred to as \"non-specific defense\") provides very quick, but non-specific responses to pathogens. It responds the same way regardless of the type of pathogen that is attacking the host. It includes barriers \u2014 such as the skin and mucous membranes \u2014 that normally keep pathogens out of the body. It also includes general responses to pathogens that manage to breach these barriers, including chemicals and cells that attack the pathogens inside the human host. Certain leukocytes (white blood cells), for example, engulf and destroy pathogens they encounter in the process called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1680\">phagocytosis<\/a>, which is illustrated in Figure 17.2.2. Exposure to pathogens leads to an immediate maximal response from the innate immune system.<\/p>\n<figure id=\"attachment_1610\" aria-describedby=\"caption-attachment-1610\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1609\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Phagocytosis.jpg\" alt=\"17.2.2 Phagocytosis\" width=\"400\" height=\"274\"><figcaption id=\"caption-attachment-1610\" class=\"wp-caption-text\"><em>Figure 17.2.2 A leukocyte called a macrophage phagocytizes bacteria in the series of steps shown here: engulfing a bacterium, digesting the bacterium with enzymes, and absorbing leftover products.<\/em><\/figcaption><\/figure>\n<div>\n<p>Watch the video below, \"Neutrophil Phagocytosis - White Blood Cells Eats Staphylococcus Aureus Bacteria\" by ImmiflexImmuneSystem, to see phagocytosis in action.<\/p>\n<p>https:\/\/youtu.be\/Z_mXDvZQ6dU<\/p>\n<p class=\"title style-scope ytd-video-primary-info-renderer\" style=\"text-align: center\">Neutrophil Phagocytosis - White Blood Cell Eats Staphylococcus Aureus Bacteria, ImmiflexImmuneSystem, 2013.<\/p>\n<\/div>\n<h2>Adaptive Immune System<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a><\/strong>\u00a0is activated if pathogens successfully enter the body and manage to evade the general defenses of the innate immune system. An adaptive response is specific to the particular type of pathogen that has invaded the body, or to cancerous cells. It takes longer to launch a specific attack, but once it is underway, its specificity makes it very effective. An adaptive response also usually leads to immunity. This is a state of resistance to a specific pathogen, due to the adaptive immune system's ability to \u201cremember\u201d the pathogen and immediately mount a strong attack tailored to that particular pathogen if it invades again in the future.<\/p>\n<div>\n<h1>Self vs. Non-Self<\/h1>\n<\/div>\n<p>Both innate and adaptive immune responses depend on the immune system's ability to distinguish between self- and non-self molecules. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4823\">Self molecules<\/a><\/strong>\u00a0are those components of an organism\u2019s body that can be distinguished from foreign substances by the immune system. Virtually all body cells have surface proteins that are part of a complex called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4825\">major histocompatibility complex (MHC)<\/a><\/strong>. These proteins are one way the immune system recognizes body cells as self.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1960\">Non-self proteins<\/a><\/strong>, in contrast, are recognized as foreign, because they are different from self proteins.<\/p>\n<h2>Antigens and Antibodies<\/h2>\n<p>Many non-self molecules comprise a class of compounds called antigens.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2704\">Antigen<\/strong><strong style=\"font-size: 1em\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">, which are usually proteins, bind to specific receptors on immune system cells and elicit an adaptive immune response. Some adaptive immune system cells (B cells) respond to foreign antigens by producing antibodies. An\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2215\">antibody<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0is a molecule that precisely matches and binds to a specific antigen. This may target the antigen (and the pathogen displaying it) for destruction by other immune cells.<\/span><\/p>\n<p>Antigens on the surface of pathogens are how the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a> recognizes specific pathogens. Antigen specificity allows for the generation of responses tailored to the specific pathogen. It is also how the adaptive immune system \u201dremembers\u201d the same pathogen in the future.<\/p>\n<h2>Immune Surveillance<\/h2>\n<p>Another important role of the immune system is to identify and eliminate tumor cells. This is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4827\">immune surveillance<\/a>.<\/strong>\u00a0The transformed cells of tumors express antigens that are not found on normal body cells. The main response of the immune system to tumor cells is to destroy them. This is carried out primarily by aptly-named killer T cells of the adaptive immune system.<\/p>\n<div>\n<h1>Lymphatic System<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2911\">lymphatic system<\/a><\/strong> is a human organ system that is a vital part of the adaptive immune system. It is also part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2571\">cardiovascular system<\/a> and plays a major role in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2628\">digestive system<\/a> (see section <a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/chapter\/19-3-lymphatic-system\/\">17.3 Lymphatic System<\/a>). The major structures of the lymphatic system are shown in Figure 17.2.3 .<\/p>\n<figure id=\"attachment_1610\" aria-describedby=\"caption-attachment-1610\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1610\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2201_Anatomy_of_the_Lymphatic_System.jpg\" alt=\"17.2.3 The Lymphatic System\" width=\"1024\" height=\"1085\"><figcaption id=\"caption-attachment-1610\" class=\"wp-caption-text\"><em>Figure 17.2.3 The lymphatic system includes the organs and vessels illustrated here.<\/em><\/figcaption><\/figure>\n<p>The lymphatic system consists of several lymphatic organs and a body-wide network of lymphatic vessels that transport the fluid called lymph.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4552\">Lymph<\/a><\/strong>\u00a0is essentially blood plasma that has leaked from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2566\">capillaries<\/a> into tissue spaces. It includes many leukocytes, especially <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4832\">lymphocyte<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\">, which are the major cells of the lymphatic system. Like other leukocytes, lymphocytes defend the body. There are several different types of lymphocytes that fight pathogens or cancer cells as part of the adaptive immune system.<\/span><\/p>\n<p>Major lymphatic organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4829\">thymus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4021\">bone marrow<\/a>. Their function is to form and\/or mature lymphocytes. Other lymphatic organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4497\">spleen<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4830\">tonsils<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4831\">lymph nodes<\/a>, which are small clumps of lymphoid tissue clustered along lymphatic vessels. These other lymphatic organs harbor mature lymphocytes and filter lymph. They are sites where pathogens collect, and adaptive immune responses generally begin.<\/p>\n<div>\n<h1>Neuroimmune System vs. Peripheral Immune System<\/h1>\n<\/div>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2554\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3010\">spinal cord<\/a> are normally protected from pathogens in the blood by the selectively permeable blood-brain and blood-spinal cord barriers. These barriers are part of the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4833\">neuroimmune system<\/a>.<\/strong>\u00a0The neuroimmune system has traditionally been considered distinct from the rest of the immune system, which is called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4834\">peripheral immune system<\/a>\u00a0<\/strong>\u2014 although that view may be changing. Unlike the peripheral system, in which leukocytes are the main cells, the main cells of the neuroimmune system are thought to be nervous system cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2985\">neuroglia<\/a>. These cells can recognize and respond to pathogens, debris, and other potential dangers. Types of neuroglia involved in neuroimmune responses include microglial cells and astrocytes.<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4835\">Microglial cells<\/a><\/strong> are among the most prominent types of neuroglia in the brain. One of their main functions is to phagocytize cellular debris that remains when neurons die. Microglial cells also \u201cprune\u201d obsolete synapses between neurons.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4836\">Astrocytes<\/a><\/strong> are neuroglia that have a different immune function. They allow certain immune cells from the peripheral immune system to cross into the brain via the blood-brain barrier to target both pathogens and damaged nervous tissue.<\/li>\n<\/ul>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<p>\u201cThey\u2019ll have to rewrite the textbooks!\u201d<\/p>\n<p>That sort of response to a scientific discovery is sure to attract media attention, and it did. It\u2019s what Kevin Lee, a neuroscientist at the University of Virginia, said in 2016 when his colleagues told him they had discovered human anatomical structures that had never before been detected. The structures were tiny lymphatic vessels in the meningeal layers surrounding the brain.<\/p>\n<p>How these lymphatic vessels could have gone unnoticed when all human body systems have been studied so completely is amazing in its own right. The suggested implications of the discovery are equally amazing:<\/p>\n<ul>\n<li>The presence of these lymphatic vessels means that the brain is directly connected to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4834\">peripheral immune system<\/a>, presumably allowing a close association between the human brain and human pathogens. This suggests an entirely new avenue by which humans and their pathogens may have influenced each other\u2019s evolution. The researchers speculate that our pathogens even may have influenced the evolution of our social behaviors.<\/li>\n<li>The researchers think there will also be many medical applications of their discovery. For example, the newly discovered lymphatic vessels may play a major role in neurological diseases that have an immune component, such as <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/multiple-sclerosis\/symptoms-causes\/syc-20350269\">multiple sclerosis<\/a>. The discovery might also affect how conditions such as <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/autism-spectrum-disorder\/symptoms-causes\/syc-20352928\">autism spectrum<\/a> disorders and <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/symptoms-causes\/syc-20354443\">schizophrenia<\/a> are treated.<\/li>\n<\/ul>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">17.2 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Any agent that can cause disease is called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2405\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2371\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4283\">viruses<\/a>. The immune system is the\u00a0body\u00a0system that defends the human host from pathogens and cancerous cells.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4820\">innate immune system<\/a> is a subset of the immune system that provides very quick, but non-specific responses to pathogens. It includes multiple types of barriers to pathogens, leukocytes that <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1680\">phagocytize<\/a> pathogens, and several other general responses.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a> is a subset of the immune system that provides specific responses tailored to particular pathogens. It takes longer to put into effect, but it may lead to immunity to the pathogens.<\/li>\n<li>Both innate and adaptive immune responses depend on the immune system's ability to distinguish between self and non-self molecules. Most body cells have <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4825\">major histocompatibility complex (MHC)<\/a> proteins that identify them as self. Pathogens and tumor cells have non-self antigens that the immune system recognizes as foreign.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2704\">Antigens<\/a>\u00a0are proteins that bind to specific receptors on immune system cells and elicit an adaptive immune response. Generally, they are non-self molecules on pathogens or infected cells. Some immune cells (B cells) respond to foreign antigens by producing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2215\">antibodies<\/a> that bind with antigens and target pathogens for destruction.<\/li>\n<li>Tumor surveillance is an important role of the immune system. Killer T cells of the adaptive immune system find and destroy tumor cells, which they can identify from their abnormal antigens.<\/li>\n<li>The lymphatic system is a human organ system vital\u00a0to\u00a0the adaptive immune system. It consists of several organs and a system of vessels that transport lymph. The main immune function of the lymphatic system is to produce, mature, and circulate lymphocytes, which are the main cells in the adaptive immune system.<\/li>\n<li>The neuroimmune system that protects the central nervous system is thought to be distinct from the peripheral immune system that protects the rest of the human body. The blood-brain and blood-spinal cord barriers are one type of protection for the neuroimmune system. Neuroglia also play role in this system, for example, by carrying out phagocytosis.<\/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\">17.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-326\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-326\" class=\"h5p-iframe\" data-content-id=\"326\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"17.2 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What is a pathogen?<\/li>\n<li>State the purpose of the immune system.<\/li>\n<li>Compare and contrast the innate and adaptive immune systems.<\/li>\n<li>Explain how the immune system distinguishes self molecules from non-self molecules.<\/li>\n<li>What are antigens?<\/li>\n<li>Define tumor surveillance.<\/li>\n<li>Briefly describe the lymphatic system and its role in immune function.<\/li>\n<li>Identify the neuroimmune system.<\/li>\n<li>What does it mean that the immune system is not just composed of organs?<\/li>\n<li>Why is the immune system considered \u201clayered?\u201d<\/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\">17.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/xZbcwi7SfZE<\/p>\n<p style=\"text-align: center\">The Antibiotic Apocalypse Explained, Kurzgesagt \u2013 In a Nutshell, 2016.<\/p>\n<div class=\"badge badge-style-type-verified style-scope ytd-badge-supported-renderer\"><\/div>\n<p>https:\/\/youtu.be\/Nw27_jMWw10<\/p>\n<p style=\"text-align: center\">Overview of the Immune System, Handwritten Tutorials, 2011.<\/p>\n<p>https:\/\/youtu.be\/gVdY9KXF_Sg<\/p>\n<p style=\"text-align: center\">The surprising reason you feel awful when you're sick - Marco A. Sotomayor, TED-Ed, 2016.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.1.1<\/strong><\/p>\n<p><a href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=1762\" rel=\"cc:attributionURL\">Schistosome Parasite<\/a> by Bruce Wetzel and Harry Schaefer (Photographers) from the National Cancer Institute, Visuals online 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 17.1.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Phagocytosis.JPG\">Phagocytosis<\/a> by <a class=\"extiw\" title=\"wikibooks:en:User:Rlawson\" href=\"https:\/\/en.wikibooks.org\/wiki\/en:User:Rlawson\">Rlawson<\/a>\u00a0at\u00a0<a class=\"external text\" href=\"https:\/\/en.wikibooks.org\/\">en.wikibooks<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en\">CC BY \u00adSA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en) license. (Transferred from\u00a0<a class=\"external text\" href=\"https:\/\/en.wikibooks.org\/\">en.wikibooks<\/a>\u00a0to Commons by\u00a0<a title=\"User:Adrignola\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Adrignola\">User:Adrignola.<\/a>)<\/p>\n<p><strong>Figure 17.1.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2201_Anatomy_of_the_Lymphatic_System.jpg\" rel=\"cc:attributionURL\">2201_Anatomy_of_the_Lymphatic_System<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems\">OpenStax College<\/a> on Wikimedia Commons is used under a <a 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>&nbsp;<\/p>\n<p><strong>Table 17.1.1\u00a0<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:EscherichiaColi_NIAID.jpg\">EscherichiaColi NIAID<\/a> [photo] by Rocky Mountain Laboratories,\u00a0 NIH\u00a0National Institute of Allergy and Infectious Diseases (<a class=\"owner-name truncate\" title=\"Go to NIAID's photostream\" href=\"https:\/\/www.flickr.com\/photos\/niaid\/\" data-track=\"attributionNameClick\">NIAID)<\/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).<\/li>\n<li><a href=\"https:\/\/en.wikipedia.org\/wiki\/File:Herpes_simplex_virus_TEM_B82-0474_lores.jpg\">Herpes simplex virus TEM B82-0474 lores<\/a> by Dr. Erskine Palmer\/ <a href=\"https:\/\/phil.cdc.gov\/PHIL_Images\/08301998\/00014\/B82-0474_lores.jpg\">CDC Public Health Image Library (PHIL)<\/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).<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Red_death_cap_mushroom.jpg\">Red death cap mushroom<\/a> by Rosendahl 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). (Transferred from <a href=\"https:\/\/pixnio.com\/flora-plants\/fungi-mushrooms\/red-death-cap-mushroom\">Pixnio<\/a> by <a class=\"mw-userlink\" title=\"User:F\u00e6\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:F%C3%A6\">F\u00e6<\/a>.)<\/li>\n<li><a href=\"https:\/\/phil.cdc.gov\/Details.aspx?pid=8698\">Scanning electron micrograph (SEM) of Giardia lamblia<\/a> by Janice Haney Carr\/ CDC, Public Health Image Library (PHIL) Photo ID# 8698 is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/li>\n<\/ul>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Barney, J. (2016, March 21). They\u2019ll have to rewrite the textbooks [online article]. <em>Illimitable<\/em> - <em>Discovery<\/em>. UVA Today\/ University of Virginia. https:\/\/news.virginia.edu\/illimitable\/discovery\/theyll-have-rewrite-textbooks<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" 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=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" data-highlighted=\"true\">21.2<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"93337\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" data-highlighted=\"true\">Anatomy of the lymphatic system<\/span><\/span><span class=\"os-divider\">\u00a0<\/span>[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 21.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems<\/p>\n<p class=\"hanging-indent\">Handwritten Tutorials. (2011, October 25). Overview of the immune system. YouTube. https:\/\/www.youtube.com\/watch?v=Nw27_jMWw10&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">ImmiflexImmuneSystem. (2013). Neutrophil phagocytosis - White blood cell eats staphylococcus aureus bacteria. YouTube. https:\/\/www.youtube.com\/watch?v=Z_mXDvZQ6dU<\/p>\n<p class=\"hanging-indent\">Kurzgesagt \u2013 In a Nutshell. (2016, March 16). The antibiotic apocalypse explained. YouTube. https:\/\/www.youtube.com\/watch?v=xZbcwi7SfZE&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Louveau, A., Smirnov, I., Keyes, T. J., Eccles, J. D., Rouhani, S. J., Peske, J. D., Derecki, N. C., Castle, D., Mandell, J. W., Lee, K. S., Harris, T. H., &amp; Kipnis, J. (2015). Structural and functional features of central nervous system lymphatic vessels. <em>Nature, 523<\/em>(7560), 337\u2013341. https:\/\/doi.org\/10.1038\/nature14432<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Autism spectrum disorder [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/autism-spectrum-disorder\/symptoms-causes\/syc-20352928<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Multiple sclerosis [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/multiple-sclerosis\/symptoms-causes\/syc-20350269<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Schizophrenia [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/schizophrenia\/symptoms-causes\/syc-20354443<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, April 19). The surprising reason you feel awful when you're sick - Marco A. Sotomayor. YouTube. https:\/\/www.youtube.com\/watch?v=gVdY9KXF_Sg&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_4782_3030\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3030\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 322px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1847\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/512px-Marie_Stopes.jpg\" alt=\"18.11.1 Marie Stopes\" width=\"322\" height=\"400\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.1 Family planning champion, Marie Stopes.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Family Planning Pioneer<\/h1>\n<\/div>\n<p>Her name was <a href=\"https:\/\/en.wikipedia.org\/wiki\/Marie_Stopes\">Marie Stopes<\/a>, and she was a British author and paleobotanist who lived from 1880 to 1958. She is pictured in Figure 18.11.1 in her lab next to her microscope. Stopes made significant contributions to science and was the first woman on the faculty of the University of Manchester in England. Her primary claim to fame was her work as a family planning pioneer.<\/p>\n<p>Along with her husband, Stopes founded the first birth control clinic in Britain. She also edited a newsletter called\u00a0<em>Birth Control News<\/em>, which gave explicit practical advice on how to avoid unwanted pregnancies. In 1918, she published a sex manual titled\u00a0<em><a href=\"https:\/\/en.wikisource.org\/wiki\/Married_Love\">Married Love<\/a>. <\/em>The book was controversial and influential, bringing the subject of contraception into wide public discourse for the first time.<\/p>\n<div>\n<h1>What Is Contraception?<\/h1>\n<\/div>\n<p>About a century\u00a0after\u00a0<em>Married Love<\/em>, more than half of all fertile married couples worldwide use some form of contraception.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5349\">Contraception<\/a>,<\/strong>\u00a0also known as birth control, is any method or device used to prevent pregnancy. Birth control methods have been used for centuries, but safe and effective methods only became available in the 20th\u00a0century, in part because of the work of people\u00a0like\u00a0Marie Stopes.<\/p>\n<p>Many different birth control methods are currently available, but they differ considerably in their effectiveness at preventing pregnancy. The effectiveness of contraception is generally expressed as the failure rate, which is the percentage of women who become pregnant using a given method during the first year of use. Virtually no one uses any method of birth control perfectly, so the failure rate with typical use is almost always higher \u2014 and often much higher \u2014 than the failure rate\u00a0<em>with<\/em> perfect use. For example, with perfect use, a birth control method might have a failure rate of just 1%, whereas with typical use, the failure rate might be 25%. For comparison, there is an average one-year pregnancy rate of 85% if no contraception is used.<\/p>\n<p>All methods of birth control have potential adverse effects, but their health risks are less than the health risks associated with pregnancy. Using contraception to space the children in a family is also good for the children\u2019s health and development, as well as for the health of the mother.<\/p>\n<div>\n<h1>Types of Contraception and Their Effectiveness<\/h1>\n<\/div>\n<p>Types of birth control methods include barrier methods, hormonal methods, intrauterine devices, behavioural methods, and sterilization. With the exception of sterilization, all of these methods are reversible. Examples of each type of birth control method and their failure rates with typical use are described below. Much of the information is also summarized in Figure 18.11.2.<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 907px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1849\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Effectivenessofcontraceptives.png\" alt=\"18.11.2 Comparison of Contraceptive Measures\" width=\"907\" height=\"659\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.2 This figure compares different contraceptive methods and devices in terms of their effectiveness at preventing pregnancies with typical use.<\/em><\/figcaption><\/figure>\n<h2>Barrier Methods<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5351\">Barrier methods<\/a><\/strong>\u00a0are devices that are used to physically block <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2506\">sperm<\/a> from entering the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5102\">uterus<\/a>. They include condoms and diaphragms.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 300px\" class=\"wp-caption alignright\"><img class=\"wp-image-1851 size-medium\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/photo-1576071804486-b8bc22106dbf-300x192.jpg\" alt=\"\" width=\"300\" height=\"192\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\">Figure 18.11.3 Rolled up male condom.<\/figcaption><\/figure>\n<h3>Condoms<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5352\">Condoms<\/a><\/strong> are the most commonly used method of birth control globally. There are condoms for females and males, but male condoms are more widely used, less expensive, and more readily available. Both types of condoms are pictured in Figures 18.11.3 and 18.11.4. A male condom is placed on a man\u2019s erect penis, and a female condom is placed inside a woman\u2019s vagina. Whichever type of condom is used, it must be put in place before sexual intercourse occurs. Condoms work by physically blocking ejaculated sperm from entering the vagina of the sexual partner. With typical use, male condoms have an 18% failure rate, and female condoms have a 21% failure rate. Unlike virtually all other birth control methods, condoms also help prevent the spread of sexually transmitted infections (STIs), in addition to helping to prevent pregnancy.<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 350px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1852\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Female-condom.jpg\" alt=\"18.11.4 Female Condom\" width=\"350\" height=\"158\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.4 Unrolled female condom.<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img class=\"wp-image-1853\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Contraceptive_diaphragm.jpg\" alt=\"18.11.5 Diaphragm\" width=\"300\" height=\"350\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.5 A diaphragm is pictured here beside a U.S. quarter coin for size comparison. The diaphragm should fit snugly over the cervix so it blocks sperm from entering the cervical canal.<\/em><\/figcaption><\/figure>\n<h3>Diaphragms<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5355\">Diaphragms<\/a><\/strong>, like the one pictured in Figure 18.11.5, ideally prevent sperm from passing through the cervical canal and into the uterus. A diaphragm is inserted vaginally before <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5149\">sexual intercourse<\/a> occurs and must be placed over the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5235\">cervix<\/a> to be effective. It is usually recommended that a diaphragm be covered with spermicide before insertion for extra protection. It is also recommended that the diaphragm be left in place for at least six hours after intercourse. The failure rate of diaphragms with typical use is about 12%, which is about half that of condoms. However, diaphragms do not help prevent the spread of STIs, and their use is also associated with an increased frequency of urinary tract infections in females.<\/p>\n<p>&nbsp;<\/p>\n<h2>Hormonal Methods<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5358\">Hormonal contraception<\/a><\/strong>\u00a0is the administration of hormones to prevent ovulation. Hormones can be taken orally in birth control pills, implanted under the skin, injected into a muscle, or received transdermally from a skin patch. Hormonal methods are currently available only for women, although hormonal contraceptives for men are being tested in clinical trials.<\/p>\n<p>Birth control pills are the most common form of hormonal contraception. There are two types of pills: the combined pill (which contains both estrogen and progesterone) and the progesterone-only pill. Both types of pills inhibit ovulation and thicken cervical mucus. The failure rate of birth control pills is only about 1% or less, if used perfectly. However, the failure rate rises to about 10% with typical use, because women do not always remember to take the pill at the same time every day. The combined pill is associated with a slightly increased risk of blood clots, but a reduced risk of ovarian and endometrial cancers. The progesterone-only pill does not increase the risk of blood clots, but it may cause irregular menstrual periods. It may take a few weeks or even months for fertility to return to normal after long-term use of birth control pills.<\/p>\n<h2>Intrauterine Devices<\/h2>\n<p>An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5359\">intrauterine device (IUD)<\/a><\/strong> is a T-shaped or coiled plastic structure that is inserted into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5102\">uterus<\/a> via the vagina and cervix that contains either copper or a hormone. You can see an IUD in the uterus in the drawing of the female reproductive system in Figure 18.11.6. An IUD is inserted by a physician and may be left in place for months or even years. A physician also must remove an IUD, using the strings attached to the device. The copper in copper IUDs prevents pregnancy by interfering with the movement of sperm so they cannot reach and fertilize an egg. The copper may also prevent implantation in the unlikely circumstance of a sperm managing to reach and fertilize an ovum, in which case the blastocyst\/zygote would be shed during menstruation. The hormones in hormonal IUDs prevent pregnancy by thickening cervical mucus and trapping sperm. The hormones may also interfere with ovulation, so there is no egg to fertilize.<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1856\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0585_IUD.png\" alt=\"18.11.6 Intra-Uterine Device\" width=\"500\" height=\"375\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.6 An IUD is placed inside the uterus by a doctor and left in place to provide long-acting but reversible contraception.<\/em><\/figcaption><\/figure>\n<p>For both types of IUDs, the failure rates are &lt;1%, and failure rates with typical use are virtually the same as failure rates with perfect use. Their effectiveness is one reason that IUDs are among the most widely used forms of reversible contraception. Once removed, even after long-term use, fertility returns to normal immediately. On the other hand, IUDs do have a risk of complications, including increased menstrual bleeding and more painful menstrual cramps. IUDs are also occasionally expelled from the uterus, and there is a slight risk of perforation of the uterus by the IUD.<\/p>\n<h2>Behavioural Methods<\/h2>\n<p>The least effective methods of contraception are <strong>behavioural methods<\/strong>. They involve regulating the timing or method of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present. Behavioural methods include fertility awareness methods and withdrawal. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5361\">Abstinence<\/a> from sexual activity, or at least from vaginal intercourse, is sometimes considered a behavioural method, as well \u2014 but it is unlikely to be practiced consistently enough by most people to prevent pregnancy. Even teens who receive abstinence-only sex education do not have reduced rates of pregnancy. Abstinence is also ineffective in cases of non-consensual sex.<\/p>\n<h3>Fertility Awareness Methods<\/h3>\n<p><strong>Fertility awareness methods<\/strong> involve estimating the most fertile days of the menstrual cycle and then avoiding unprotected vaginal intercourse on those days. The most fertile days are generally a few days before ovulation occurs, the day of ovulation, and another day or two after that. Unless unprotected sex occurs on those days, pregnancy is unlikely. Techniques for estimating the most fertile days include monitoring and detecting minor changes in basal body temperature or cervical secretions. This requires daily motivation and diligence, so it is not surprising that typical-use failure rates of these methods are at least 20\u201325%, and for some individuals may be as high as using no contraception at all (85%).<\/p>\n<p>Basal body temperature is the lowest body temperature when the body is at rest (usually during sleep). It is most often estimated by a temperature measurement taken immediately upon awakening in the morning and before any physical activity has occurred. Basal body temperature normally rises after ovulation occurs, as shown in the graph below (Figure 18.11.7). The increase in temperature is small but consistent and may be used to determine when ovulation occurs, around which time unprotected intercourse should be avoided to prevent pregnancy. However, basal body temperature only shows when ovulation has already occurred, and it cannot predict in advance when ovulation will occur. Sperm can live for up to a week in the female reproductive tract, so determining the occurrence of ovulation only after ovulation has already happened is a major drawback of this method.<\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1857 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Basal_Body_Temperature-1-e1593220170819.png\" alt=\"18.11.7 Basal Body Temperature\" width=\"800\" height=\"254\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.7 A woman\u2019s basal body temperature rises slightly when ovulation occurs and stays slightly elevated until the start of the next menstrual period.<\/em><\/figcaption><\/figure>\n<p>Monitoring cervical mucus has the potential for being more effective than monitoring basal body temperature, because it can predict ovulation ahead of time. As ovulation approaches, cervical secretions usually increase in amount and become thinner (which helps sperm swim through the cervical canal). By recognizing the changing characteristics of cervical mucus, a woman\u00a0may be able to\u00a0predict when she will ovulate. From this information, she can determine\u00a0when\u00a0she should avoid unprotected sex to prevent pregnancy.<\/p>\n<h3>Withdrawal<\/h3>\n<p><strong>Withdrawal<\/strong> (also called coitus interruptus) is the practice of withdrawing the penis from the vagina before <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5150\">ejaculation<\/a> ensues. The main risk of the withdrawal method is that the man may not perform the maneuver correctly or in a timely manner. Fluid typically released from the penis before ejaculation occurs may also contain some sperm. In addition, if sperm are ejaculated just outside of the vagina, there is a chance they will be able to enter the vagina and travel through the female reproductive tract to fertilize an egg. For all these reasons, the withdrawal method has a relatively high failure rate of about 22% with typical use.<\/p>\n<h2>Sterilization<\/h2>\n<p>The most effective contraceptive method is\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5363\">sterilization<\/a>.<\/strong>\u00a0In both sexes, sterilization generally involves surgical procedures that are considered irreversible. Additional surgery may be able to reverse a sterilization procedure, but there are no guarantees. Male sterilization is generally less invasive and less risky than female sterilization.<\/p>\n<h3>Male Sterilization<\/h3>\n<p>Male sterilization is usually achieved with a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5364\">vasectomy<\/a>.<\/strong> In this surgery, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5095\"><em>vas deferens<\/em><\/a> from each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3486\">testis<\/a> is clamped, cut, or otherwise sealed (see Figure 18.11.8). This prevents sperm from traveling from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5090\">epididymis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5174\">ejaculatory duct<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\">\u00a0and being ejaculated from the penis. The same amount of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4885\">semen<\/a> will still be ejaculated, but it will not contain any sperm, making fertilization impossible. After a vasectomy, the testes continue to produce sperm, but the sperm are reabsorbed. It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. In the meantime, another method of birth control should be used.<\/span><\/p>\n<figure id=\"attachment_1858\" aria-describedby=\"caption-attachment-1858\" style=\"width: 463px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1858\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Open_Vasectomy_.jpeg\" alt=\"18.11.8 Vasectomy\" width=\"463\" height=\"500\"><figcaption id=\"caption-attachment-1858\" class=\"wp-caption-text\"><em>Figure 18.11.8 The vasectomy cuts and seals the vas deferens between the epididymis and seminal vesicles so that sperm have no path out of the body.<\/em><\/figcaption><\/figure>\n<h3>Female Sterilization<\/h3>\n<p>The procedure undertaken for female sterilization is usually\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5366\">tubal ligation<\/a>.<\/strong> The oviducts may be tied or cut in a surgical procedure, which permanently blocks the tubes. Alternatively, tiny metal implants may be inserted into the oviducts in a nonsurgical procedure. Over time, scar tissue grows around the implants and permanently blocks the tubes. Either method stops eggs from traveling from the ovaries through the oviducts, where fertilization usually takes place.<\/p>\n<h2>Emergency Contraception<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5367\">Emergency contraception<\/a><\/strong> is any form of contraception that is used after unprotected vaginal intercourse. One method is the so-called \u201cmorning-after\u201d pill. This is essentially a high-dose birth control pill that helps prevent pregnancy by temporarily preventing ovulation. It works only if ovulation has not already occurred, and when taken within five days after unprotected sex. The sooner the pill is taken, the more likely it is to work. Another method of emergency contraception is the IUD. An IUD that is inserted up to five days after unprotected sex can prevent nearly 100% of pregnancies. It keeps sperm from reaching and fertilizing an egg, or inhibits implantation if an ovum has already been fertilized. The IUD can then be left in place to prevent future pregnancies.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.11 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>More than half of all fertile couples worldwide use contraception (birth control), which is any method or device used to prevent pregnancy. Different methods of contraception vary in their effectiveness, typically expressed as the failure rate, or the percentage of women who become pregnant using a given method during the first year of use. For most methods, the failure rate with typical use is much higher than the failure rate with perfect use.<\/li>\n<li>Types of birth control methods include barrier methods, hormonal methods, intrauterine devices, behavioural methods, and sterilization. Except for sterilization, all of the methods are reversible. All of the methods have health risks, but they are less than the risks of pregnancy.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5351\">Barrier methods<\/a> are devices that block sperm from entering the uterus. They include condoms and diaphragms. Of all birth control methods, only condoms can prevent the spread of sexually transmitted infections in addition to pregnancy.<\/li>\n<li>Hormonal methods involve the administration of hormones to prevent <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5239\">ovulation<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2218\">Hormones<\/a> can be administered in various ways, such as in an injection, through a skin patch, or \u2014 most commonly \u2014 in birth control pills. There are two types of birth control pills: those that contain estrogen and progesterone, and those that contain only progesterone. Both types are equally effective, but they have different potential side effects.<\/li>\n<li>An <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5359\">intrauterine device (IUD)<\/a> is a small T-shaped plastic structure containing copper or a hormone that is inserted into the uterus by a physician and left in place for months or even years. It is highly effective even with typical use, but it does have some risks, such as increased menstrual bleeding and, rarely, perforation of the uterus.<\/li>\n<li>Behavioural methods involve regulating the timing or method of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present. In fertility awareness methods, unprotected intercourse is avoided during the most fertile days of the cycle, as estimated by basal body temperature or the characteristics of cervical mucus. In withdrawal (coitus interruptus), the penis is withdrawn from the vagina before ejaculation occurs. Behavioural methods are the least effective methods of contraception.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5363\">Sterilization<\/a> is the most effective contraceptive method, but it requires a surgical procedure and may be irreversible. Male sterility is usually achieved with a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5364\">vasectomy<\/a>, in which the <em>vas deferens<\/em> are clamped or cut to prevent sperm from being ejaculated in semen. Female sterility is usually achieved with a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5366\">tubal ligation<\/a>, in which the oviducts\u00a0 are clamped or cut to prevent sperm from reaching and fertilizing eggs.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_5367\">Emergency contraception<\/a> is any form of contraception used after unprotected vaginal intercourse. One method is the \u201cmorning after\u201d pill, which is a high-dose birth control pill that can be taken up to five days after unprotected sex. Another method is an IUD, which can be inserted up to five days after unprotected sex.<\/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\">18.11\u00a0 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-365\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-365\" class=\"h5p-iframe\" data-content-id=\"365\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.11 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>How is the effectiveness of contraceptive methods typically measured?<\/li>\n<li>What is an IUD?<\/li>\n<li>Discuss sterilization as a birth control method. Compare sterilization in males and females.<\/li>\n<li>What is emergency contraception? When is it used? What are two forms of emergency contraception?<\/li>\n<li>How does the thickness of cervical mucus relate to fertility?\u00a0How do two methods of contraception take advantage of this relationship?<\/li>\n<li>If a newly developed method of contraception had a 35% failure rate, would you consider this to be an effective method? 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\">18.11 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/Zx8zbTMTncs<\/p>\n<p style=\"text-align: center\">How do contraceptives work? - NWHunter, TED-Ed, 2016.<\/p>\n<p>https:\/\/youtu.be\/jdr1yDO7MoY<\/p>\n<p style=\"text-align: center\">The History Of Birth Control | TIME, 2015.<\/p>\n<p>https:\/\/youtu.be\/vIaL5QiKbWI<\/p>\n<p style=\"text-align: center\">Finally, A Male Pill? SciShow, 2012.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.11.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Marie_Stopes.jpg\" rel=\"cc:attributionURL\">512px-Marie_Stopes<\/a> [cropped] by <a class=\"mw-userlink\" title=\"User:AdamBMorgan\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:AdamBMorgan\">AdamBMorgan<\/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>\u00a0(Original by Unknown author: <a title=\"File:Marie Stopes in her laboratory, 1904.jpg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Marie_Stopes_in_her_laboratory,_1904.jpg\">File:Marie Stopes in her laboratory, 1904.jpg).<\/a><\/p>\n<p><strong>Figure 18.11.2<\/strong><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Effectivenessofcontraceptives.png\" rel=\"cc:attributionURL\"><br \/>\nEffectivenessofcontraceptives<\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0by <a href=\"https:\/\/www.cdc.gov\/reproductivehealth\/UnintendedPregnancy\/PDF\/effectiveness_of_contraceptive_methods.pdf\">Center for Disease Control and Prevention<\/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).<\/span><\/p>\n<p><strong>Figure 18.11.3<\/strong><\/p>\n<p><a href=\"https:\/\/images.unsplash.com\/photo-1576071804486-b8bc22106dbf?ixlib=rb-1.2.1&amp;ixid=MnwxMjA3fDB8MHxwaG90by1wYWdlfHx8fGVufDB8fHx8&amp;auto=format&amp;fit=crop&amp;w=1208&amp;q=80\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\" data-linkindex=\"18\">Condom<\/a>\u00a0by \u00a0<a href=\"https:\/\/unsplash.com\/@rhsupplies\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\" data-linkindex=\"19\">Reproductive Health Supplies Coalition\u00a0<\/a>on\u00a0<a href=\"https:\/\/unsplash.com\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\" data-linkindex=\"20\">Unsplash<\/a>\u00a0is used under the\u00a0<a href=\"https:\/\/unsplash.com\/license\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\" data-linkindex=\"21\">Unsplash License<\/a>\u00a0(<a href=\"https:\/\/unsplash.com\/license\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\" data-linkindex=\"22\">https:\/\/unsplash.com\/license<\/a>).<\/p>\n<p><strong>Figure 18.11.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Pr%C3%A9servatif_f%C3%A9minin.jpg\" rel=\"cc:attributionURL\">Female condom<\/a> by <a class=\"new\" title=\"User:Ceridwen (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Ceridwen&amp;action=edit&amp;redlink=1\">Ceridwen<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/fr\/deed.en\">CC BY-SA 2.0 FR<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/fr\/deed.en) license.<\/p>\n<p><strong>Figure 18.11.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Contraceptive_diaphragm.jpg\" rel=\"cc:attributionURL\">Contraceptive_diaphragm<\/a> by <a class=\"new\" title=\"User:Axefan2 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Axefan2&amp;action=edit&amp;redlink=1\">Axefan2<\/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).<\/p>\n<p><strong>Figure 18.11.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0585_IUD.png\" rel=\"cc:attributionURL\">1024px-Blausen_0585_IUD<\/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 18.11.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Basal_Body_Temperature.png\" rel=\"cc:attributionURL\">Basal_Body_Temperature<\/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 18.11.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Open_Vasectomy_.jpeg\" rel=\"cc:attributionURL\">1024px-Open_Vasectomy_<\/a> by <a title=\"User:Timdwilliamson\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Timdwilliamson\">Timdwilliamson<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\">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\">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\">SciShow. (2012, August 16). Finally, a male pill? YouTube. https:\/\/www.youtube.com\/watch?v=vIaL5QiKbWI&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Stopes, M. (1918). Married love. <i>Wikisource.<\/i>\u00a0https:\/\/en.wikisource.org\/w\/index.php?title=Married_Love&amp;oldid=6230157 (Originally published with Preface and Notes by William J. Robinson, by The Critic and Guide Company. This book was banned in the United States until 1933.)<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, September). How do contraceptives work? - NWHunter. YouTube. https:\/\/www.youtube.com\/watch?v=Zx8zbTMTncs&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Time. (2015, January 30). The history of birth control | TIME. YouTube. https:\/\/www.youtube.com\/watch?v=jdr1yDO7MoY&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, August 9). Marie Stopes. In\u00a0<i>Wikipedia. <\/i>https:\/\/en.wikipedia.org\/w\/index.php?title=Marie_Stopes&amp;oldid=972063381<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_3015\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3015\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1617\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/512px-Tonsillitis.jpg\" alt=\"17.3.1 Tonsilitis\" width=\"400\" height=\"305\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.1 Ouch! Tonsillitis can be very painful.\u00a0<\/em><\/figcaption><\/figure>\n<div>\n<h1>Tonsillitis<\/h1>\n<\/div>\n<p>The white patches on either side of the throat in Figure 17.3.1 are signs of tonsillitis. The tonsils are small structures in the throat that are very common sites of infection. The white spots on the tonsils pictured here are evidence of infection. The patches consist of large amounts of dead bacteria, cellular debris, and white blood cells \u2014 in a word: pus. Children with recurrent tonsillitis may have their tonsils removed surgically to eliminate this type of infection. The tonsils are organs of the lymphatic system.<\/p>\n<div>\n<h1>What Is the Lymphatic System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2911\">lymphatic system<\/a><\/strong>\u00a0is a collection of organs involved in the production, maturation, and harboring of white\u00a0blood\u00a0cells\u00a0called lymphocytes. It also includes a network of vessels that transport or filter the fluid known as\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4552\">lymph<\/a><\/strong> in which lymphocytes circulate. Figure 17.3.2 shows major lymphatic vessels and other structures that make up the lymphatic system. Besides the tonsils, organs of the lymphatic system include the thymus, the spleen, and hundreds of lymph nodes distributed along the lymphatic vessels.<\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1619\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0623_LymphaticSystem_Female.png\" alt=\"17.3.2 Lymphatic System\" width=\"1024\" height=\"945\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.2 The lymphatic system includes organs such as the thymus and spleen, as well as a body-wide network of vessels that transport lymph.<\/em><\/figcaption><\/figure>\n<p>The lymphatic vessels form a transportation network similar in many respects to the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2448\">blood vessel<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\">\u00a0of the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2571\">cardiovascular system<\/a>. However, unlike the cardiovascular system, the lymphatic system is not a closed system. Instead, lymphatic vessels carry lymph in a <em>single<\/em> direction \u2014 always toward the upper chest, where the lymph empties from lymphatic vessels into blood vessels.<\/span><\/p>\n<div>\n<h1>Cardiovascular Function of the Lymphatic System<\/h1>\n<\/div>\n<p>The return of lymph to the bloodstream is one of the major functions of the lymphatic system. When blood travels through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2566\">capillaries<\/a> of the cardiovascular system, it is under pressure, which forces some of the components of blood (such as water, oxygen, and nutrients) through the walls of the capillaries and into the tissue spaces between cells, forming tissue fluid, also called interstitial fluid (see Figure 17.3.3). Interstitial fluid bathes and nourishes cells, and also absorbs their waste products. Much of the water from interstitial fluid is reabsorbed into the capillary blood by osmosis. Most of the remaining fluid is absorbed by tiny lymphatic vessels called lymph capillaries. Once interstitial fluid enters the lymphatic vessels, it is called lymph. Lymph is very similar in composition to blood plasma. Besides water, lymph may contain proteins, waste products, cellular debris, and pathogens. It also contains numerous white blood cells, especially the subset of white blood cells known as lymphocytes. In fact, lymphocytes are the main cellular components of lymph.<\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 482px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1620 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2201_Anatomy_of_the_Lymphatic_System-1-e1592718747447.jpg\" alt=\"17.3.3 Interstitial Fluid\" width=\"482\" height=\"292\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.3 Fluid and other substances in blood are forced by blood pressure through the walls of capillaries and into the surrounding tissue spaces. Some of the tissue fluid is absorbed by tiny lymphatic vessels, forming lymph. The arrows show the direction of lymph through the\u00a0 lymphatic vessels.<\/em><\/figcaption><\/figure>\n<p>The lymph that enters lymph capillaries in tissues is transported through the lymphatic vessel network to two large lymphatic ducts in the upper chest. From there, the lymph flows into two major veins (called subclavian veins) of the cardiovascular system. Unlike blood, lymph is not pumped through its network of vessels. Instead, lymph moves through lymphatic vessels via a combination of contractions of the vessels themselves and the forces applied to the vessels externally by skeletal muscles, similarly to how blood moves through veins. Lymphatic vessels also contain numerous valves that keep lymph flowing in just one direction, thereby preventing backflow.<\/p>\n<div>\n<h1>Digestive Function of the Lymphatic System<\/h1>\n<\/div>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 253px\" class=\"wp-caption alignright\"><img class=\" wp-image-1621\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Intestinal_villus_simplified.svg_.png\" alt=\"17.3.4 Lacteals\" width=\"253\" height=\"322\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.4 Vessels called lacteals in the villi lining the small intestine are the main way that fatty acids from digestion are absorbed from the gastrointestinal tract. These nutrients eventually reach the blood circulation after traveling through the network of lymphatic vessels.<\/em><\/figcaption><\/figure>\n<p>Lymphatic vessels called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4607\">lacteal<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\"> (see Figure 17.3.4) are present in the lining of the gastrointestinal tract, mainly in the small intestine. Each tiny <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4543\">villus<\/a> in the lining of the small intestine has an internal bed of capillaries and lacteals. The capillaries absorb most nutrients from the digestion of food into the blood. The lacteals absorb mainly fatty acids from lipid digestion into the lymph, forming a fatty-acid-enriched fluid called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4844\">chyle<\/a>. Vessels of the lymphatic network then transport chyle from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4559\">small intestine<\/a> to the main lymphatic ducts in the chest, from which it drains into the blood circulation. The nutrients in chyle then circulate in the blood to the liver, where they are processed along with the other nutrients that reach the liver directly via the bloodstream.<\/span><\/p>\n<div>\n<h1>Immune Function of the Lymphatic System<\/h1>\n<\/div>\n<p>The primary immune function of the lymphatic system is to protect the body against pathogens and cancerous cells. This function of the lymphatic system is centred on the production, maturation, and circulation of lymphocytes. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4832\">Lymphocyte<\/strong><strong style=\"font-size: 1em\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0are leukocytes that are involved in the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a>. They are responsible for the recognition of \u2014 and tailored defense against \u2014 specific pathogens or tumor cells. Lymphocytes may also create a lasting memory of pathogens, so they can be attacked quickly and strongly if they ever invade the body again. In this way, lymphocytes bring about long-lasting\u00a0immunity\u00a0to specific pathogens.<\/span><\/p>\n<p>There are two major types of lymphocytes, called B cells and T cells. Both B cells and T cells are involved in the adaptive immune response, but they play different roles.<\/p>\n<h2>Production and Maturation of Lymphocytes<\/h2>\n<p>Like all other types of blood cells (including erythrocytes), both B cells and T cells are produced from stem cells in the red marrow inside bones. After lymphocytes first form, they must go through a complicated maturation process before they are ready to search for pathogens. In this maturation process, they \u201clearn\u201d to distinguish self from non-self. Only those lymphocytes that successfully complete this maturation process go on to actually fight infections by pathogens.<\/p>\n<p>B cells mature in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4021\">bone marrow<\/a>, which is why they are called B cells. After they mature and leave the bone marrow, they travel first to the\u00a0circulatory system\u00a0and then enter the lymphatic system to search for pathogens. T cells, on the other hand, mature in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4829\">thymus<\/a>, which is why they are called T cells. The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4829\">thymus<\/a><\/strong> is illustrated in Figure 17.3.5. It is a small lymphatic organ in the chest that consists of an outer cortex and inner medulla, all surrounded by a fibrous capsule. After maturing in the thymus, T cells enter the rest of the lymphatic system to join B cells in the hunt for pathogens. The bone marrow and thymus are called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4845\">primary lymphoid organ<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\">\u00a0because of their role in the production and\/or maturation of lymphocytes.<\/span><\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-1624\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2206_The_Location_Structure_and_Histology_of_the_Thymus.jpg\" alt=\"17.3.5 The Thymus\" width=\"1024\" height=\"718\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.5 The thymus is an important organ of the lymphatic system because it is the location of T cell maturation.<\/em><\/figcaption><\/figure>\n<h2>Lymphocytes in Secondary Lymphoid Organs<\/h2>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4830\">tonsil<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\">, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4831\">lymph node<\/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\">\u00a0are referred to as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4847\">secondary lymphoid organs<\/a>. These organs do not produce or mature lymphocytes. Instead, they filter lymph and store lymphocytes. It is in these secondary lymphoid organs that pathogens (or their antigens) activate lymphocytes and initiate adaptive immune responses. Activation leads to\u00a0cloning\u00a0of pathogen-specific lymphocytes, which then circulate between the lymphatic system and the blood, searching for and destroying their specific pathogens by producing antibodies against them.<\/span><\/p>\n<h3>Tonsils<\/h3>\n<p>There are four pairs of human <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4830\">tonsil<\/strong><strong style=\"font-size: 1em\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a>.<\/strong><span style=\"text-align: initial;font-size: 1em\"> Three of the four are shown in Figure 17.3.6. The fourth pair, called tubal tonsils, is located at the back of the nasopharynx. The palatine tonsils are the tonsils that are visible on either side of the throat. All four pairs of tonsils encircle a part of the anatomy where the respiratory and gastrointestinal tracts intersect, and where pathogens have ready access to the body. This ring of tonsils is called Waldeyer's ring.<\/span><\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 488px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1625\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0861_TonsilsThroat_Anatomy2.png\" alt=\"17.3.6 Tonsils\" width=\"488\" height=\"488\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.6 Three of four pairs of human tonsils are shown in this figure.<\/em><\/figcaption><\/figure>\n<h3>Spleen<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4497\">spleen<\/a><\/strong> (Figure 17.3.7) is the largest of the secondary lymphoid organs, and is centrally located in the body. Besides harboring <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4832\">lymphocyte<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\">\u00a0and filtering <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4552\">lymph<\/a>, the spleen also filters <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2702\">blood<\/a>. Most dead or aged erythrocytes are removed from the blood in the red pulp of the spleen. Lymph is filtered in the white pulp of the spleen. In the fetus, the spleen has the additional function of producing red blood cells. This function is taken over by bone marrow after birth.<\/span><\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 544px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1627\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Figure_42_02_14.jpg\" alt=\"17.3.7 The Spleen\" width=\"544\" height=\"581\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.7 The spleen is a secondary lymphoid organ, where pathogens are likely to encounter lymphocytes and trigger an adaptive immune response.<\/em><\/figcaption><\/figure>\n<h3>Lymph Nodes<\/h3>\n<p>Each\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4831\">lymph node<\/a><\/strong> is a small, but organized collection of lymphoid tissue (see Figure 17.3.8) that contains many lymphocytes. Lymph nodes are located at intervals along the lymphatic vessels, and lymph passes through them on its way back to the blood.<\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 465px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1628\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Illu_lymph_node_structure.png\" alt=\"17.3.8 Lymph Node\" width=\"465\" height=\"265\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.8 Lymph flows through lymph nodes like this one before returning to the blood.<\/em><\/figcaption><\/figure>\n<p>There are at least 500 lymph nodes in the human body. Many of them are clustered at the base of the limbs and in the neck. Figure 17.3.9 shows the major lymph node concentrations, and includes the spleen and the region named Waldeyer\u2019s ring, which consists of the tonsils.<\/p>\n<figure id=\"attachment_1631\" aria-describedby=\"caption-attachment-1631\" style=\"width: 464px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1631\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Lymph_node_regions.svg_.png\" alt=\"17.3.9 Lymph Node Regions\" width=\"464\" height=\"663\"><figcaption id=\"caption-attachment-1631\" class=\"wp-caption-text\"><em>Figure 17.3.9 In this diagram, lymph node regions are shown for the left side of the body only. The same regions are also found on the right side of the body.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Feature: Myth vs. Reality<\/h1>\n<\/div>\n<p>When lymph nodes become enlarged and tender to the touch, they are obvious signs of immune system activity. Because it is easy to see and feel swollen lymph nodes, they are one way an individual can monitor his or her own health. To be useful in this way, it is important to know the myths and realities about swollen lymph nodes.<\/p>\n<p>&nbsp;<\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%;height: 374px\" border=\"0\">\n<tbody>\n<tr style=\"height: 63px\">\n<td style=\"width: 37.9081%;height: 63px\">\n<h2><span style=\"color: #ff0000\">Myth<\/span><\/h2>\n<p>&nbsp;<\/td>\n<td style=\"width: 62.0919%;height: 63px\">\n<h2><span style=\"color: #339966\">Reality<\/span><\/h2>\n<p>&nbsp;<\/td>\n<\/tr>\n<tr style=\"height: 111px\">\n<td style=\"width: 37.9081%;height: 111px\"><em><span style=\"font-size: 16px\">\"You should see a doctor immediately whenever you have swollen lymph nodes.\"<\/span><\/em><\/td>\n<td style=\"width: 62.0919%;height: 111px\"><strong><span style=\"font-size: 16px\">Lymph nodes are constantly filtering lymph, so it is expected that they will change in size with varying amounts of debris or pathogens that may be present. A minor, unnoticed infection may cause swollen lymph nodes that may last for a few weeks. Generally, lymph nodes that return to their normal size within two or three weeks are not a cause for concern.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 111px\">\n<td style=\"width: 37.9081%;height: 111px\"><em><span style=\"font-size: 16px\">\"Swollen lymph nodes mean you have a bacterial infection.\"<\/span><\/em><\/td>\n<td style=\"width: 62.0919%;height: 111px\"><strong><span style=\"font-size: 16px\">Although an infection is the most common cause of swollen lymph nodes, not\u00a0<\/span><em style=\"font-size: 16px\">all<\/em><span style=\"font-size: 16px\">\u00a0infections are caused by\u00a0bacteria. Mononucleosis, for example, commonly causes swollen lymph nodes, and it is caused by viruses. There are also other causes of swollen lymph nodes besides infections, such as\u00a0cancer\u00a0and certain medications.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 79px\">\n<td style=\"width: 37.9081%;height: 79px\"><em><span style=\"font-size: 16px\">\"A swollen lymph node means you have cancer.\"<\/span><\/em><\/td>\n<td style=\"width: 62.0919%;height: 79px\"><strong><span style=\"font-size: 16px\">Cancer\u00a0is far less likely to be the cause of a swollen lymph node than is an infection. However, if a lymph node remains swollen longer than a few weeks \u2014 especially in the absence of an apparent infection \u2014 you should have your doctor check it.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 63px\">\n<td style=\"width: 37.9081%;height: 63px\"><em><span style=\"font-size: 16px\">\"Cancer in a lymph node always originates somewhere else. There is no cancer of the lymph nodes.\"<\/span><\/em><\/td>\n<td style=\"width: 62.0919%;height: 63px\"><strong><span style=\"font-size: 16px\">Cancers do commonly spread from their site of origin to nearby lymph nodes and then to other organs, but cancer may also originate in the lymph nodes. This type of cancer is called lymphoma.<\/span><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\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\">17.3 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_4782_2911\">lymphatic system<\/a> is a collection of organs involved in the production, maturation, and harboring of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2172\">leukocytes<\/a>\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4832\">lymphocytes<\/a>. It also includes a network of vessels that transport or filter the fluid called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4552\">lymph<\/a> in which lymphocytes circulate.<\/li>\n<li>The return of lymph to the bloodstream is one of the functions of the lymphatic system. Lymph flows from tissue spaces \u2014 where it leaks out of blood vessels \u2014 to the subclavian veins in the upper chest, where it is returned to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2571\">cardiovascular system<\/a>. Lymph is similar in composition to blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4395\">plasma<\/a>. Its main cellular components are lymphocytes.<\/li>\n<li>Lymphatic vessels called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4607\">lacteals<\/a>\u00a0are found in villi that line the\u00a0small intestine. Lacteals absorb fatty acids from the digestion of\u00a0lipids\u00a0in the\u00a0digestive system. The fatty acids are then transported through the network of lymphatic vessels to the bloodstream.<\/li>\n<li>The primary immune function of the lymphatic system is\u00a0to protect the body against pathogens and cancerous cells. It is responsible for producing mature lymphocytes and circulating them in lymph. Lymphocytes, which include B cells and T cells, are the subset of white blood cells involved in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune responses<\/a>. They may create a lasting memory of and\u00a0immunity\u00a0to specific pathogens.<\/li>\n<li>All lymphocytes are produced in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4021\">bone marrow<\/a> and then go through a process of maturation in which they \u201clearn\u201d to distinguish self from non-self. B cells mature in the bone marrow, and T cells mature in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4829\">thymus<\/a>. Both the bone marrow and thymus are considered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4845\">primary lymphatic organs<\/a>.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4847\">Secondary lymphatic organs<\/a>\u00a0include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4830\">tonsils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4831\">lymph nodes<\/a>. There are four pairs of tonsils that encircle the throat. The spleen filters blood, as well as lymph. There are hundreds of lymph nodes located in clusters along the lymphatic vessels. All of these secondary organs filter lymph and store lymphocytes, so they are sites where pathogens encounter and activate lymphocytes and initiate adaptive immune responses.<\/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\">17.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the lymphatic system?<\/li>\n<li>\n<div id=\"h5p-328\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-328\" class=\"h5p-iframe\" data-content-id=\"328\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"17.3 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Summarize the immune function of the lymphatic system.<\/li>\n<li>Explain the difference between lymphocyte maturation and lymphocyte activation.<\/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\">17.3 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/RMLPwOiYnII<\/p>\n<p style=\"text-align: center\">What is Lymphoedema or Lymphedema? Compton Care, 2016.<\/p>\n<p>https:\/\/youtu.be\/ah74jT00jBA<\/p>\n<p style=\"text-align: center\">Spleen physiology What does the spleen do in 2 minutes, Simple Nursing, 2015.<\/p>\n<p>https:\/\/youtu.be\/L4KexZZAdyA<\/p>\n<p style=\"text-align: center\">How to check your lymph nodes, University Hospitals Bristol and Weston NHS FT, 2020.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.3.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Tonsillitis.jpg\" rel=\"cc:attributionURL\">512px-Tonsillitis<\/a> by <a class=\"extiw\" title=\"wikipedia:User:Michaelbladon\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Michaelbladon\">Michaelbladon<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"wikipedia:\" href=\"https:\/\/en.wikipedia.org\/wiki\/\">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). \u00a0(Transferred from\u00a0<span class=\"plainlinks\"><a class=\"external text\" href=\"https:\/\/en.wikipedia.org\/\">en.wikipedia<\/a><\/span> to Commons by <a class=\"mw-userlink\" title=\"User:Kauczuk\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Kauczuk\">Kauczuk<\/a>)<\/p>\n<p><strong>Figure 17.3.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0623_LymphaticSystem_Female.png\" rel=\"cc:attributionURL\">Blausen_0623_LymphaticSystem_Female<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0 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 17.3.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2201_Anatomy_of_the_Lymphatic_System.jpg\" rel=\"cc:attributionURL\">2201_Anatomy_of_the_Lymphatic_System<\/a> (cropped)\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems\">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 17.3.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Intestinal_villus_simplified.svg\" rel=\"cc:attributionURL\">1000px-Intestinal_villus_simplified.svg<\/a> by <a title=\"User:Snow93\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Snow93\">Snow93<\/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 17.3.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2206_The_Location_Structure_and_Histology_of_the_Thymus.jpg\" rel=\"cc:attributionURL\">2206_The_Location_Structure_and_Histology_of_the_Thymus<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems\">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 17.3.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0861_Tonsils%26Throat_Anatomy2.png\" rel=\"cc:attributionURL\">Blausen_0861_Tonsils&amp;Throat_Anatomy2<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0 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 17.3.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_42_02_14.jpg\" rel=\"cc:attributionURL\">Figure_42_02_14<\/a>\u00a0by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.8:etZobsU-@6\/Adaptive-Immune-Response\">CNX 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) license.<\/p>\n<p><strong>Figure 17.3.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Illu_lymph_node_structure.png\" rel=\"cc:attributionURL\">Illu_lymph_node_structure<\/a> by <a href=\"https:\/\/training.seer.cancer.gov\/anatomy\/lymphatic\/components\/nodes.html\">NCI\/ SEER<\/a> Training 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). (Archives: https:\/\/web.archive.org\/web\/20070311015818\/http:\/\/training.seer.cancer.gov\/module_anatomy\/unit8_2_lymph_compo1_nodes.html)<\/p>\n<p><strong>Figure 17.3.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Lymph_node_regions.svg\" rel=\"cc:attributionURL\">1000px-Lymph_node_regions.svg<\/a> by <a title=\"User:Fred the Oyster\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fred_the_Oyster\">Fred the Oyster<\/a> (derivative work) 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). (Original by <a href=\"https:\/\/training.seer.cancer.gov\/lymphoma\/anatomy\/lymph-nodes.html\">NCI\/ SEER<\/a> Training)<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" 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=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" data-highlighted=\"true\">21.2<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"93337\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" data-highlighted=\"true\">Anatomy of the lymphatic system<\/span><\/span><span class=\"os-divider\">\u00a0<\/span>[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 21.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597689412024\" data-highlight-id=\"765c359c-d30b-4bbe-839d-a71c956f03e0\" 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 class=\"os-number\">21.7<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"32303\" class=\"os-title\" data-type=\"title\">Location, structure, and histology of the thymus<\/span> <\/span>[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 21.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-1-anatomy-of-the-lymphatic-and-immune-systems<\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014\".\u00a0<em>WikiJournal of Medicine\u00a01\u00a0<\/em>(2).\u00a0DOI:10.15347\/wjm\/2014.010.\u00a0ISSN\u00a02002-4436<\/p>\n<p class=\"hanging-indent\">Compton Care. (2016, March 7). What is lymphoedema or lymphedema? YouTube. https:\/\/www.youtube.com\/watch?v=RMLPwOiYnII&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">OpenStax. (2016, May 27) Figure 14. The spleen is similar to a lymph node but is much larger and filters blood instead of lymph [digital image]. In <em>Open Stax, Biology<\/em> (Section 42.2). OpenStax CNX.\u00a0 https:\/\/cnx.org\/contents\/GFy_h8cu@10.8:etZobsU-@6\/Adaptive-Immune-Response<\/p>\n<p class=\"hanging-indent\">Simple Nursing. (2015, June 28). Spleen physiology What does the spleen do in 2 minutes. YouTube. https:\/\/www.youtube.com\/watch?v=ah74jT00jBA&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">University Hospitals Bristol and Weston NHS FT. (2020, May 13). How to check your lymph nodes. YouTube. https:\/\/www.youtube.com\/watch?v=L4KexZZAdyA&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_4782_3016\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3016\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1636\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Oww_Papercut_14365.jpg\" alt=\"17.4.1 Paper Cut\" width=\"400\" height=\"250\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.1 Darn it!\u00a0 Paper cuts are the worst!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Paper Cut<\/h1>\n<\/div>\n<p>It\u2019s just a paper cut, but the break in your skin could provide an easy way for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2405\">pathogen<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\">\u00a0to enter your body. If\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2588\">bacteria<\/a>\u00a0were to enter through the cut and infect the wound, your innate immune system would quickly respond with a dizzying array of general defenses.<\/span><\/p>\n<div>\n<h1>What Is the Innate Immune System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4820\">innate immune system<\/a><\/strong>\u00a0is a subset of the human immune system that produces rapid, but non-specific responses to pathogens. Innate responses are generic, rather than tailored to a particular\u00a0pathogen. The innate system responds in the same general way to every pathogen\u00a0it encounters. Although the innate immune system provides immediate and rapid defenses against pathogens, it does not confer long-lasting\u00a0immunity\u00a0to them. In most organisms, the innate immune system is the dominant system of host defense. Other than most vertebrates (including humans), the innate immune system is the only system of host defense.<\/p>\n<p>In humans, the innate immune system includes surface barriers, inflammation, the complement system, and a variety of cellular responses. Surface barriers of various types generally keep most pathogens out of the body. If these barriers fail, then other innate defenses are triggered. The triggering event is usually the identification of pathogens by pattern-recognition receptors on\u00a0cells\u00a0of the innate immune system. These receptors recognize molecules that are broadly shared by pathogens, but distinguishable from host molecules. Alternatively, the other innate defenses may be triggered when damaged, injured, or stressed cells send out alarm signals, many of which are recognized by the same receptors as those that recognize pathogens.<\/p>\n<div>\n<h1>Barriers to Pathogens<\/h1>\n<\/div>\n<p>The body\u2019s first line of defense consists of three different types of barriers that keep most pathogens out of\u00a0body tissues. The types of barriers are mechanical, chemical, and biological barriers.<\/p>\n<h2>Mechanical Barriers<\/h2>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 343px\" class=\"wp-caption alignleft\"><img class=\" wp-image-1637\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/hairy-nose.jpg\" alt=\"17.4.2 Hairy Nose\" width=\"343\" height=\"343\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.2 Nasal hairs are a mechanical barrier to larger particles in the air.<\/em><\/figcaption><\/figure>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4857\">Mechanical barriers<\/a> are the first line of defense against pathogens, and they physically block pathogens from entering the body. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3521\">skin<\/a> is the most important mechanical barrier. In fact, it is the single most important defense the body has. The outer layer of skin \u2014 the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2655\">epidermis<\/a>\u00a0\u2014 is tough, and very difficult for pathogens to penetrate. It consists of dead\u00a0cells\u00a0that are constantly shed from the body surface, a process that helps remove\u00a0bacteria\u00a0and other infectious agents that have adhered to the skin. The epidermis also lacks\u00a0blood vessels\u00a0and is usually lacking moisture, so it does not provide a suitable environment for most pathogens.\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3531\">Hair<\/a> \u2014 which is an accessory organ of the skin \u2014 also helps keep out pathogens. Hairs inside the nose may trap larger pathogens and other particles in the air before they can enter the airways of the respiratory system (see Figure 17.4.2).<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 422px\" class=\"wp-caption alignright\"><img class=\" wp-image-1638\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Sneeze.jpg\" alt=\"17.4.3 Sneeze\" width=\"422\" height=\"282\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.3 A sneeze can expel many pathogens from the respiratory tract, which is why you should always cover your mouth and nose and when you sneeze.<\/em><\/figcaption><\/figure>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3538\">Mucous membrane<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\"> provide a mechanical barrier to pathogens and other particles at body openings. These membranes also line the respiratory, gastrointestinal, urinary, and reproductive tracts. Mucous membranes secrete mucus, which is a slimy and somewhat sticky substance that traps pathogens. Many mucous membranes also have hair-like <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1597\">cilia<\/a> that sweep mucus and trapped pathogens toward body openings, where they can be removed from the body. When you sneeze or cough, mucus and pathogens are mechanically ejected from the nose and throat, as you can see in Figure 17.4.3.\u00a0 A sneeze can travel as fast as 160 Km\/hr (about 99 mi\/hour) and expel as many as 100,000 droplets into the air around you (a good reason to cover your sneezes!). Other mechanical defenses include tears, which wash pathogens from the eyes, and urine, which flushes pathogens out of the urinary tract.<\/span><\/p>\n<h2>Chemical Barriers<\/h2>\n<p>Chemical barriers also protect against infection by pathogens. They destroy pathogens on the outer body surface, at body openings, and on inner body linings. Sweat, mucus, tears, saliva, and breastmilk all contain antimicrobial substances (such as the\u00a0enzyme\u00a0lysozyme) that kill pathogens, especially\u00a0bacteria. Sebaceous glands in the\u00a0dermis\u00a0of the skin secrete acids that form a very fine, slightly acidic film on the surface of the skin. This film acts as a barrier to bacteria, viruses, and other potential contaminants that might penetrate the skin. Urine and vaginal secretions are also too acidic for many pathogens to endure. Semen contains zinc \u2014 which most pathogens cannot tolerate \u2014 as well as defensins, which are antimicrobial\u00a0proteins\u00a0that act mainly by disrupting bacterial cell membranes. In the stomach, stomach\u00a0acid\u00a0and digestive\u00a0enzymes\u00a0called proteases (which break down proteins) kill most of the pathogens that enter the gastrointestinal tract in food or\u00a0water.<\/p>\n<h2>Biological Barriers<\/h2>\n<p>Biological barriers are living organisms that help protect the body from pathogens. Trillions of harmless bacteria normally live on the human skin and in the urinary, reproductive, and gastrointestinal tracts. These bacteria use up food and surface space that help prevent pathogenic bacteria from colonizing the body. Some of these harmless bacteria also secrete substances that change the conditions of their environment, making it less hospitable to potentially harmful bacteria.\u00a0They may release toxins or change the\u00a0pH, for example. All of these effects of harmless bacteria reduce the chances that pathogenic microorganisms will be able to reach sufficient numbers and cause illness.<\/p>\n<div>\n<h1>Inflammation<\/h1>\n<\/div>\n<p>If pathogens manage to breach the barriers protecting the body, one of the first active responses of the innate immune system kicks in. This response is\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4860\">inflammation<\/a>.<\/strong>\u00a0The main function of inflammation is to establish a physical barrier against the spread of infection. It also eliminates the initial cause of cell injury, clears out dead\u00a0cells\u00a0and tissues damaged from the original insult and the inflammatory process, and initiates tissue repair. Inflammation is often a response to infection by pathogens, but there are other possible causes, including burns, frostbite, and exposure to toxins.<\/p>\n<p>The signs and symptoms of inflammation include redness, swelling, warmth, pain, and frequently some loss of function. These symptoms are caused by increased blood flow into infected tissue, and a number of other processes, illustrated in Figure 17.4.4.<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-1639\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/OSC_Microbio_17_06_Erythema.jpg\" alt=\"17.4.4 Inflammatory Response\" width=\"1024\" height=\"472\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.4 This drawing shows what happens during the inflammatory response.<\/em><\/figcaption><\/figure>\n<p>Inflammation is triggered by chemicals such as\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4865\">cytokines<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4866\">histamines<\/a>,<\/strong>which are released by injured or infected cells, or by immune system cells such as macrophages (described below) that are already present in tissues. These chemicals cause capillaries to dilate and become leaky, increasing blood flow to the infected area and allowing blood to enter the tissues. Pathogen-destroying leukocytes and tissue-repairing proteins migrate into tissue spaces from the bloodstream to attack pathogens and repair their damage. Cytokines also promote <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4867\">chemotaxis<\/a>, which is migration to the site of infection by pathogen-destroying leukocytes. Some cytokines have anti-viral effects. They may shut down protein synthesis in host cells, which viruses need in order to survive and replicate.<\/p>\n<p>See the video \"The inflammatory response\" by Neural Academy to learn about inflammatory response in more detail:<\/p>\n<p>https:\/\/youtu.be\/Fbzb75HA9M8<\/p>\n<p style=\"text-align: center\">The inflammatory response, Neural Academy, 2019.<\/p>\n<div>\n<h1>Complement System<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4868\">complement system<\/a><\/strong>\u00a0is a complex biochemical mechanism named for its ability to \u201ccomplement\u201d the killing of pathogens by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2215\">antibodies<\/a>, which are produced as part of an adaptive immune response. The complement system consists of more than two dozen\u00a0proteins\u00a0normally found in the\u00a0blood\u00a0and synthesized in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2989\">liver<\/a>. The proteins usually circulate as non-functional precursor molecules until activated.<\/p>\n<p>As shown in Figure 17.4.5, when the first protein in the complement series is activated \u2014typically by the binding of an antibody to an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2704\">antigen<\/a> on a pathogen \u2014 it sets in motion a domino effect. Each component takes its turn in a precise chain of steps known as the complement cascade. The end product is a cylinder that punctures a hole in the pathogen\u2019s cell membrane. This allows fluids and molecules to flow in and out of the cell, which swells and bursts.<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 643px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1641\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2212_Complement_Cascade_and_Function.jpg\" alt=\"17.4.5 Complement Cascade\" width=\"643\" height=\"673\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.5 The complement system is a cascade of proteins that complements the killing of pathogen cells by antibodies.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Cellular Responses<\/h1>\n<\/div>\n<p>Cellular responses of the innate immune system involve a variety of different types of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2172\">leukocyte<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\">. Many of these leukocytes circulate in the blood and act like independent, single-celled organisms, searching out and destroying pathogens in the human host. These and other immune cells of the innate system identify pathogens or debris, and then help to eliminate them in some way. One way is by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1680\">phagocytosis<\/a>.<\/span><\/p>\n<h2>Phagocytosis<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1680\">Phagocytosis<\/a><\/strong>\u00a0is an important feature of innate\u00a0immunity\u00a0that is performed by cells classified as phagocytes. In the process of phagocytosis, phagocytes engulf and digest pathogens or other harmful particles. Phagocytes generally patrol the body searching for pathogens, but they can also be called to specific locations by the release of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4865\">cytokine<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\">\u00a0when <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4860\">inflammation<\/a> occurs. Some phagocytes reside permanently in certain tissues.<\/span><\/p>\n<p>As shown in Figure 17.4.6, when a pathogen such as a bacterium is encountered by a phagocyte, the phagocyte extends a portion of its plasma membrane, wrapping the membrane around the pathogen until it is enveloped. Once inside the phagocyte, the pathogen becomes enclosed within an intracellular vesicle called a phagosome. The phagosome then fuses with another vesicle called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4870\">lysosome<\/a>, forming a phagolysosome. Digestive enzymes and acids from the lysosome kill and digest the pathogen in the phagolysosome. The final step of phagocytosis is excretion of soluble debris from the destroyed pathogen through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_1682\">exocytosis<\/a>.<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1642\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Phagocytosis2.png\" alt=\"17.4.6 Phagocytosis\" width=\"512\" height=\"360\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.6 Phagocytosis is a multi-step process in which a pathogen is engulfed and digested by immune cells called phagocytes.<\/em><\/figcaption><\/figure>\n<p>Types of leukocytes that kill pathogens by phagocytosis include neutrophils, macrophages, and dendritic cells. You can see illustrations of these and other leukocytes involved in innate immune responses in Figure 17.4.7.<\/p>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 292px\" class=\"wp-caption alignright\"><img class=\" wp-image-1644\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Innate_Immune_cells.svg_.png\" alt=\"17.4.7 Innate Immune Cells\" width=\"292\" height=\"684\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.7 Types of leukocytes evolved in innate immune responses are illustrated here.<\/em><\/figcaption><\/figure>\n<h2>Neutrophils<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2067\">Neutrophils<\/a><\/strong>\u00a0are leukocytes that travel throughout the body in the blood. They are usually the first immune cells to arrive at the site of an infection. They are the most numerous types of phagocytes, and they normally make up at least half of the total circulating leukocytes. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4021\">bone marrow<\/a> of a normal healthy adult produces more than 100 billion neutrophils per day. During acute inflammation, more than\u00a0<em>ten times<\/em>\u00a0that many neutrophils may be produced each day. Many neutrophils are needed to fight infections, because after a neutrophil phagocytizes just a few pathogens, it generally dies.<\/p>\n<h2>Macrophages<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4340\">Macrophage<\/strong><strong style=\"font-size: 1em\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0are large phagocytic leukocytes that develop from monocytes. Macrophages spend much of their time within the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4874\">interstitial fluid<\/a> in\u00a0body tissues. They are the most efficient phagocytes, and they can phagocytize substantial numbers of pathogens or other cells. Macrophages are also versatile cells that produce a wide array of chemicals\u00a0\u2014\u00a0including\u00a0enzymes, complement proteins, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4865\">cytokine<\/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\">\u00a0\u2014 in addition to their phagocytic action. As phagocytes, macrophages act as scavengers that rid tissues of worn-out cells and other debris, as well as pathogens. In addition, macrophages act as antigen-presenting cells that activate the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a>.<\/span><\/p>\n<h2>Dendritic Cells<\/h2>\n<p>Like macrophages,\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4875\">dendritic cells<\/a><\/strong>\u00a0develop from monocytes. They reside in tissues that have contact with the external environment, so they are located mainly in the skin, nose, lungs, stomach, and intestines. Besides engulfing and digesting pathogens, dendritic cells also act as antigen-presenting cells that trigger adaptive immune responses.<\/p>\n<h2>Eosinophils<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2045\">Eosinophils<\/a><\/strong> are non-phagocytic leukocytes that are related to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2067\">neutrophil<\/a>. They specialize in defending against <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4812\">parasites<\/a>. They are very effective in killing large parasites (such as worms) by secreting a range of highly-toxic substances when activated. Eosinophils may become overactive and cause <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4877\">allergies<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4348\">asthma<\/a>.<\/p>\n<h2>Basophils<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2103\">Basophils<\/a><\/strong>\u00a0are non-phagocytic leukocytes that are also related to neutrophils. They are the least numerous of all white blood cells. Basophils secrete two types of chemicals that aid in body defenses: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4879\"><strong>histamine<span style=\"font-size: 1em\">s<\/span><\/strong><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\"> and heparin. <\/span>Histamines<span style=\"text-align: initial;font-size: 1em\">\u00a0are responsible for dilating\u00a0blood vessels\u00a0and increasing their permeability in inflammation.\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4880\">Heparin<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0inhibits blood clotting, and also promotes the movement of leukocytes into an area of infection.<\/span><\/p>\n<h2>Mast Cells<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4881\">Mast cells<\/a><\/strong>\u00a0are non-phagocytic leukocytes that help initiate <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4860\">inflammation<\/a> by secreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4879\">histamine<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\">. In some people, histamines trigger <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4877\">allergic reactions<\/a>, as well as inflammation. Mast cells may also secrete chemicals that help defend against parasites.<\/span><\/p>\n<h2>Natural Killer Cells<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2027\">Natural killer cells<\/a><\/strong>\u00a0are in the subset of leukocytes called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4832\">lymphocyte<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\">, which are produced by the\u00a0lymphatic system. Natural killer cells destroy <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2148\">cancer<\/span><span style=\"font-size: 1em\">ous<\/span><span style=\"font-size: 1em;text-align: initial\"><\/a><\/span><span style=\"font-size: 1em;text-align: initial\">\u00a0or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4283\">virus<\/a>-infected host cells, although they do not directly attack invading pathogens. Natural killer cells recognize these host cells by a condition they exhibit called \u201cmissing self.\u201d Cells with missing self have abnormally low levels of cell-surface proteins of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4825\">major histocompatibility complex (MHC)<\/a>, which normally identify\u00a0body cells\u00a0as self.<\/span><\/p>\n<div>\n<h1>Innate Immune Evasion<\/h1>\n<\/div>\n<p>Many pathogens have evolved mechanisms that allow them to evade\u00a0human hosts'\u00a0innate immune systems. Some of these mechanisms include:<\/p>\n<ul>\n<li><strong>Invading host cells to replicate so they are \u201chidden\u201d from the immune system.<\/strong>\u00a0The bacterium that causes <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/tuberculosis\/symptoms-causes\/syc-20351250\">tuberculosis<\/a> uses this mechanism.<\/li>\n<li><strong>Forming a protective capsule around themselves to avoid being destroyed by immune system cells.<\/strong>\u00a0This defense occurs in bacteria, such as\u00a0<a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/salmonella\/symptoms-causes\/syc-20355329\"><em>Salmonella<\/em><\/a>\u00a0species.<\/li>\n<li><strong>Mimicking host cells so the immune system does not recognize them as foreign.<\/strong>\u00a0Some\u00a0species\u00a0of\u00a0<a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/staph-infections\/multimedia\/staph-infection\/img-20008600\"><em>Staphylococcus<\/em><\/a>\u00a0bacteria use this mechanism.<\/li>\n<li><strong>Directly killing phagocytes.<\/strong>\u00a0This ability evolved in several\u00a0species\u00a0of bacteria, including the species that causes <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/anthrax\/symptoms-causes\/syc-20356203\">anthrax<\/a>.<\/li>\n<li><strong>Producing molecules that prevent the formation of interferons, which are immune chemicals that fight viruses.<\/strong>\u00a0Some <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/flu\/symptoms-causes\/syc-20351719\">influenza<\/a> viruses have this capability.<\/li>\n<li><strong>Forming complex biofilms that provide protection from the cells and proteins of the immune system.<\/strong> This characterizes some species of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2588\">bacteria<\/a> and fungi. You can see an example of a bacterial biofilm on teeth in Figure 17.4.8.<\/li>\n<\/ul>\n<figure id=\"attachment_1646\" aria-describedby=\"caption-attachment-1646\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1646\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Gingivitis-before-and-after-3.jpg\" alt=\"17.4.8 Gingivitis\" width=\"400\" height=\"349\"><figcaption id=\"caption-attachment-1646\" class=\"wp-caption-text\"><em>Figure 17.4.8 The dental plaque on the top set of teeth is a biofilm that sticks to the teeth and consists of many species of bacteria. The plaque biofilm is difficult to remove, and it subjects the teeth and gums to high concentrations of bacterial metabolites, which result in dental disease. The same teeth after plaque removal are shown in the bottom picture.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">17.4 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_4782_4820\">innate immune system<\/a> is a subset of the human immune system that produces rapid, but non-specific responses to pathogens. Unlike the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4822\">adaptive immune system<\/a>, the innate system does not confer\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4884\">immunity<\/a>. The innate immune system includes surface barriers, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4860\">inflammation<\/a>, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4868\">complement system<\/a>, and a variety of cellular responses.<\/li>\n<li>The body\u2019s first line of defense consists of three different types of barriers that keep most pathogens out of\u00a0body tissues. The types of barriers are mechanical, chemical, and biological barriers.<\/li>\n<li>Mechanical barriers\u00a0\u2014\u00a0which include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3521\">skin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_3538\">mucous membranes<\/a>, and fluids such as tears and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4717\">urine<\/a> \u2014 physically block pathogens from entering the body. Chemical barriers\u00a0\u2014\u00a0such as enzymes in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4711\">sweat<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4595\">saliva<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4885\">semen<\/a>\u00a0\u2014\u00a0kill pathogens on body surfaces. Biological barriers are harmless bacteria that use up food and space so pathogenic bacteria cannot colonize the body.<\/li>\n<li>If pathogens breach protective barriers, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4860\">inflammation<\/a> occurs. This creates a physical barrier against the spread of infection, and repairs tissue damage. Inflammation is triggered by chemicals such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4865\">cytokines<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4879\">histamines<\/a>, and it causes swelling, redness, and warmth.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4868\">complement system<\/a> is a complex biochemical mechanism that helps <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2215\">antibodies<\/a> kill pathogens. Once activated, the complement system consists of more than two dozen proteins that lead to disruption of the\u00a0cell membrane\u00a0of pathogens and bursting of the cells.<\/li>\n<li>Cellular responses of the innate immune system involve various types of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2172\">leukocytes<\/a>. For example, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2067\">neutrophils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4340\">macrophages<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4875\">dendritic cells<\/a>\u00a0phagocytize pathogens. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2103\">Basophils<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4881\">mast cells<\/a>\u00a0release chemicals that trigger inflammation. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2027\">Natural killer cells<\/a>\u00a0destroy cancerous or virus-infected cells, and eosinophils kill parasites.<\/li>\n<li>Many pathogens have evolved mechanisms that help them evade the innate immune system. For example, some pathogens form a protective capsule around themselves, and some mimic host cells so the immune system does not recognize them as foreign.<\/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\">17.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the innate immune system?<\/li>\n<li>Identify the body\u2019s first line of defense.<\/li>\n<li>\n<div id=\"h5p-329\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-329\" class=\"h5p-iframe\" data-content-id=\"329\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"17.4 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What are biological barriers? How do they protect the body?<\/li>\n<li>State the purposes of inflammation. What triggers inflammation, and what signs and symptoms does it cause?<\/li>\n<li>Define the complement system. How does it help destroy pathogens?<\/li>\n<li>Describe two ways that pathogens can evade the innate immune system.<\/li>\n<li>What are the ways in which phagocytes can encounter pathogens in the body?<\/li>\n<li>Describe two different ways in which enzymes play a role in the innate immune response.<\/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\">17.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/WW4skW6gucU<\/p>\n<p style=\"text-align: center\">How mucus keeps us healthy - Katharina Ribbeck, TED-Ed, 2015.<\/p>\n<p>https:\/\/youtu.be\/sYjtMP67vyk<\/p>\n<p style=\"text-align: center\">Human Physiology - Innate Immune System, Janux, 2015.<\/p>\n<p>https:\/\/youtu.be\/c64M1tZyWPM<\/p>\n<p style=\"text-align: center\">Myriam Sidibe: The simple power of handwashing, TED, 2014.<\/p>\n<p>https:\/\/youtu.be\/shEPwQPQG4I<\/p>\n<p style=\"text-align: center\">Everything You Didn't Want To Know About Snot, Gross Science, 2017.<\/p>\n<p>https:\/\/youtu.be\/dy1D3d1FBcw<\/p>\n<p style=\"text-align: center\">Cough Grosser Than Sneeze? | Curiosity - World's Dirtiest Man, Discovery, 2011.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Oww_Papercut_14365.jpg\" rel=\"cc:attributionURL\">Oww_Papercut_14365<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/photos\/11374424@N03\" rel=\"nofollow\">Laurence Facun<\/a> 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 style=\"text-align: initial;font-size: 1em\">Figure 17.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/www.needpix.com\/photo\/download\/1540666\/hairy-hair-nose-closeup-photo-photography-hairy-nose-free-pictures-free-photos\" rel=\"cc:attributionURL\">hairy-nose<\/a> by Piotr Siedlecki\u00a0 on <a href=\"https:\/\/www.publicdomainpictures.net\/it\/view-image.php?image=215098&amp;picture=naso-peloso\">publicdomainpictures.net<\/a> is used under a <a class=\"black_white_text\" href=\"http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"license noopener noreferrer\">CC0 1.0<\/a> Universal Public Domain Dedication (http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) license.<\/p>\n<p><strong>Figure 17.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sneeze.JPG\" rel=\"cc:attributionURL\">1024px-Sneeze<\/a> by James Gathany\/ <a class=\"external text\" href=\"http:\/\/phil.cdc.gov\/phil\/details.asp?pid=11162\" rel=\"nofollow\">CDC Public Health Image library (PHIL) ID# 11162<\/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).<\/p>\n<p><strong>Figure 17.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:OSC_Microbio_17_06_Erythema.jpg\" rel=\"cc:attributionURL\">OSC_Microbio_17_06_Erythema<\/a> by <a href=\"https:\/\/openstax.org\/books\/microbiology\/pages\/17-5-inflammation-and-fever\">CNX 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) license.<\/p>\n<p><strong>Figure 17.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2212_Complement_Cascade_and_Function.jpg\" rel=\"cc:attributionURL\">2212_Complement_Cascade_and_Function<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-2-barrier-defenses-and-the-innate-immune-response\">OpenStax College<\/a> on Wikimedia Commons is used under a\u00a0<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 17.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Phagocytosis2.png\" rel=\"cc:attributionURL\">512px-Phagocytosis2<\/a> by <a class=\"extiw\" title=\"en:User:GrahamColm\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:GrahamColm\">Graham\u00a0<span style=\"color: blue\">Colm<\/span><\/a> at <span class=\"licensetpl_aut\"><a class=\"extiw\" title=\"wikipedia:\" href=\"https:\/\/en.wikipedia.org\/wiki\/\">English Wikipedia<\/a><\/span>\u00a0on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\" rel=\"license\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0) license.<\/p>\n<p><strong>Figure 17.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Innate_Immune_cells.svg\" rel=\"cc:attributionURL\">Innate_Immune_cells.svg<\/a> by <a title=\"User:Fred the Oyster\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fred_the_Oyster\">Fred the Oyster<\/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 17.4.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gingivitis-before-and-after-3.jpg\" rel=\"cc:attributionURL\">1024px-Gingivitis-before-and-after-3<\/a> by <a title=\"User:Onetimeuseaccount\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Onetimeuseaccount\">Onetimeuseaccount<\/a> on Wikimedia Commons is used under a <a class=\"black_white_text\" href=\"http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" target=\"_blank\" rel=\"license noopener noreferrer\">CC0 1.0<\/a> Universal Public Domain Dedication (http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) license.<\/p>\n<h2>References<\/h2>\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, June 19). Figure 21.13 Complement cascade and function [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 21.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/21-2-barrier-defenses-and-the-innate-immune-response<\/p>\n<p class=\"hanging-indent\">Discovery. (2011, October 27). Cough grosser than sneeze? | Curiosity - World's dirtiest man. YouTube. https:\/\/www.youtube.com\/watch?v=dy1D3d1FBcw&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Gross Science. (2017, January 31). Everything you didn't want to know about snot. YouTube. https:\/\/www.youtube.com\/watch?v=shEPwQPQG4I&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Janux. (2015, January 10). Human physiology - Innate immune system. YouTube. https:\/\/www.youtube.com\/watch?v=sYjtMP67vyk&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Anthrax [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/anthrax\/symptoms-causes\/syc-20356203<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Influenza (flu) [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/flu\/symptoms-causes\/syc-20351719<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Salmonella infection [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/salmonella\/symptoms-causes\/syc-20355329<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Staph infection [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/staph-infections\/multimedia\/staph-infection\/img-20008600<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Tuberculosis [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/tuberculosis\/symptoms-causes\/syc-20351250<\/p>\n<p class=\"hanging-indent\">OpenStax. (2016, November 11). <span class=\"os-title-label\">Figure\u00a0<\/span><span class=\"os-number\">17.23<\/span> A typical case of acute inflammation at the site of a skin wound - Erythema [digital image]. In <em>OpenStax, Microbiology<\/em> (Section 17.5). https:\/\/openstax.org\/details\/books\/microbiology?Bookdetails<\/p>\n<p class=\"hanging-indent\">TED. (2014, October 14). Myriam Sidibe: The simple power of handwashing. YouTube. https:\/\/www.youtube.com\/watch?v=c64M1tZyWPM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, November 5). How mucus keeps us healthy - Katharina Ribbeck. YouTube. https:\/\/www.youtube.com\/watch?v=WW4skW6gucU&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_4782_5987\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_5987\"><div tabindex=\"-1\"><p>A division of the autonomic nervous system that controls digestive functions.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_5913\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_5913\"><div tabindex=\"-1\"><p>A rigid organ that constitutes part of the vertebrate skeleton in animals.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_2929\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_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_4782_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_4782_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_4782_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_4782_2484\">haploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_2471\">zygote<\/a><\/strong>. A zygote is a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2103\">diploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_2153\">homologous (paired) chromosomes<\/a> separate, and four <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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_4782_2468\">sexual reproduction<\/a>, two parents produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2694\">gametes<\/a> that unite in the process of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2677\">fertilization<\/a>\u00a0to form a single-celled <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2471\">zygote<\/a>. Gametes are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_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_4782_2506\">sperm<\/a> in a process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2507\">spermatogenesis<\/a>, and females produce gametes called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2467\">eggs<\/a> in the process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2509\">oogenesis<\/a>.<\/li>\n<li>Sexual reproduction produces genetically unique offspring. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2500\">Crossing-over<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_5939\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_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_4782_5901\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_5901\"><div tabindex=\"-1\"><p>A long extension of the cell body of a neuron that transmits nerve impulses to other cells.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_5931\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_5931\"><div tabindex=\"-1\"><p>The central part of a neuron that contains the nucleus and other cell organelles.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_3004\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3004\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1472\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Scleral_Icterus.jpg\" alt=\"15.6.1 Jaundiced eye\" width=\"400\" height=\"223\"><figcaption id=\"caption-attachment-1483\" 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_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 438px\" class=\"wp-caption alignright\"><img class=\" wp-image-1474\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-1.png\" alt=\"15.6.2 Accessory Organs of the Digestive System\" width=\"438\" height=\"876\"><figcaption id=\"caption-attachment-1483\" 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_4782_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 495px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1476\" 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_.png\" alt=\"15.6.3 Hepatic and Portal vessels\" width=\"495\" height=\"502\"><figcaption id=\"caption-attachment-1483\" 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_4782_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_4782_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_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1479\" 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.jpg\" alt=\"15.6.4\" width=\"789\" height=\"526\"><figcaption id=\"caption-attachment-1483\" 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_4782_1945\">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_4782_2422\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2279\">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_4782_2047\">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_4782_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_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 563px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1482\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder_organ-1.png\" alt=\"15.6.5 Gallbladder\" width=\"563\" height=\"563\"><figcaption id=\"caption-attachment-1483\" 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_4782_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_4782_2628\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2648\">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_1483\" aria-describedby=\"caption-attachment-1483\" style=\"width: 519px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1483\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0698_PancreasAnatomy.png\" alt=\"15.6.6\" width=\"519\" height=\"519\"><figcaption id=\"caption-attachment-1483\" 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_4782_2218\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2719\">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_4782_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_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_4782_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_4782_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_4782_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_4782_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_4782_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-295\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-295\" class=\"h5p-iframe\" data-content-id=\"295\" 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_4782_3005\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_3005\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1489\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/BADAS_Crohn.jpg\" alt=\"15.7.1 Crohn's Rash\" width=\"400\" height=\"263\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.1 Ouch!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Crohn\u2019s Rash<\/h1>\n<\/div>\n<p>If you had a skin rash like the one shown in Figure 15.7.1, you probably wouldn\u2019t assume that it was caused by a digestive system disease. However, that\u2019s exactly why the individual in the picture has a rash. He has a gastrointestinal (GI) tract disorder called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4668\">Crohn\u2019s disease<\/a>. This disease is one of a group of GI tract disorders that are known collectively as inflammatory bowel disease. Unlike other inflammatory bowel diseases, signs and symptoms of Crohn\u2019s disease may not be confined to the GI tract.<\/p>\n<div>\n<h1>Inflammatory Bowel Disease<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4669\">Inflammatory bowel disease<\/a> <\/strong><strong>(IBD)<\/strong> is a collection of inflammatory conditions primarily affecting the intestines. The two principal inflammatory bowel diseases are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4670\">ulcerative colitis<\/a>. Unlike Crohn\u2019s disease \u2014 which may affect any part of the GI tract and the\u00a0joints, as well as the skin \u2014 ulcerative colitis mainly affects just the colon and rectum. Both diseases occur when the body\u2019s own immune system attacks the digestive system. Both diseases typically first appear in the late teens or early twenties, and occur equally in males and females.\u00a0 Approximately 270,000 Canadians are currently living with IBD, 7,000 of which are children.\u00a0 The annual cost of caring for these Canadians is estimated at $1.28 billion.\u00a0 The number of cases of IBD has been steadily increasing and it is expected that by 2030 the number of Canadians suffering from IBD will grow to 400,000.<\/p>\n<h2>Crohn\u2019s Disease<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4668\">Crohn\u2019s disease<\/a><\/strong> is a type of inflammatory bowel disease that may affect any part of the GI tract from the mouth to the anus, among other body tissues. The most commonly affected region is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4606\">ileum<\/a>, which is the final part of the small intestine. Signs and symptoms of Crohn\u2019s disease typically include abdominal pain, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4671\">diarrhea<\/a> (with or without blood), fever, and weight loss. Malnutrition because of faulty absorption of nutrients may also occur. Potential complications of Crohn\u2019s disease include obstructions and abscesses of the bowel. People with Crohn\u2019s disease are also at slightly greater risk than the general population of developing bowel <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2148\">cancer<\/a>. Although there is a slight reduction in life expectancy in people with Crohn\u2019s disease, if the disease is well-managed, affected people can live full and productive lives.\u00a0 Approximately 135,000 Canadians are living with Crohn's disease.<\/p>\n<p>Crohn\u2019s disease is caused by a combination of genetic and environmental factors that lead to impairment of the generalized immune response (called innate immunity). The chronic inflammation of Crohn\u2019s disease is thought to be the result of the immune system \u201ctrying\u201d to compensate for the impairment. Dozens of genes are likely to be involved, only a few of which have been identified. Because of the genetic component, close relatives such as siblings of people with Crohn\u2019s disease are many times more likely to develop the disease than people in the general\u00a0population. Environmental factors that appear to increase the risk of the disease include smoking tobacco and eating a diet high in animal\u00a0proteins. Crohn\u2019s disease is typically diagnosed on the basis of a colonoscopy, which provides a direct visual examination of the inside of the colon and the ileum of the\u00a0small intestine.<\/p>\n<p>People with Crohn\u2019s disease typically experience recurring periods of flare-ups followed by remission. There are no medications or surgical procedures that can cure Crohn\u2019s disease, although medications such as anti-inflammatory or immune-suppressing drugs may alleviate symptoms during flare-ups and help maintain remission. Lifestyle changes, such as dietary modifications and smoking cessation, may also help control symptoms and reduce the likelihood of flare-ups. Surgery may be needed to resolve bowel obstructions, abscesses, or other complications of the disease.<\/p>\n<h2>Ulcerative Colitis<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4670\">Ulcerative colitis<\/a><\/strong>\u00a0is an inflammatory bowel disease that causes inflammation and ulcers (sores) in the colon and rectum. Unlike Crohn\u2019s disease, other parts of the GI tract are rarely affected in ulcerative colitis. The primary symptoms of the disease are lower abdominal pain and bloody <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4671\">diarrhea<\/a>.\u00a0Weight\u00a0loss, fever, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2061\">anemia<\/a> may also be present. Symptoms typically occur intermittently with periods of no symptoms between flare-ups. People with ulcerative colitis have a considerably increased risk of colon\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2148\">cancer<\/a>\u00a0and should be screened for colon cancer more frequently than the general\u00a0population.\u00a0Ulcerative colitis, however, seems to primarily reduce the quality of life, and not the lifespan.<\/p>\n<p>The exact cause of ulcerative colitis is not known.\u00a0Theories\u00a0about its cause involve immune system dysfunction, genetics, changes in normal gut\u00a0bacteria, and lifestyle factors, such as a diet high in animal\u00a0protein\u00a0and the consumption of alcoholic beverages. Genetic involvement is suspected in part because ulcerative colitis tens to \u201crun\u201d in families. It is likely that multiple genes are involved. Diagnosis is typically made on the basis of colonoscopy and tissue biopsies.<\/p>\n<p>Lifestyle changes, such as reducing the consumption of animal\u00a0protein and alcohol, may improve symptoms of ulcerative colitis. A number of medications are also available to treat symptoms and help prolong remission. These include anti-inflammatory drugs and drugs that suppress the immune system. In cases of severe disease, removal of the colon and rectum may be required and can cure the disease.<\/p>\n<div>\n<h1>Diverticulitis<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4672\">Diverticulitis<\/a><\/strong> is a digestive disease in which tiny pouches in the wall of the large intestine become infected and inflamed. Symptoms typically include lower abdominal pain of sudden onset. There may also be fever, nausea, diarrhea or constipation, and blood in the stool. Having large intestine pouches called diverticula (see Figure 15.7.2) that are not inflamed is called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4673\">diverticulosis<\/a>.<\/strong> Diverticulosis is thought to be caused by a combination of genetic and environmental factors, and is more common in people who are obese. Infection and inflammation of the pouches (diverticulitis) occurs in about 10\u201325% of people with diverticulosis, and is more common at older ages. The infection is generally caused by bacteria.<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1490\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Ds00070_an01934_im00887_divert_s_gif.webp_.png\" alt=\"15.7.2\" width=\"512\" height=\"370\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.2 This images show multiple pouches called diverticula in the wall of the large intestine.<\/em><\/figcaption><\/figure>\n<p>Diverticulitis can usually be diagnosed with a CT scan and can be monitored with a colonoscopy (as seen in Figure 15.7.3). Mild diverticulitis may be treated with oral antibiotics and a short-term liquid diet. For severe cases, intravenous antibiotics, hospitalization, and complete bowel rest (no nourishment via the mouth) may be recommended. Complications such as abscess formation or perforation of the colon require surgery.<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 579px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1491\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Colon_diverticulum.jpg\" alt=\"15.7.3 Diverticula\" width=\"579\" height=\"428\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.3 You can see small diverticula in this image from a colonoscopy.<\/em><\/figcaption><\/figure>\n<div>\n<h3>Peptic Ulcer<\/h3>\n<\/div>\n<p>A\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4676\">peptic ulcer<\/a><\/strong> is a sore in the lining of the stomach or the duodenum (first part of the small intestine). If the ulcer occurs in the stomach, it is called a gastric ulcer. If it occurs in the duodenum, it is called a duodenal ulcer. The most common symptoms of peptic ulcers are upper abdominal pain that often occurs in the night and improves with eating. Other symptoms may include belching, vomiting,\u00a0weight\u00a0loss, and poor appetite.\u00a0Many people with peptic ulcers, particularly older people, have no symptoms. Peptic ulcers are relatively common, with about ten per cent of people developing a peptic ulcer at some point in their life.<\/p>\n<p>The most common cause of peptic ulcers is infection with the bacterium\u00a0<em>Helicobacter pylori<\/em>, which may be transmitted by food, contaminated water, or human saliva (for example, by kissing or sharing eating utensils). Surprisingly, the bacterial cause of peptic ulcers was not discovered until the 1980s. The scientists who made the discovery are Australians Robin Warren and Barry J. Marshall. Although the two scientists eventually won a Nobel Prize for their discovery, their hypothesis was poorly received at first. To demonstrate the validity of their discovery, Marshall used himself in an experiment. He drank a culture of bacteria from a peptic ulcer patient and developed symptoms of peptic ulcer in a matter of days. His symptoms resolved on their own within a couple of weeks, but, at his wife's urging, he took antibiotics to kill any remaining bacteria. Marshall\u2019s self-experiment was published in the Australian Medical Journal, and is among the most cited articles ever published in the journal.\u00a0 Figure 15.7.4 shows how <em>H. pylori<\/em> cause peptic ulcers.<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1492\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/H_pylori_ulcer_diagram.png\" alt=\"15.7.4 H.Pylori and Peptic Ulcer\" width=\"1024\" height=\"768\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.4 H.Pylori penetrate the protective mucus layer of the mucosa and damages the cells of the lower GI tract.<\/em><\/figcaption><\/figure>\n<p>Another relatively common cause of peptic ulcers is chronic use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. Additional contributing factors may include tobacco smoking and stress, although these factors have not been demonstrated conclusively to cause peptic ulcers independent of\u00a0<em>H. pylori<\/em>\u00a0infection. Contrary to popular belief, diet does not appear to play a role in either causing or preventing peptic ulcers. Eating spicy foods and drinking coffee and alcohol were once thought to cause peptic ulcers. These lifestyle choices are no longer thought to have much (if any) of an effect on the\u00a0development\u00a0of peptic ulcers.<\/p>\n<p>Peptic ulcers are typically diagnosed on the basis of symptoms or the presence of\u00a0<em>H. pylori<\/em> in the GI tract. However, endoscopy (shown in Figure 15.7.5), which allows direct visualization of the stomach and duodenum with a camera, may be required for a definitive diagnosis. Peptic ulcers are usually treated with antibiotics to kill <em>H. pylori<\/em>, along with medications to temporarily decrease stomach\u00a0acid\u00a0and aid in healing. Unfortunately,\u00a0<em>H. pylori<\/em>\u00a0has developed\u00a0resistance\u00a0to commonly used antibiotics, so treatment is not always effective. If a peptic ulcer has penetrated so deep into the tissues that it causes a perforation of the wall of the stomach or duodenum, then emergency surgery is needed to repair the damage.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1493\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Endoscopy_training.jpg\" alt=\"15.7.5 Endoscopy\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.5 A doctor inserts a tiny camera through a tube (called an endoscope) to examine a patient\u2019s upper GI tract for peptic ulcers. He views the image created by the camera on a screen above the patient\u2019s head.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Gastroenteritis<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4679\">Gastroenteritis<\/a>,<\/strong> also known as infectious diarrhea or stomach flu, is an acute and usually self-limiting infection of the GI tract by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_2405\">pathogens<\/a>. Symptoms typically include some combination of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4671\">diarrhea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4680\">vomiting<\/a>, and abdominal pain. Fever, lack of energy, and dehydration may also occur. The illness generally lasts less than two weeks, even without treatment, but in young children it is potentially deadly. Gastroenteritis is very common, especially in poorer nations. Worldwide, up to five billion cases occur each year, resulting in about 1.4 million deaths.<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 419px\" class=\"wp-caption alignleft\"><img class=\"size-full wp-image-1494\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gastroenteritis_viruses.jpg\" alt=\"15.7.6 Gastroenteritis causing Viruses\" width=\"419\" height=\"328\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.6 These micrographs show four types of viruses that commonly cause gastroenteritis in humans: A. rotavirus, B. adenovirus, C. norovirus, and D. astrovirus.<\/em><\/figcaption><\/figure>\n<p>Commonly called \u201cstomach flu,\u201d gastroenteritis is unrelated to the influenza virus, although viruses are the most common cause of the disease (see Figure 15.7.6). In children, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4681\">rotavirus<\/a> is most often the cause which is why the British Columbia immunization schedule now includes a rotovirus vaccine. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4682\">Norovirus <\/a>is more likely to be the cause of gastroenteritis in adults. Besides viruses, other potential causes of gastroenteritis include fungi,\u00a0<span style=\"font-size: 1em\">bacteria (most often\u00a0<\/span><em style=\"font-size: 1em\">E. coli<\/em><span style=\"font-size: 1em\">\u00a0or\u00a0<\/span><em style=\"font-size: 1em\">Campylobacter jejuni), and <\/em><span style=\"text-align: initial;font-size: 1em\">protozoa(including <\/span><em style=\"text-align: initial;font-size: 1em\">Giardia lamblia, <\/em>more commonly called Beaver Fever,<span style=\"text-align: initial;font-size: 1em\"> described below)<\/span><em style=\"text-align: initial;font-size: 1em\">.<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0Transmission of pathogens may occur due to eating improperly prepared foods or foods left to stand at room\u00a0temperature, drinking contaminated\u00a0water, or having close contact with an infected individual.<\/span><\/p>\n<p>Gastroenteritis is less common in adults than children, partly because adults have acquired\u00a0immunity\u00a0after repeated exposure to the most common infectious agents. Adults also tend to have better hygiene than children. If children have frequent repeated incidents of gastroenteritis, they may suffer from malnutrition, stunted growth, and developmental delays. Many cases of gastroenteritis in children can be avoided by giving them a rotavirus vaccine. Frequent and thorough handwashing can cut down on infections caused by other pathogens.<\/p>\n<p>Treatment of gastroenteritis generally involves increasing fluid intake to replace fluids lost in vomiting or diarrhea. Oral rehydration\u00a0solution, which is a combination of\u00a0water, salts, and sugar, is often recommended. In severe cases, intravenous fluids may be needed. Antibiotics are not usually prescribed, because they are ineffective against viruses that cause most cases of gastroenteritis.<\/p>\n<div>\n<h1>Giardiasis<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4684\">Giardiasis<\/a>,<\/strong>\u00a0popularly known as beaver fever, is a type of gastroenteritis caused by a GI tract parasite, the single-celled protozoan\u00a0<em>Giardia lamblia <\/em>(pictured in Figure 15.7.7). In addition to human beings, the parasite inhabits the digestive tract of a wide variety of domestic and wild animals, including cows, rodents, and sheep, as well as beavers (hence its popular name). Giardiasis is one of the most common parasitic infections in people the world over, with hundreds of millions of people infected worldwide each year.<\/p>\n<figure id=\"attachment_1495\" aria-describedby=\"caption-attachment-1495\" style=\"width: 351px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1495 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Giardia_lamblia_SEM_8698_lores-e1592589161905.jpg\" alt=\"15.7.7 Giardia lamblia\" width=\"351\" height=\"388\"><figcaption id=\"caption-attachment-1495\" class=\"wp-caption-text\"><em>Figure 15.7.7 Giardia lamblia is a single-celled organism that parasitizes the GI tract of humans as well as many other animal species.<\/em><\/figcaption><\/figure>\n<p>Transmission of\u00a0<em>G. lamblia<\/em> is via a fecal-oral route (as in, you got feces in your food). Those at greatest risk include travelers to countries where giardiasis is common, people who work in child-care settings, backpackers and campers who drink untreated water from lakes or rivers, and people who have close contact with infected people or animals in other settings. In Canada,\u00a0<em>Giardia<\/em> is the most commonly identified intestinal parasite and approximately 3,000 Canadians will contract the parasite annually.<\/p>\n<p>Symptoms of giardiasis can vary widely. About one-third third of people with the infection have no symptoms, whereas others have severe diarrhea with poor absorption of nutrients. Problems with absorption occur because the parasites inhibit intestinal digestive enzyme production, cause detrimental changes in microvilli lining the small intestine, and kill off small intestinal epithelial cells. The illness can result in weakness, loss of appetite, stomach cramps, vomiting, and excessive gas. Without treatment, symptoms may continue for several weeks. Treatment with anti-parasitic medications may be needed if symptoms persist longer or are particularly severe.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.7 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_4782_4669\">Inflammatory bowel disease<\/a> is a collection of inflammatory conditions primarily affecting the intestines. The diseases involve the immune system attacking the GI tract, and they have multiple genetic and environmental causes. Typical symptoms include abdominal pain and diarrhea, which show a pattern of repeated flare-ups interrupted by periods of remission. Lifestyle changes and medications may control flare-ups and extend remission. Surgery is sometimes required.<\/li>\n<li>The two principal inflammatory bowel diseases are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4670\">ulcerative colitis<\/a>. Crohn\u2019s disease may affect any part of the GI tract from the mouth to the anus, among other\u00a0body tissues. Ulcerative colitis affects the colon and\/or rectum.<\/li>\n<li>Some people have little pouches, called diverticula, in the lining of their\u00a0large intestine, a condition called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4673\">diverticulosis<\/a>. People with diverticulosis may develop diverticulitis, in which one or more of the diverticula become infected and inflamed. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4672\">Diverticulitis<\/a> is generally treated with antibiotics and bowel rest. Sometimes, surgery is required.<\/li>\n<li>A peptic ulcer is a sore in the lining of the stomach (gastric ulcer) or duodenum (duodenal ulcer). The most common cause is infection with the bacterium\u00a0<em>Helicobacter pylori<\/em>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4686\">NSAIDs<\/a> (such as aspirin) can also cause peptic ulcers, and some lifestyle factors may play contributing roles. Antibiotics and\u00a0acid\u00a0reducers are typically prescribed, and surgery is not often needed.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4782_4679\">Gastroenteritis<\/a>, or infectious diarrhea, is an acute and usually self-limiting infection of the GI tract by pathogens, most often viruses. Symptoms typically include diarrhea, vomiting, and\/or abdominal pain. Treatment includes replacing lost fluids. Antibiotics are not usually effective.<\/li>\n<li>Giardiasis is a type of gastroenteritis caused by infection of the GI tract with the\u00a0protozoa\u00a0parasite\u00a0<em>Giardia lamblia<\/em>. It may cause malnutrition. Generally self-limiting, severe or long-lasting cases may require antibiotics.<\/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\">15.7 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-298\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-298\" class=\"h5p-iframe\" data-content-id=\"298\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.7 Name the Disorder of the Digestive System\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-299\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-299\" class=\"h5p-iframe\" data-content-id=\"299\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.7 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Compare and contrast Crohn\u2019s disease and ulcerative colitis.<\/li>\n<li>How are diverticulosis and diverticulitis related?<\/li>\n<li>Identify the cause of giardiasis. Why may it cause malabsorption?<\/li>\n<li>Name three disorders of the GI tract that can be caused\u00a0by bacteria.<\/li>\n<li>Name one disorder of the GI tract that can be\u00a0<em>helped\u00a0<\/em>by anti-inflammatory medications, and one that can be\u00a0<em>caused<\/em>\u00a0by chronic use of anti-inflammatory medications.<\/li>\n<li>Describe one reason why it can be dangerous to drink untreated water.<\/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\">15.7 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/H5zin8jKeT0<\/p>\n<p style=\"text-align: center\">Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress, TED-Ed, 2018.<\/p>\n<p>https:\/\/youtu.be\/V_U6czbDHLE<\/p>\n<p style=\"text-align: center\">The surprising cause of stomach ulcers - Rusha Modi, TED-Ed, 2017.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:BADAS_Crohn.jpg\" rel=\"cc:attributionURL\">BADAS_Crohn<\/a> by Dayavathi Ashok and Patrick Kiely\/ <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2045102\/?tool=pubmed\">Journal of medical case reports<\/a> 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 15.7.2<\/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<\/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>\u00a0 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 15.7.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Colon_diverticulum.jpg\" rel=\"cc:attributionURL\">Colon_diverticulum<\/a> by <a title=\"User:\u30e1\u30eb\u30d3\u30eb\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:%E3%83%A1%E3%83%AB%E3%83%93%E3%83%AB\">melvil<\/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 15.7.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:H_pylori_ulcer_diagram.png\" rel=\"cc:attributionURL\">H_pylori_ulcer_diagram<\/a> by <a title=\"User:Y tambe\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Y_tambe\">Y_tambe<\/a> on Wikimedia Commons is used under a <a href=\"http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\" rel=\"license\">CC BY-SA 3.0<\/a>\u00a0(http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license.<\/p>\n<p><strong>Figure 15.7.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Endoscopy_training.jpg\" rel=\"cc:attributionURL\">1024px-Endoscopy_training<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/photos\/76758469@N00\" rel=\"nofollow\">Yuya Tamai<\/a> 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 15.7.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gastroenteritis_viruses.jpg\" rel=\"cc:attributionURL\">Gastroenteritis_viruses<\/a> by Dr. Graham Beards [<a class=\"extiw\" title=\"en:User:Graham Beards\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Graham_Beards\">en:User:Graham Beards]<\/a> at en.wikipedia 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 15.7.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Giardia_lamblia_SEM_8698_lores.jpg\" rel=\"cc:attributionURL\">Giardia_lamblia_SEM_8698_lores<\/a> by Janice Haney Carr from <a href=\"https:\/\/phil.cdc.gov\/PHIL_Images\/8698\/\">CDC\/ Public Health Image Library (PHIL) ID# 8698<\/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).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Ashok, D., &amp; Kiely, P. (2007). Bowel associated dermatosis - arthritis syndrome: a case report.\u00a0<i>Journal of medical case reports<\/i>,\u00a0<i>1<\/i>, 81. https:\/\/doi.org\/10.1186\/1752-1947-1-81<\/p>\n<p class=\"hanging-indent\">Marshall, B. J., Armstrong, J. A., McGechie, D. B., &amp; Glancy, R. J. (1985). Attempt to fulfil Koch's postulates for pyloric Campylobacter. <em>The Medical Journal of Australia, 142<\/em>(8), 436\u2013439.<\/p>\n<p class=\"hanging-indent\">Marshall, B. J., McGechie, D. B., Rogers, P. A., &amp; Glancy, R. J. (1985). Pyloric campylobacter infection and gastroduodenal disease. <em>The Medical Journal of Australia<\/em>, <em>142<\/em>(8), 439\u2013444.<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, September 28). The surprising cause of stomach ulcers - Rusha Modi. YouTube. https:\/\/www.youtube.com\/watch?v=V_U6czbDHLE&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2018, January 4). Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress. YouTube. https:\/\/www.youtube.com\/watch?v=H5zin8jKeT0&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_4782_6013\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_6013\"><div tabindex=\"-1\"><p>An involuntary human body response mediated by the nervous and endocrine systems that prepares the body to fight or flee from perceived danger.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4782_5969\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4782_5969\"><div tabindex=\"-1\"><p>A body system including a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine, and anus. The liver, pancreas, and gallbladder are the solid organs of the digestive system.<\/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":6,"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-4782","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\/4782","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\/4782\/revisions"}],"predecessor-version":[{"id":6439,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4782\/revisions\/6439"}],"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\/4782\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/media?parent=4782"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapter-type?post=4782"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/contributor?post=4782"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/license?post=4782"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}