{"id":4805,"date":"2019-06-24T14:54:44","date_gmt":"2019-06-24T14:54:44","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-9-case-study-conclusion-fading-memory-3\/"},"modified":"2023-11-30T18:51:46","modified_gmt":"2023-11-30T18:51:46","slug":"10-9-case-study-conclusion-fading-memory-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/10-9-case-study-conclusion-fading-memory-3\/","title":{"raw":"8.9\u00a0Case Study Conclusion: Fading Memory","rendered":"8.9\u00a0Case Study Conclusion: Fading Memory"},"content":{"raw":"&nbsp;\r\n\r\n[caption id=\"attachment_3191\" align=\"aligncenter\" width=\"1023\"]<img class=\"wp-image-3191\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Alzheimers_Disease-2.jpg\" alt=\"\" width=\"1023\" height=\"791\" \/> <em>Figure 8.9.1 Molecular and cellular changes occur in a brain with Alzheimer\u2019s disease (AD).<\/em>[\/caption]\r\n<h1>Case Study Conclusion: Fading Memory<\/h1>\r\nThe illustration above (Figure 8.9.1) shows some of the molecular and cellular changes that occur in Alzheimer\u2019s disease (AD). Rosa was diagnosed with AD at the beginning of this chapter after experiencing memory problems and other changes in her cognitive functioning, mood, and personality. These abnormal changes in the brain include the development of amyloid plaques between brain cells and neurofibrillary tangles inside of neurons. These hallmark characteristics of AD are associated with the loss of synapses between neurons, and ultimately the death of neurons.\r\n\r\nAfter reading this chapter, you should have a good appreciation for the importance of keeping neurons alive and communicating with each other at synapses. The nervous system coordinates all of the body\u2019s voluntary and involuntary activities. It interprets information from the outside world through sensory systems, and makes appropriate responses through the motor system, through communication between the PNS and CNS. The brain directs the rest of the nervous system and controls everything from basic vital functions (such as heart rate and breathing) to high-level functions (such as problem solving and abstract thought). The nervous system\u00a0can\u00a0perform these important functions by generating action potentials in neurons in response to stimulation and sending messages between cells at synapses, typically using chemical neurotransmitter molecules. When neurons are not functioning properly, lose their synapses, or die, they cannot carry out the signaling essential for the proper functioning of the nervous system.\r\n\r\nAD is a progressive neurodegenerative disease, meaning that the damage to the brain becomes more extensive as time goes on. The picture in Figure 8.9.2 illustrates how the damage progresses from before AD is diagnosed (preclinical AD), to mild and moderate AD, to severe AD.\r\n\r\n[caption id=\"attachment_3192\" align=\"aligncenter\" width=\"644\"]<img class=\" wp-image-3192\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Alzheimers-Disease-stagess-scaled-3.jpg\" alt=\"\" width=\"644\" height=\"1388\" \/> <em>Figure 8.9.2 Illustration showing the areas of the brain that become damaged as Alzheimer\u2019s disease (AD) progresses. This is a side view along the middle of the brain, with the front of the brain shown to the left. Damaged areas are shown in blue.<\/em>[\/caption]\r\n\r\n<div>\r\n\r\n&nbsp;\r\n\r\n<\/div>\r\nYou can see that the damage starts in a relatively small location toward the bottom of the brain. One of the earliest brain areas to be affected by AD is the hippocampus. As you have learned, the hippocampus is important for learning and memory, which explains why many of Rosa\u2019s symptoms of mild AD involve deficits in memory, such as trouble remembering where she placed objects, recent conversations, and appointments.\r\n\r\nAs AD progresses, more of the brain is affected, including areas involved in emotional regulation, social behavior, planning, language, spatial navigation, and higher-level thought. Rosa is beginning to show signs of problems in these areas, including irritability, lashing out at family members, getting lost in her neighborhood, problems finding the right words, putting objects in unusual locations, and difficulty in managing her finances. You can see that as AD progresses, damage spreads further across the cerebrum, which you now know controls conscious functions\u00a0like\u00a0reasoning, language, and interpretation of sensory stimuli. You can also see how the frontal lobe \u2014 which controls executive functions such as planning, self-control, and abstract thought \u2014 becomes increasingly damaged.\r\n\r\nIncreasing damage to the brain causes corresponding deficits in functioning. In moderate AD, patients have increased memory, language, and cognitive deficits, compared to mild AD. They may not recognize their own family members, and may wander and get lost, engage in inappropriate behaviors, become easily agitated, and have trouble carrying out daily activities such as dressing. In severe AD, much of the brain is affected. Patients usually cannot recognize family members or communicate, and they are often fully dependent on others for their care. They begin to lose the ability to control their basic functions, such as bladder control, bowel control, and proper swallowing. Eventually, AD causes death, usually as a result of this loss of basic functions.\r\n\r\nFor now, Rosa only has mild AD and is still able to function relatively well with care from her family. The medication her doctor gave her has helped improve some of her symptoms. It is a cholinesterase inhibitor, which blocks an enzyme that normally degrades the neurotransmitter acetylcholine. With more of the neurotransmitter available, more of it can bind to neurotransmitter receptors on postsynaptic cells. Therefore, this drug acts as an agonist for acetylcholine, which enhances communication between neurons in Rosa\u2019s brain. This increase in neuronal communication can help restore some of the functions lost in early Alzheimer\u2019s disease and may slow the progression of symptoms.\r\n\r\nBut medication such as this is only a short-term measure, and does not halt the progression of the underlying disease. Ideally, the damaged or dead neurons would be replaced by new, functioning neurons. Why does this not happen automatically in the body? As you have learned, neurogenesis is very limited in adult humans, so once neurons in the brain die, they are not normally replaced to any significant extent.\u00a0Scientists, however, are studying the ways in which neurogenesis might be increased in cases of disease or injury to the brain.\u00a0They are also investigating the possibility of using stem cell transplants to replace damaged or dead neurons with new neurons. But this research is in very early stages and is not currently a treatment for AD.\r\n\r\nOne promising area of research is in the development of methods to allow earlier detection and treatment of AD, given that the changes in the brain may actually start ten to 20 years before diagnosis of AD.\u00a0A\u00a0radiolabeled chemical called Pittsburgh Compound B (PiB) binds to amyloid plaques in the brain, and in the future, it may be used in conjunction with brain imaging techniques to detect early signs of AD. Scientists are also looking for biomarkers in bodily fluids (such as blood and cerebrospinal fluid) that might indicate the presence of AD before symptoms appear. Finally, researchers are also investigating possible early and subtle symptoms (such as changes in how people move or a loss of smell) to see whether they can be used to identify people who will go on to develop AD. This research is in the early stages, but the hope is that patients can be identified earlier, allowing for earlier and more effective treatment, as well as more planning time for families.\r\n\r\nScientists are also still trying to fully understand the causes of AD, which affects more than five million Americans. Some genetic mutations have been identified\u00a0as contributors, but environmental factors also appear to be important. With more research into the causes and mechanisms of AD, hopefully a cure can be found, and people like Rosa can live a longer and better life.\r\n<div>\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">Chapter 8 Summary<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nIn this chapter, you learned about the human nervous system. Specifically, you learned that:\r\n<ul>\r\n \t<li>The [pb_glossary id=\"2908\"]nervous system[\/pb_glossary] is the organ system that coordinates all of the body\u2019s [pb_glossary id=\"3004\"]voluntary[\/pb_glossary] and [pb_glossary id=\"3005\"]involuntary[\/pb_glossary] actions by transmitting signals to and from different parts of the body. It has two major divisions: the [pb_glossary id=\"5933\"]central nervous system[\/pb_glossary] (CNS) and the [pb_glossary id=\"3009\"]peripheral nervous system[\/pb_glossary] (PNS).\r\n<ul>\r\n \t<li>The CNS\u00a0includes\u00a0the brain and spinal cord.<\/li>\r\n \t<li>The PNS consists mainly of nerves that connect the CNS with the rest of the body. It has two major divisions: the [pb_glossary id=\"3014\"]somatic nervous system[\/pb_glossary] and the [pb_glossary id=\"5899\"]autonomic nervous system[\/pb_glossary]. These divisions control different types of functions, and often interact with the CNS to carry out these functions. The somatic system controls activities that are under voluntary control. The autonomic system controls activities that are involuntary.\r\n<ul>\r\n \t<li>The autonomic nervous system is further divided into the [pb_glossary id=\"3015\"]sympathetic division[\/pb_glossary] (which controls the fight-or-flight response), the [pb_glossary id=\"3016\"]parasympathetic division[\/pb_glossary] (which controls most routine involuntary responses), and the [pb_glossary id=\"5987\"]enteric division[\/pb_glossary] (which provides local control for digestive processes).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\"><\/li>\r\n \t<li>Signals sent by the nervous system are electrical signals called [pb_glossary id=\"5697\"]nerve impulses[\/pb_glossary]. They are transmitted by special, electrically excitable cells called [pb_glossary id=\"2984\"]neurons[\/pb_glossary], which are one of two major types of cells in the nervous system.<\/li>\r\n \t<li>[pb_glossary id=\"2985\"]Neuroglia[\/pb_glossary] are the other major type of nervous system cells. There are many types of glial cells, and they have many specific functions. In general, neuroglia function to support, protect, and nourish neurons.<\/li>\r\n \t<li>The main parts of a neuron include the [pb_glossary id=\"5931\"]cell body[\/pb_glossary], [pb_glossary id=\"5965\"]dendrites[\/pb_glossary], and [pb_glossary id=\"5901\"]axon[\/pb_glossary]. The cell body contains the nucleus. Dendrites receive nerve impulses from other cells, and the axon transmits nerve impulses to other cells at axon terminals. A synapse is a complex membrane junction at the end of an axon terminal that transmits signals to another cell.<\/li>\r\n \t<li>Axons are often wrapped in an electrically-insulating [pb_glossary id=\"3028\"]myelin sheath[\/pb_glossary], which is produced by oligodendrocytes or schwann cells, both of which are types of neuroglia. Electrical impulses called [pb_glossary id=\"3049\"]action potentials[\/pb_glossary]\u00a0occur at gaps in the myelin sheath, called [pb_glossary id=\"3041\"]nodes of Ranvier[\/pb_glossary], which speeds the conduction of nerve impulses down the axon.<\/li>\r\n \t<li>[pb_glossary id=\"3025\"]Neurogenesis[\/pb_glossary], or the formation of new neurons by cell division, may occur in a mature human brain \u2014 but only to a limited extent.<\/li>\r\n \t<li>The nervous tissue in the [pb_glossary id=\"5915\"]brain [\/pb_glossary]and [pb_glossary id=\"3010\"]spinal cord[\/pb_glossary] consists of gray matter \u2014 which contains mainly unmyelinated cell bodies and dendrites of neurons \u2014 and white matter, which contains mainly myelinated axons of neurons. Nerves of the peripheral nervous system consist of long bundles of myelinated axons that extend throughout the body.<\/li>\r\n \t<li>There are hundreds of types of neurons in the human nervous system, but many can be classified on the basis of the direction in which they carry nerve impulses. [pb_glossary id=\"3030\"]Sensory neurons[\/pb_glossary] carry nerve impulses away from the body and toward the central nervous system, [pb_glossary id=\"3031\"]motor neurons[\/pb_glossary] carry them away from the central nervous system and toward the body, and [pb_glossary id=\"3032\"]interneurons[\/pb_glossary] often carry them between sensory and motor neurons.<\/li>\r\n \t<li>A nerve impulse is an electrical phenomenon that occurs because of a difference in electrical charge across the plasma membrane of a neuron.<\/li>\r\n \t<li>The [pb_glossary id=\"5713\"]sodium-potassium pump[\/pb_glossary] maintains an electrical gradient across the plasma membrane of a neuron when it is not actively transmitting a nerve impulse. This gradient is called the resting potential of the neuron.<\/li>\r\n \t<li>An action potential is a sudden reversal of the electrical gradient across the plasma membrane of a resting neuron. It begins when the neuron receives a chemical signal from another cell or some other type of stimulus. The action potential travels rapidly down the neuron\u2019s axon as an electric current.<\/li>\r\n \t<li>A nerve impulse is transmitted to another cell at either an electrical or a chemical [pb_glossary id=\"3040\"]synapse[\/pb_glossary]. At a chemical synapse, [pb_glossary id=\"3056\"]neurotransmitter[\/pb_glossary] chemicals are released from the [pb_glossary id=\"3052\"]presynaptic cell[\/pb_glossary] into the synaptic cleft between cells. The chemicals travel across the cleft to the [pb_glossary id=\"3053\"]postsynaptic cell[\/pb_glossary] and bind to receptors embedded in its membrane.<\/li>\r\n \t<li>There are many different types of neurotransmitters. Their effects on the postsynaptic cell generally depend on the type of receptor they bind to. The effects may be excitatory, inhibitory, or modulatory in more complex ways. Both physical and mental disorders may occur if there are problems with neurotransmitters or their receptors.<\/li>\r\n \t<li>The CNS includes the brain and spinal cord. It is physically protected by [pb_glossary id=\"5913\"]bones[\/pb_glossary], [pb_glossary id=\"2929\"]meninges[\/pb_glossary], and [pb_glossary id=\"5939\"]cerebrospinal fluid[\/pb_glossary]. It is chemically protected by the blood-brain barrier.<\/li>\r\n \t<li>The brain is the control center of the nervous system and of the entire organism. The brain uses a relatively large proportion of the body\u2019s energy, primarily in the form of [pb_glossary id=\"5451\"]glucose[\/pb_glossary].<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>The brain is divided into three major parts, each with different functions: the forebrain, the midbrain and the hindbrain.\r\n<ul>\r\n \t<li>The forebrain includes the [pb_glossary id=\"5941\"]cerebrum[\/pb_glossary], the [pb_glossary id=\"3095\"]thalamus[\/pb_glossary], the [pb_glossary id=\"2937\"]hypothalamus[\/pb_glossary], the [pb_glossary id=\"3096\"]hippocampus[\/pb_glossary] and the [pb_glossary id=\"5883\"]amygdala[\/pb_glossary]. The cerebrum is further divided into left and right hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal, and occipital. Each lobe is associated with specific senses or other functions.\u00a0 The cerebrum has a thin outer layer called the cerebral cortex. Its many folds give it a large surface area. This is where most information processing takes place.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>The thalamus, hypothalamus, hippocampus and amygdala are all part of the limbic system which helps regulate memories, coordination and attention<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>The [pb_glossary id=\"3010\"]spinal cord[\/pb_glossary] is a tubular bundle of nervous tissues that extends from the head down the middle of the back to the pelvis. It functions mainly to connect the brain with the PNS. It also controls certain rapid responses called reflexes without input from the brain.\r\n<ul>\r\n \t<li>A spinal cord injury may lead to paralysis (loss of sensation and movement) of the body below the level of the injury, because nerve impulses can no longer travel up and down the spinal cord beyond that point.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>The PNS consists of all the nervous tissue that lies outside of the CNS. Its main function is to connect the CNS to the rest of the organism.<\/li>\r\n \t<li>The tissues that make up the PNS are [pb_glossary id=\"3011\"]nerves[\/pb_glossary] and [pb_glossary id=\"6027\"]ganglia[\/pb_glossary]. Nerves are bundles of axons and ganglia are groups of cell bodies.\u00a0Nerves are classified as sensory, motor, or\u00a0a mix of the two.\r\n<ul>\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 diabetes, 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<\/li>\r\n \t<li>The human body has two major types of senses: special senses and general senses. Special senses have specialized sense organs and include vision (eyes), hearing (ears), balance (ears), taste (tongue), and smell (nasal passages). General senses are all associated with touch and lack special sense organs. Touch receptors are found throughout the body but particularly in the skin.<\/li>\r\n \t<li>All senses depend on sensory receptor cells to detect sensory stimuli and transform them into nerve impulses. Types of sensory receptors include [pb_glossary id=\"3124\"]mechanoreceptors[\/pb_glossary]\u00a0(mechanical forces), [pb_glossary id=\"3125\"]thermoreceptors[\/pb_glossary]\u00a0(temperature), [pb_glossary id=\"3126\"]nociceptors[\/pb_glossary]\u00a0(pain), [pb_glossary id=\"3127\"]photoreceptors[\/pb_glossary]\u00a0(light), and [pb_glossary id=\"3128\"]chemoreceptors[\/pb_glossary]\u00a0(chemicals).\r\n<ul>\r\n \t<li>[pb_glossary id=\"3129\"]Touch[\/pb_glossary] includes the ability to sense pressure, vibration, temperature, pain, and other tactile stimuli. The skin includes several different types of touch receptor cells.<\/li>\r\n \t<li>[pb_glossary id=\"3164\"]Vision[\/pb_glossary] is the ability to sense light and see. The eye is the special sensory organ that collects and focuses light, forms images, and changes them to nerve impulses. Optic nerves send information from the eyes to the brain, which processes the visual information and \u201ctells\u201d us what we are seeing.\r\n<ul>\r\n \t<li>Common vision problems include [pb_glossary id=\"3144\"]myopia[\/pb_glossary] (nearsightedness), [pb_glossary id=\"3145\"]hyperopia[\/pb_glossary] (farsightedness), and [pb_glossary id=\"3165\"]presbyopia[\/pb_glossary] (age-related decline in close vision).<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>[pb_glossary id=\"3151\"]Hearing[\/pb_glossary] is the ability to sense sound waves, and the ear is the organ that senses sound. It changes sound waves to vibrations that trigger nerve impulses, which travel to the brain through the auditory nerve. The brain processes the information and \u201ctells\u201d us what we are hearing.<\/li>\r\n \t<li>The ear is also the organ responsible for the sense of [pb_glossary id=\"3155\"]balance[\/pb_glossary], which is the ability to sense and maintain an appropriate body position. The ears send impulses on head position to the brain, which sends messages to skeletal muscle via the peripheral nervous system. The muscles respond by contracting to maintain balance.<\/li>\r\n \t<li>[pb_glossary id=\"3157\"]Taste[\/pb_glossary] and [pb_glossary id=\"3158\"]smell[\/pb_glossary] are both abilities to sense chemicals. Taste receptors in taste buds on the tongue sense chemicals in food, and olfactory receptors in the nasal passages sense chemicals in the air. The sense of smell contributes significantly to the sense of taste.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>[pb_glossary id=\"3169\"]Psychoactive drugs[\/pb_glossary] are substances that change the function of the brain and result in alterations of mood, thinking, perception, and behavior. They include prescription medications (such as opioid painkillers), legal substances (such as nicotine and alcohol), and illegal drugs (such as LSD and heroin).<\/li>\r\n \t<li>Psychoactive drugs are divided into different classes according to their pharmacological effects. They include [pb_glossary id=\"3171\"]stimulants[\/pb_glossary], [pb_glossary id=\"3172\"]depressants[\/pb_glossary], [pb_glossary id=\"3173\"]anxiolytics[\/pb_glossary], [pb_glossary id=\"3174\"]euphoriants[\/pb_glossary], [pb_glossary id=\"3175\"]hallucinogens[\/pb_glossary], and [pb_glossary id=\"3176\"]empathogens[\/pb_glossary]. Many psychoactive drugs have multiple effects, so they may be placed in more than one class.<\/li>\r\n \t<li>Psychoactive drugs generally produce their effects by affecting brain chemistry. Generally, they act either as [pb_glossary id=\"3178\"]agonists[\/pb_glossary], which enhance the activity of particular neurotransmitters, or as [pb_glossary id=\"3179\"]antagonists[\/pb_glossary], which decrease the activity of particular neurotransmitters.<\/li>\r\n \t<li>Psychoactive drugs are used for\u00a0medical, ritual, and recreational\u00a0purposes.<\/li>\r\n \t<li>Misuse of psychoactive drugs may lead to [pb_glossary id=\"3184\"]addiction[\/pb_glossary], which is the compulsive use of a drug, despite its negative consequences. Sustained use of an addictive drug may produce physical or psychological [pb_glossary id=\"5553\"]dependence[\/pb_glossary] on the drug. Rehabilitation typically involves psychotherapy, and sometimes the temporary use of other psychoactive drugs.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\"><\/li>\r\n<\/ul>\r\nIn addition to the nervous system, there is another system of the body that is important for coordinating and regulating many different functions \u2013 the endocrine system. You will learn about the endocrine system in the next chapter.\r\n\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;\">Chapter 8 Review<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>Imagine that you decide to make a movement. To carry out this decision, a neuron in the cerebral cortex of your brain (neuron A) fires a nerve impulse that is sent to a neuron in your spinal cord (neuron B). Neuron B then sends the signal to a muscle cell, causing it to contract, resulting in movement. Answer the following questions about this pathway.\r\n<ol type=\"a\">\r\n \t<li>Which part of the brain is neuron A located in \u2014 the cerebellum, cerebrum, or brain stem? Explain how you know.<\/li>\r\n \t<li>The cell body of neuron A is located in a lobe of the brain that is involved in abstract thought, problem solving, and planning. Which lobe is this?<\/li>\r\n \t<li>Part of neuron A travels all the way down to the spinal cord to meet neuron B. Which part of neuron A travels to the spinal cord?<\/li>\r\n \t<li>Neuron A forms a chemical synapse with neuron B in the spinal cord. How is the signal from neuron A transmitted to neuron B?<\/li>\r\n \t<li>Is neuron A in the central nervous system (CNS) or peripheral nervous system (PNS)?<\/li>\r\n \t<li>The axon of neuron B travels in a nerve to a skeletal muscle cell. Is the nerve part of the CNS or PNS? Is this an afferent nerve or an efferent nerve?<\/li>\r\n \t<li>What part of the PNS is involved in this pathway \u2014 the autonomic nervous system or the somatic nervous system? Explain your answer.<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>What are the differences between a neurotransmitter receptor and a sensory receptor?<\/li>\r\n \t<li>[h5p id=\"569\"]<\/li>\r\n \t<li>If a person has a stroke and then has trouble using language correctly, which hemisphere of their brain was most likely damaged? Explain your answer.<\/li>\r\n \t<li>Electrical gradients are responsible for the resting potential and action potential in neurons. Answer the following questions about the electrical characteristics of neurons.\r\n<ol type=\"a\">\r\n \t<li>Define an electrical gradient, in the context of a cell.<\/li>\r\n \t<li>What is responsible for maintaining the electrical gradient that results in the resting potential?<\/li>\r\n \t<li>Compare and contrast the resting potential and the action potential.<\/li>\r\n \t<li>Where along a myelinated axon does the action potential occur? Why does it happen here?<\/li>\r\n \t<li>What does it mean that the action potential is \u201call-or-none?\u201d<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>Compare and contrast Schwann cells and oligodendrocytes.<\/li>\r\n \t<li>For the senses of smell and hearing, name their respective sensory receptor cells, what type of receptor cells they are, and what stimuli they detect.<\/li>\r\n \t<li>Nicotine is a psychoactive drug that binds to and activates a receptor for the neurotransmitter acetylcholine. Is nicotine an agonist or an antagonist for acetylcholine? Explain your answer.<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<h2>Attributions<\/h2>\r\n<strong>Figure 8.9.1<\/strong>\r\n\r\n<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Alzheimers_Disease.jpg\" rel=\"cc:attributionURL\">Alzheimers_Disease<\/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\/deed.en) license.\r\n\r\n<strong>Figure 8.9.2<\/strong>\r\n\r\n<a href=\"https:\/\/www.flickr.com\/photos\/nihgov\/24524716351\/\" rel=\"cc:attributionURL\">Alzheimer\u2019s Disease stagess<\/a> by <a class=\"owner-name truncate no-outline\" 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 in the <a class=\"photo-license-url\" href=\"https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/\" target=\"_newtab\" rel=\"license cc:license noopener noreferrer\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).","rendered":"<p>&nbsp;<\/p>\n<figure id=\"attachment_3191\" aria-describedby=\"caption-attachment-3191\" style=\"width: 1023px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3191\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Alzheimers_Disease-2.jpg\" alt=\"\" width=\"1023\" height=\"791\" \/><figcaption id=\"caption-attachment-3191\" class=\"wp-caption-text\"><em>Figure 8.9.1 Molecular and cellular changes occur in a brain with Alzheimer\u2019s disease (AD).<\/em><\/figcaption><\/figure>\n<h1>Case Study Conclusion: Fading Memory<\/h1>\n<p>The illustration above (Figure 8.9.1) shows some of the molecular and cellular changes that occur in Alzheimer\u2019s disease (AD). Rosa was diagnosed with AD at the beginning of this chapter after experiencing memory problems and other changes in her cognitive functioning, mood, and personality. These abnormal changes in the brain include the development of amyloid plaques between brain cells and neurofibrillary tangles inside of neurons. These hallmark characteristics of AD are associated with the loss of synapses between neurons, and ultimately the death of neurons.<\/p>\n<p>After reading this chapter, you should have a good appreciation for the importance of keeping neurons alive and communicating with each other at synapses. The nervous system coordinates all of the body\u2019s voluntary and involuntary activities. It interprets information from the outside world through sensory systems, and makes appropriate responses through the motor system, through communication between the PNS and CNS. The brain directs the rest of the nervous system and controls everything from basic vital functions (such as heart rate and breathing) to high-level functions (such as problem solving and abstract thought). The nervous system\u00a0can\u00a0perform these important functions by generating action potentials in neurons in response to stimulation and sending messages between cells at synapses, typically using chemical neurotransmitter molecules. When neurons are not functioning properly, lose their synapses, or die, they cannot carry out the signaling essential for the proper functioning of the nervous system.<\/p>\n<p>AD is a progressive neurodegenerative disease, meaning that the damage to the brain becomes more extensive as time goes on. The picture in Figure 8.9.2 illustrates how the damage progresses from before AD is diagnosed (preclinical AD), to mild and moderate AD, to severe AD.<\/p>\n<figure id=\"attachment_3192\" aria-describedby=\"caption-attachment-3192\" style=\"width: 644px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3192\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Alzheimers-Disease-stagess-scaled-3.jpg\" alt=\"\" width=\"644\" height=\"1388\" \/><figcaption id=\"caption-attachment-3192\" class=\"wp-caption-text\"><em>Figure 8.9.2 Illustration showing the areas of the brain that become damaged as Alzheimer\u2019s disease (AD) progresses. This is a side view along the middle of the brain, with the front of the brain shown to the left. Damaged areas are shown in blue.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>You can see that the damage starts in a relatively small location toward the bottom of the brain. One of the earliest brain areas to be affected by AD is the hippocampus. As you have learned, the hippocampus is important for learning and memory, which explains why many of Rosa\u2019s symptoms of mild AD involve deficits in memory, such as trouble remembering where she placed objects, recent conversations, and appointments.<\/p>\n<p>As AD progresses, more of the brain is affected, including areas involved in emotional regulation, social behavior, planning, language, spatial navigation, and higher-level thought. Rosa is beginning to show signs of problems in these areas, including irritability, lashing out at family members, getting lost in her neighborhood, problems finding the right words, putting objects in unusual locations, and difficulty in managing her finances. You can see that as AD progresses, damage spreads further across the cerebrum, which you now know controls conscious functions\u00a0like\u00a0reasoning, language, and interpretation of sensory stimuli. You can also see how the frontal lobe \u2014 which controls executive functions such as planning, self-control, and abstract thought \u2014 becomes increasingly damaged.<\/p>\n<p>Increasing damage to the brain causes corresponding deficits in functioning. In moderate AD, patients have increased memory, language, and cognitive deficits, compared to mild AD. They may not recognize their own family members, and may wander and get lost, engage in inappropriate behaviors, become easily agitated, and have trouble carrying out daily activities such as dressing. In severe AD, much of the brain is affected. Patients usually cannot recognize family members or communicate, and they are often fully dependent on others for their care. They begin to lose the ability to control their basic functions, such as bladder control, bowel control, and proper swallowing. Eventually, AD causes death, usually as a result of this loss of basic functions.<\/p>\n<p>For now, Rosa only has mild AD and is still able to function relatively well with care from her family. The medication her doctor gave her has helped improve some of her symptoms. It is a cholinesterase inhibitor, which blocks an enzyme that normally degrades the neurotransmitter acetylcholine. With more of the neurotransmitter available, more of it can bind to neurotransmitter receptors on postsynaptic cells. Therefore, this drug acts as an agonist for acetylcholine, which enhances communication between neurons in Rosa\u2019s brain. This increase in neuronal communication can help restore some of the functions lost in early Alzheimer\u2019s disease and may slow the progression of symptoms.<\/p>\n<p>But medication such as this is only a short-term measure, and does not halt the progression of the underlying disease. Ideally, the damaged or dead neurons would be replaced by new, functioning neurons. Why does this not happen automatically in the body? As you have learned, neurogenesis is very limited in adult humans, so once neurons in the brain die, they are not normally replaced to any significant extent.\u00a0Scientists, however, are studying the ways in which neurogenesis might be increased in cases of disease or injury to the brain.\u00a0They are also investigating the possibility of using stem cell transplants to replace damaged or dead neurons with new neurons. But this research is in very early stages and is not currently a treatment for AD.<\/p>\n<p>One promising area of research is in the development of methods to allow earlier detection and treatment of AD, given that the changes in the brain may actually start ten to 20 years before diagnosis of AD.\u00a0A\u00a0radiolabeled chemical called Pittsburgh Compound B (PiB) binds to amyloid plaques in the brain, and in the future, it may be used in conjunction with brain imaging techniques to detect early signs of AD. Scientists are also looking for biomarkers in bodily fluids (such as blood and cerebrospinal fluid) that might indicate the presence of AD before symptoms appear. Finally, researchers are also investigating possible early and subtle symptoms (such as changes in how people move or a loss of smell) to see whether they can be used to identify people who will go on to develop AD. This research is in the early stages, but the hope is that patients can be identified earlier, allowing for earlier and more effective treatment, as well as more planning time for families.<\/p>\n<p>Scientists are also still trying to fully understand the causes of AD, which affects more than five million Americans. Some genetic mutations have been identified\u00a0as contributors, but environmental factors also appear to be important. With more research into the causes and mechanisms of AD, hopefully a cure can be found, and people like Rosa can live a longer and better life.<\/p>\n<div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">Chapter 8 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you learned about the human nervous system. Specifically, you learned that:<\/p>\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2908\">nervous system<\/a> is the organ system that coordinates all of the body\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3004\">voluntary<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3005\">involuntary<\/a> actions by transmitting signals to and from different parts of the body. It has two major divisions: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5933\">central nervous system<\/a> (CNS) and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3009\">peripheral nervous system<\/a> (PNS).\n<ul>\n<li>The CNS\u00a0includes\u00a0the brain and spinal cord.<\/li>\n<li>The PNS consists mainly of nerves that connect the CNS with the rest of the body. It has two major divisions: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3014\">somatic nervous system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5899\">autonomic nervous system<\/a>. These divisions control different types of functions, and often interact with the CNS to carry out these functions. The somatic system controls activities that are under voluntary control. The autonomic system controls activities that are involuntary.\n<ul>\n<li>The autonomic nervous system is further divided into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3015\">sympathetic division<\/a> (which controls the fight-or-flight response), the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3016\">parasympathetic division<\/a> (which controls most routine involuntary responses), and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5987\">enteric division<\/a> (which provides local control for digestive processes).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\"><\/li>\n<li>Signals sent by the nervous system are electrical signals called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5697\">nerve impulses<\/a>. They are transmitted by special, electrically excitable cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2984\">neurons<\/a>, which are one of two major types of cells in the nervous system.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2985\">Neuroglia<\/a> are the other major type of nervous system cells. There are many types of glial cells, and they have many specific functions. In general, neuroglia function to support, protect, and nourish neurons.<\/li>\n<li>The main parts of a neuron include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5931\">cell body<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5965\">dendrites<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5901\">axon<\/a>. The cell body contains the nucleus. Dendrites receive nerve impulses from other cells, and the axon transmits nerve impulses to other cells at axon terminals. A synapse is a complex membrane junction at the end of an axon terminal that transmits signals to another cell.<\/li>\n<li>Axons are often wrapped in an electrically-insulating <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3028\">myelin sheath<\/a>, which is produced by oligodendrocytes or schwann cells, both of which are types of neuroglia. Electrical impulses called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3049\">action potentials<\/a>\u00a0occur at gaps in the myelin sheath, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3041\">nodes of Ranvier<\/a>, which speeds the conduction of nerve impulses down the axon.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3025\">Neurogenesis<\/a>, or the formation of new neurons by cell division, may occur in a mature human brain \u2014 but only to a limited extent.<\/li>\n<li>The nervous tissue in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5915\">brain <\/a>and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3010\">spinal cord<\/a> consists of gray matter \u2014 which contains mainly unmyelinated cell bodies and dendrites of neurons \u2014 and white matter, which contains mainly myelinated axons of neurons. Nerves of the peripheral nervous system consist of long bundles of myelinated axons that extend throughout the body.<\/li>\n<li>There are hundreds of types of neurons in the human nervous system, but many can be classified on the basis of the direction in which they carry nerve impulses. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3030\">Sensory neurons<\/a> carry nerve impulses away from the body and toward the central nervous system, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3031\">motor neurons<\/a> carry them away from the central nervous system and toward the body, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3032\">interneurons<\/a> often carry them between sensory and motor neurons.<\/li>\n<li>A nerve impulse is an electrical phenomenon that occurs because of a difference in electrical charge across the plasma membrane of a neuron.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5713\">sodium-potassium pump<\/a> maintains an electrical gradient across the plasma membrane of a neuron when it is not actively transmitting a nerve impulse. This gradient is called the resting potential of the neuron.<\/li>\n<li>An action potential is a sudden reversal of the electrical gradient across the plasma membrane of a resting neuron. It begins when the neuron receives a chemical signal from another cell or some other type of stimulus. The action potential travels rapidly down the neuron\u2019s axon as an electric current.<\/li>\n<li>A nerve impulse is transmitted to another cell at either an electrical or a chemical <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3040\">synapse<\/a>. At a chemical synapse, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3056\">neurotransmitter<\/a> chemicals are released from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3052\">presynaptic cell<\/a> into the synaptic cleft between cells. The chemicals travel across the cleft to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3053\">postsynaptic cell<\/a> and bind to receptors embedded in its membrane.<\/li>\n<li>There are many different types of neurotransmitters. Their effects on the postsynaptic cell generally depend on the type of receptor they bind to. The effects may be excitatory, inhibitory, or modulatory in more complex ways. Both physical and mental disorders may occur if there are problems with neurotransmitters or their receptors.<\/li>\n<li>The CNS includes the brain and spinal cord. It is physically protected by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5913\">bones<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2929\">meninges<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5939\">cerebrospinal fluid<\/a>. It is chemically protected by the blood-brain barrier.<\/li>\n<li>The brain is the control center of the nervous system and of the entire organism. The brain uses a relatively large proportion of the body\u2019s energy, primarily in the form of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5451\">glucose<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>The brain is divided into three major parts, each with different functions: the forebrain, the midbrain and the hindbrain.\n<ul>\n<li>The forebrain includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5941\">cerebrum<\/a>, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3095\">thalamus<\/a>, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2937\">hypothalamus<\/a>, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3096\">hippocampus<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5883\">amygdala<\/a>. The cerebrum is further divided into left and right hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal, and occipital. Each lobe is associated with specific senses or other functions.\u00a0 The cerebrum has a thin outer layer called the cerebral cortex. Its many folds give it a large surface area. This is where most information processing takes place.<\/li>\n<\/ul>\n<\/li>\n<li>The thalamus, hypothalamus, hippocampus and amygdala are all part of the limbic system which helps regulate memories, coordination and attention<\/li>\n<\/ul>\n<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3010\">spinal cord<\/a> is a tubular bundle of nervous tissues that extends from the head down the middle of the back to the pelvis. It functions mainly to connect the brain with the PNS. It also controls certain rapid responses called reflexes without input from the brain.\n<ul>\n<li>A spinal cord injury may lead to paralysis (loss of sensation and movement) of the body below the level of the injury, because nerve impulses can no longer travel up and down the spinal cord beyond that point.<\/li>\n<\/ul>\n<\/li>\n<li>The PNS consists of all the nervous tissue that lies outside of the CNS. Its main function is to connect the CNS to the rest of the organism.<\/li>\n<li>The tissues that make up the PNS are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3011\">nerves<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_6027\">ganglia<\/a>. Nerves are bundles of axons and ganglia are groups of cell bodies.\u00a0Nerves are classified as sensory, motor, or\u00a0a mix of the two.\n<ul>\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 diabetes, shingles, and heavy metal poisoning. Two disorders of the PNS are Guillain-Barre syndrome and Charcot-Marie-Tooth disease.<\/li>\n<\/ul>\n<\/li>\n<li>The human body has two major types of senses: special senses and general senses. Special senses have specialized sense organs and include vision (eyes), hearing (ears), balance (ears), taste (tongue), and smell (nasal passages). General senses are all associated with touch and lack special sense organs. Touch receptors are found throughout the body but particularly in the skin.<\/li>\n<li>All senses depend on sensory receptor cells to detect sensory stimuli and transform them into nerve impulses. Types of sensory receptors include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3124\">mechanoreceptors<\/a>\u00a0(mechanical forces), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3125\">thermoreceptors<\/a>\u00a0(temperature), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3126\">nociceptors<\/a>\u00a0(pain), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3127\">photoreceptors<\/a>\u00a0(light), and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3128\">chemoreceptors<\/a>\u00a0(chemicals).\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3129\">Touch<\/a> includes the ability to sense pressure, vibration, temperature, pain, and other tactile stimuli. The skin includes several different types of touch receptor cells.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3164\">Vision<\/a> is the ability to sense light and see. The eye is the special sensory organ that collects and focuses light, forms images, and changes them to nerve impulses. Optic nerves send information from the eyes to the brain, which processes the visual information and \u201ctells\u201d us what we are seeing.\n<ul>\n<li>Common vision problems include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3144\">myopia<\/a> (nearsightedness), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3145\">hyperopia<\/a> (farsightedness), and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3165\">presbyopia<\/a> (age-related decline in close vision).<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3151\">Hearing<\/a> is the ability to sense sound waves, and the ear is the organ that senses sound. It changes sound waves to vibrations that trigger nerve impulses, which travel to the brain through the auditory nerve. The brain processes the information and \u201ctells\u201d us what we are hearing.<\/li>\n<li>The ear is also the organ responsible for the sense of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3155\">balance<\/a>, which is the ability to sense and maintain an appropriate body position. The ears send impulses on head position to the brain, which sends messages to skeletal muscle via the peripheral nervous system. The muscles respond by contracting to maintain balance.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3157\">Taste<\/a> and smell are both abilities to sense chemicals. Taste receptors in taste buds on the tongue sense chemicals in food, and olfactory receptors in the nasal passages sense chemicals in the air. The sense of smell contributes significantly to the sense of taste.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3169\">Psychoactive drugs<\/a> are substances that change the function of the brain and result in alterations of mood, thinking, perception, and behavior. They include prescription medications (such as opioid painkillers), legal substances (such as nicotine and alcohol), and illegal drugs (such as LSD and heroin).<\/li>\n<li>Psychoactive drugs are divided into different classes according to their pharmacological effects. They include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3171\">stimulants<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3172\">depressants<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3173\">anxiolytics<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3174\">euphoriants<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3175\">hallucinogens<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3176\">empathogens<\/a>. Many psychoactive drugs have multiple effects, so they may be placed in more than one class.<\/li>\n<li>Psychoactive drugs generally produce their effects by affecting brain chemistry. Generally, they act either as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3178\">agonists<\/a>, which enhance the activity of particular neurotransmitters, or as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3179\">antagonists<\/a>, which decrease the activity of particular neurotransmitters.<\/li>\n<li>Psychoactive drugs are used for\u00a0medical, ritual, and recreational\u00a0purposes.<\/li>\n<li>Misuse of psychoactive drugs may lead to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3184\">addiction<\/a>, which is the compulsive use of a drug, despite its negative consequences. Sustained use of an addictive drug may produce physical or psychological <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5553\">dependence<\/a> on the drug. Rehabilitation typically involves psychotherapy, and sometimes the temporary use of other psychoactive drugs.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\"><\/li>\n<\/ul>\n<p>In addition to the nervous system, there is another system of the body that is important for coordinating and regulating many different functions \u2013 the endocrine system. You will learn about the endocrine system in the next chapter.<\/p>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">Chapter 8 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Imagine that you decide to make a movement. To carry out this decision, a neuron in the cerebral cortex of your brain (neuron A) fires a nerve impulse that is sent to a neuron in your spinal cord (neuron B). Neuron B then sends the signal to a muscle cell, causing it to contract, resulting in movement. Answer the following questions about this pathway.\n<ol type=\"a\">\n<li>Which part of the brain is neuron A located in \u2014 the cerebellum, cerebrum, or brain stem? Explain how you know.<\/li>\n<li>The cell body of neuron A is located in a lobe of the brain that is involved in abstract thought, problem solving, and planning. Which lobe is this?<\/li>\n<li>Part of neuron A travels all the way down to the spinal cord to meet neuron B. Which part of neuron A travels to the spinal cord?<\/li>\n<li>Neuron A forms a chemical synapse with neuron B in the spinal cord. How is the signal from neuron A transmitted to neuron B?<\/li>\n<li>Is neuron A in the central nervous system (CNS) or peripheral nervous system (PNS)?<\/li>\n<li>The axon of neuron B travels in a nerve to a skeletal muscle cell. Is the nerve part of the CNS or PNS? Is this an afferent nerve or an efferent nerve?<\/li>\n<li>What part of the PNS is involved in this pathway \u2014 the autonomic nervous system or the somatic nervous system? Explain your answer.<\/li>\n<\/ol>\n<\/li>\n<li>What are the differences between a neurotransmitter receptor and a sensory receptor?<\/li>\n<li>\n<div id=\"h5p-569\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-569\" class=\"h5p-iframe\" data-content-id=\"569\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 8 Review Questions\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>If a person has a stroke and then has trouble using language correctly, which hemisphere of their brain was most likely damaged? Explain your answer.<\/li>\n<li>Electrical gradients are responsible for the resting potential and action potential in neurons. Answer the following questions about the electrical characteristics of neurons.\n<ol type=\"a\">\n<li>Define an electrical gradient, in the context of a cell.<\/li>\n<li>What is responsible for maintaining the electrical gradient that results in the resting potential?<\/li>\n<li>Compare and contrast the resting potential and the action potential.<\/li>\n<li>Where along a myelinated axon does the action potential occur? Why does it happen here?<\/li>\n<li>What does it mean that the action potential is \u201call-or-none?\u201d<\/li>\n<\/ol>\n<\/li>\n<li>Compare and contrast Schwann cells and oligodendrocytes.<\/li>\n<li>For the senses of smell and hearing, name their respective sensory receptor cells, what type of receptor cells they are, and what stimuli they detect.<\/li>\n<li>Nicotine is a psychoactive drug that binds to and activates a receptor for the neurotransmitter acetylcholine. Is nicotine an agonist or an antagonist for acetylcholine? Explain your answer.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 8.9.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Alzheimers_Disease.jpg\" rel=\"cc:attributionURL\">Alzheimers_Disease<\/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\/deed.en) license.<\/p>\n<p><strong>Figure 8.9.2<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/nihgov\/24524716351\/\" rel=\"cc:attributionURL\">Alzheimer\u2019s Disease stagess<\/a> by <a class=\"owner-name truncate no-outline\" 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 in the <a class=\"photo-license-url\" href=\"https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/\" target=\"_newtab\" rel=\"license cc:license noopener noreferrer\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_4805_2908\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_2908\"><div tabindex=\"-1\"><p>Created by:\u00a0CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_254\" aria-describedby=\"caption-attachment-254\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"wp-image-250 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Ribosomal-Art.jpg\" alt=\"Image shows a large 3D work of art displayed at the Cold Spring Harbor Laboratory. It is a representation of ribosomes attached to a ribbon of metal meant to represent a strand of messenger RNA.\" width=\"1024\" height=\"768\"><figcaption id=\"caption-attachment-254\" class=\"wp-caption-text\"><em>Figure 4.6.1 \"Waltz of the Polypeptides\" sculpture by New York City-based artist Mara G. Haseltine, on display at Cold Spring Harbor Laboratory, NY.\u00a0 This artwork features multiple ribosomes creating polypeptides according to the directions on a piece of messenger RNA.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Ribosome\u00a0Review<\/h1>\n<\/div>\n<p>The 25-metre long sculpture shown in Figure 4.6.1 is a recognition of the beauty of one of the metabolic functions that takes place in the cells in your body.\u00a0 This artwork brings to life an important structure in living cells: the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosome<\/a><\/strong>, the\u00a0cell structure\u00a0where\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">proteins<\/a>\u00a0are synthesized. The slender silver strand is the messenger <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_519\">RNA<\/a>(mRNA)\u00a0bringing the code for a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">protein<\/a> out into the cytoplasm.\u00a0 The purple and green structures are ribosomal subunits (which together form a single <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosome<\/a>), which can \"read\" the code on the mRNA and direct the bonding of the correct sequence of amino acids to create a protein.\u00a0\u00a0All living\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2223\">cells<\/a>\u00a0\u2014 whether they are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1572\">prokaryotic<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> \u2014 contain <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosomes<\/a>, but only eukaryotic cells also contain a\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2402\">nucleus<\/a>\u00a0and several other types of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2083\">organelles<\/a>.<\/p>\n<div>\n<h1>What Are Organelles?<\/h1>\n<\/div>\n<p>An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2083\">organelle<\/a><\/strong>\u00a0is a structure within the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1963\">cytoplasm<\/a> of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2223\">cell<\/a> that is enclosed within a membrane and performs a specific job. Organelles are involved in many vital cell functions. Organelles in animal cells include the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2402\">nucleus<\/a>,\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2383\">mitochondria<\/a>,\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2335\">endoplasmic reticulum<\/a>,\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1991\">Golgi apparatus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2437\">vesicles<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2430\">vacuoles<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">Ribosomes<\/a>\u00a0are not enclosed within a membrane, but they are still commonly referred to as organelles in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> cells.<\/p>\n<div>\n<h1>The Nucleus<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2402\">nucleus<\/a><\/strong> is the largest organelle in a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> cell, and it's considered the cell\u2019s control center. It contains most of the cell\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_277\">DNA<\/a>(which makes up chromosomes), and it is encoded with the genetic instructions for making <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">proteins<\/a>. The function of the nucleus is to regulate gene expression, including controlling which proteins the cell makes. In addition to DNA, the nucleus contains a thick liquid called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2097\">nucleoplasm<\/a><\/strong>, which\u00a0is similar in\u00a0composition\u00a0to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2319\">cytosol<\/a> found in the cytoplasm outside the nucleus.\u00a0Most eukaryotic cells contain just a single nucleus, but some types of cells (such as red\u00a0blood\u00a0cells) contain no nucleus and a few other types of cells (such as muscle cells) contain multiple nuclei.<\/p>\n<figure id=\"attachment_254\" aria-describedby=\"caption-attachment-254\" style=\"width: 459px\" class=\"wp-caption alignright\"><img class=\" wp-image-251\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nucleus-1.png\" alt=\"This closeup of a cell nucleus shows that it is surrounded by a structure called the nuclear envelope, which contains tiny perforations, or pores. The nucleus also contains a dense center called the nucleolus.\" width=\"459\" height=\"425\"><figcaption id=\"caption-attachment-254\" class=\"wp-caption-text\"><em>Figure 4.6.2 This closeup of a cell nucleus shows that it is surrounded by a structure called the nuclear envelope, which contains tiny perforations, or pores. The nucleus also contains a dense center called the nucleolus.<\/em><\/figcaption><\/figure>\n<p>As you can see in the model pictured in Figure 4.6.2, the membrane enclosing the nucleus is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2386\">nuclear envelope<\/a><\/strong>. This is actually a double membrane that encloses the entire organelle and isolates its contents from the cellular cytoplasm. Tiny holes called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2391\">nuclear pores<\/a><\/strong>\u00a0allow large molecules to pass through the nuclear envelope, with the help of special proteins. Large proteins and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_519\">RNA<\/a>\u00a0molecules must be able to pass through the nuclear envelope so proteins can be synthesized in the cytoplasm and the genetic material can be maintained inside the nucleus. The nucleolus shown in the model\u00a0below\u00a0is mainly involved in the assembly of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosomes<\/a>. After being produced in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2397\">nucleolus<\/a>, ribosomes are exported to the cytoplasm, where they are involved in the synthesis of proteins.<\/p>\n<div>\n<h1>Mitochondria<\/h1>\n<\/div>\n<p>The\u00a0<strong>mitochondrion<\/strong>\u00a0(plural, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2383\">mitochondria<\/a>) is an organelle that makes\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2340\">energy<\/a>\u00a0available to the cell. This is why\u00a0mitochondria\u00a0are sometimes referred to as the \"power plants of the cell.\" They use energy from\u00a0organic compounds\u00a0(such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1945\">glucose<\/a>) to make molecules of\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2072\">ATP<\/a> (adenosine triphosphate)<\/strong>, an energy-carrying molecule that is used almost universally inside cells for\u00a0energy.<\/p>\n<figure id=\"attachment_254\" aria-describedby=\"caption-attachment-254\" style=\"width: 459px\" class=\"wp-caption alignleft\"><img class=\" wp-image-252\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Mitochondrion_structure.svg_.png\" alt=\"Image shows a diagram of a mitochondrion. Labelled are the inner and outer membranes, the intermembrane space, the matrix, DNA and ribosomes.\" width=\"459\" height=\"265\"><figcaption id=\"caption-attachment-254\" class=\"wp-caption-text\"><em>Figure 4.6.3 Mitochondria contain their own DNA and ribosomes!<\/em><\/figcaption><\/figure>\n<p>Mitochondria (as in the Figure 4.6.3 diagram) have a complex structure including an inner and out membrane.\u00a0 In addition, mitochondria have their own DNA, ribosomes, and a version of cytoplasm, called matrix.\u00a0 Does this sound similar to the requirements to be considered a cell?\u00a0 That's because they are!<\/p>\n<p>Scientists think that mitochondria were once free-living organisms because they contain their own\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_277\">DNA<\/a>. They theorize that ancient\u00a0prokaryotes\u00a0infected (or were engulfed by) larger <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1572\">prokaryotic<\/a> cells, and the two organisms evolved a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2428\">symbiotic<\/a> relationship that benefited both of them. The larger cells provided the smaller prokaryotes with a place to live. In return, the larger cells got extra\u00a0energy\u00a0from the smaller prokaryotes. Eventually, the smaller prokaryotes became permanent guests of the larger cells, as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2083\">organelles<\/a>\u00a0inside them. This theory is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1986\">endosymbiotic theory<\/a>,<\/strong> and it is widely accepted by biologists today. (See the video <span style=\"text-align: initial;font-size: 1em\">in <a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/chapter\/4-3-variation-in-cells\/\">section 4.3<\/a> to learn all about endosymbiotic theory.)<\/span><\/p>\n<div>\n<h1>Endoplasmic Reticulum<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2335\">endoplasmic reticulum<\/a><\/strong><strong>\u00a0(ER)<\/strong> is an organelle that helps make and transport <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">proteins<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2205\">lipids<\/a>. There are two types of endoplasmic reticulum: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2145\">rough endoplasmic reticulum<\/a> (rER) and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2101\">smooth endoplasmic reticulum<\/a> (sER). Both types are shown in Figure 4.6.4.<\/p>\n<ul>\n<li>rER looks rough because it is studded with ribosomes. It provides a framework for the ribosomes, which make proteins. Bits of its membrane pinch off to form tiny sacs called vesicles, which carry proteins away from the ER.<\/li>\n<li>sER looks smooth because it does not have ribosomes. sER makes\u00a0lipids, stores substances, and plays other roles.<\/li>\n<\/ul>\n<figure id=\"attachment_254\" aria-describedby=\"caption-attachment-254\" style=\"width: 726px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-253\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Endomembrane_system_diagram_en.svg_.png\" alt=\"Image shows a diagram of the organelles included in the endomembrane system, inclduing: nuclear envelope, rough ER, smooth ER, golgi body, cell membrane, and vesicles.\" width=\"726\" height=\"577\"><figcaption id=\"caption-attachment-254\" class=\"wp-caption-text\"><em>Figure 4.6.4 The rough and smooth ER are part of a larger group of organelles termed \"the endomembrane system\". All of the organelles in this system are composed of plasma membrane.<\/em><\/figcaption><\/figure>\n<div>\n<p>The Figure 4.6.4 drawing includes the nucleus, rER, sER, and Golgi apparatus. From the drawing, you can see how all these organelles work together to make and transport proteins.<\/p>\n<\/div>\n<div>\n<h1>Golgi Apparatus<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1991\">Golgi apparatus<\/a><\/strong> (shown in the Figure 4.6.4 diagram) is a large organelle that processes proteins and prepares them for use both inside and outside the cell. You can see the Golgi apparatus in the figure above. The Golgi apparatus is something like a post office. It receives items (proteins from the ER), then packages and labels them before sending them on to their destinations (to different parts of the cell or to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2169\">cell membrane<\/a> for transport out of the cell). The Golgi apparatus is also involved in the transport of lipids around the cell.<\/p>\n<div>\n<h1>Vesicles and Vacuoles<\/h1>\n<\/div>\n<p>Both\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2437\">vesicles<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2430\">vacuoles<\/a>\u00a0<\/strong>are sac-like organelles made of phospholipid bilayer that store and transport materials in the cell. Vesicles are much smaller than vacuoles and have a variety of functions. The vesicles that pinch off from the membranes of the ER and Golgi apparatus store and transport <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">protein<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2205\">lipid<\/a> molecules. You can see an example of this type of transport vesicle in the Figure 4.6.4. Some vesicles are used as chambers for biochemical reactions.<\/p>\n<p>There are some vesicles which are specialized to carry out specific functions.\u00a0 L<span style=\"font-size: 1em\">ysosomes, which use\u00a0enzymes\u00a0to break down foreign matter and dead cells, have a double membrane to make sure their contents don't leak into the rest of the cell.\u00a0 Peroxisomes are another type of specialized vesicle with the main function of breaking down fatty acids and some toxins.\u00a0<\/span><\/p>\n<div>\n<h1>Centrioles<\/h1>\n<\/div>\n<figure id=\"attachment_254\" aria-describedby=\"caption-attachment-254\" style=\"width: 442px\" class=\"wp-caption alignright\"><img class=\"wp-image-254 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Centrioles-1.png\" alt=\"Image shows a diagram of a centriole, made up of microtubules. There are nine bundles of microtubules arranged in a circle to form the tube-shaped centriole.\" width=\"442\" height=\"255\"><figcaption id=\"caption-attachment-254\" class=\"wp-caption-text\"><em>Figure 4.6.5 Centrioles are tiny cylinders near the nucleus, enlarged here to show their tubular structure.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2093\">Centrioles<\/a><\/strong>\u00a0are organelles involved in\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2186\">cell division<\/a>. The function of centrioles is to help organize the\u00a0<span style=\"font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2166\">chromosomes<\/a><\/span><span style=\"text-align: initial;font-size: 1em\">\u00a0before cell division occurs so that each daughter cell has the correct number of chromosomes after the cell divides. Centrioles are found only in animal cells, and are located near the nucleus. Each centriole is made mainly of a\u00a0<\/span>protein<span style=\"text-align: initial;font-size: 1em\">\u00a0named tubulin. The centriole is cylindrical in shape and consists of many microtubules, as shown in the model pictured\u00a0<\/span>in Figure 4.6.5<span style=\"text-align: initial;font-size: 1em\">.<\/span><\/p>\n<div>\n<figure id=\"attachment_255\" aria-describedby=\"caption-attachment-255\" style=\"width: 333px\" class=\"wp-caption alignleft\"><img class=\" wp-image-255\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Ribosome_shape.png\" alt=\"Image shows a diagram of a ribosome. It is made up of two sub-units, a smaller sub-unit shown in blue and a larger sub-unit shown in red.\" width=\"333\" height=\"314\"><figcaption id=\"caption-attachment-255\" class=\"wp-caption-text\"><em>Figure 4.6.6 Ribosomes are made up of two subunits, each consisting of protein and rRNA.<\/em><\/figcaption><\/figure>\n<h1>Ribosomes<\/h1>\n<\/div>\n<p>Ribosomes are small structures where proteins are made. Although they are not enclosed within a membrane, they are frequently considered organelles. Each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosome<\/a> is formed of two subunits, like the ones pictured at the beginning of this section (Figure 4.6.1) and in\u00a0 Figure 4.6.6. Both subunits consist of proteins and RNA. mRNA from the nucleus carries the genetic code, copied from DNA, which remains in the nucleus. At the ribosome, the genetic code in mRNA is used to assemble and join together amino acids to make proteins. Ribosomes can be found alone or in groups within the cytoplasm, as well as on the rER.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">4.6 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>An <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2083\">organelle<\/a> is a structure within the cytoplasm of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> cell that is enclosed within a membrane and performs a specific job. Although <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">ribosomes<\/a>\u00a0are not enclosed within a membrane, they are still commonly referred to as organelles in eukaryotic cells.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2402\">nucleus<\/a> is the largest organelle in a eukaryotic cell, and it is considered to be the cell's control center. It controls\u00a0gene expression, including controlling which proteins the cell makes.<\/li>\n<li>The mitochondrion (plural, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2383\">mitochondria<\/a>) is an organelle that makes energy available to the cells. It is like the power plant of the cell. According to the widely accepted <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1986\">endosymbiotic theory<\/a>, mitochondria evolved from prokaryotic cells that were once free-living organisms that infected or were engulfed by larger prokaryotic cells.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2335\">endoplasmic reticulum<\/a> (ER) is an organelle that helps make and transport proteins and lipids. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2145\">Rough endoplasmic reticulum<\/a> (rER) is studded with ribosomes. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2101\">Smooth endoplasmic reticulum<\/a> (sER) has no ribosomes.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1991\">Golgi apparatus<\/a> is a large organelle that processes proteins and prepares them for use both inside and outside the cell. It is also involved in the transport of lipids around the cell.<\/li>\n<li>Both\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2437\">vesicles<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2430\">vacuoles<\/a>\u00a0are sac-like organelles that may be used to store and transport materials in the cell or as chambers for\u00a0biochemical reactions. Lysosomes and peroxisomes are special types of vesicles that break down foreign matter, dead cells, or poisons.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2093\">Centrioles<\/a> are organelles located near the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2402\">nucleus<\/a> that help organize the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2166\">chromosomes<\/a>\u00a0before\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2186\">cell division<\/a>\u00a0so each daughter cell receives the correct number of chromosomes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2074\">Ribosomes<\/a>\u00a0are small structures where proteins are made. They are found in both\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1572\">prokaryotic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1573\">eukaryotic<\/a> cells. They may be found alone or in groups within the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1963\">cytoplasm<\/a> or on the rER.<\/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\">4.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is an\u00a0organelle?<\/li>\n<li>Describe the structure and function of the nucleus.<\/li>\n<li>Explain how the nucleus, ribosomes, rough endoplasmic reticulum, and Golgi apparatus work together to make and transport proteins.<\/li>\n<li>Why are mitochondria referred to as the \"power plants of the cell\"?<\/li>\n<li>What roles are played by\u00a0vesicles and vacuoles?<\/li>\n<li>Why\u00a0do all cells need ribosomes \u2014 even prokaryotic cells that lack a nucleus and other\u00a0cell organelles?<\/li>\n<li>Explain endosymbiotic theory as it relates to mitochondria. What is one piece of evidence that supports this theory?<\/li>\n<li>\n<div id=\"h5p-39\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-39\" class=\"h5p-iframe\" data-content-id=\"39\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cell Organelles\"><\/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\"><span style=\"color: #ffffff\">4.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\" style=\"text-align: center\">\n<p>https:\/\/www.youtube.com\/watch?v=URUJD5NEXC8&amp;t=121s<\/p>\n<p>Biology: Cell Structure I Nucleus Medical Media, Nucleus Medical Media, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=Id2rZS59xSE&amp;feature=youtu.be<\/p>\n<p>David Bolinsky: Visualizing the wonder of a living cell, TED, 2007.<\/p>\n<\/div>\n<\/div>\n<h2>Attributes<\/h2>\n<p><strong>Figure 4.6.1\u00a0<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/pedrik\/3534019319\" rel=\"cc:attributionURL\">Ribosomes at Work<\/a> by <a class=\"owner-name truncate\" title=\"Go to pedrik's photostream\" href=\"https:\/\/www.flickr.com\/photos\/pedrik\/\" data-track=\"attributionNameClick\">Pedrik<\/a> on <a href=\"https:\/\/www.flickr.com\/\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\">CC BY-NC-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/) license.<\/p>\n<p><strong>Figure 4.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/en.wikipedia.org\/wiki\/Cell_nucleus#\/media\/File:Blausen_0212_CellNucleus.png\" rel=\"cc:attributionURL\">Nucleus<\/a> <span style=\"text-align: initial;font-size: 1em\">by <a 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.\u00a0<\/span><\/p>\n<p><strong>Figure 4.6.3\u00a0<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Mitochondrion_structure.svg\" rel=\"cc:attributionURL\">Mitochondrion_structure.svg<\/a> by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Kelvin13\">Kelvinsong<\/a>; modified by <a href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sowlos&amp;action=edit&amp;redlink=1\">Sowlos<\/a> on Wikimedia Commons is used and adapted by Christine Miller under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0) license.<\/p>\n<p><strong>Figure 4.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Endomembrane_system_diagram_en.svg\" rel=\"cc:attributionURL\">Endomembrane_system_diagram_en.svg<\/a> by Mariana Ruiz [<a title=\"User:LadyofHats\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:LadyofHats\">LadyofHats]<\/a> 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>Figur<span style=\"font-size: 1em\">e 4.6.5<\/span><\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0214_Centrioles.png\" rel=\"cc:attributionURL\">Centrioles<\/a> <span style=\"text-align: initial;font-size: 1em\">by <a 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.\u00a0<\/span><\/p>\n<p><strong>Figure 4.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Ribosome_shape.png\" rel=\"cc:attributionURL\">Ribosome_shape<\/a> by <a title=\"User:Vossman\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Vossman\">Vossman<\/a> on Wikimedia Commons is used and adapted by Christine Miller under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Blausen.com staff. (2014). Nucleus - Medical gallery of Blausen Medical 2014. <i>WikiJournal of Medicine<\/i>\u00a01\u00a0(2).\u00a0DOI:10.15347\/wjm\/2014.010.\u00a0ISSN\u00a02002-4436. https:\/\/en.wikiversity.org\/wiki\/WikiJournal_of_Medicine\/Medical_gallery_of_Blausen_Medical_2014<\/p>\n<p class=\"hanging-indent\">Blausen.com staff (2014). Centrioles - Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.https:\/\/en.wikiversity.org\/wiki\/WikiJournal_of_Medicine\/Medical_gallery_of_Blausen_Medical_2014<\/p>\n<p class=\"hanging-indent\">Nucleus Medical Media. (2015, March 18). Biology: Cell structure I Nucleus Medical Media. YouTube. https:\/\/www.youtube.com\/watch?v=URUJD5NEXC8&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2007, July 24). David Bolinsky: Visualizing the wonder of a living cell. YouTube. https:\/\/www.youtube.com\/watch?v=Id2rZS59xSE&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3004\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2422\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_2628\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2218\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3005\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4671\">diarrhea<\/a>.\u00a0Weight\u00a0loss, fever, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2405\">pathogens<\/a>. Symptoms typically include some combination of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4671\">diarrhea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_5933\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_3009\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_4717\">Urine<\/a> is formed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>, which filter many substances out of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2702\">Blood<\/a> is filtered and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4708\">urea<\/a> \u2014 a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2299\">catabolism<\/a> \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4709\">uric\u00a0acid<\/a>, a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_2648\">endocrine<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_2368\">metabolism<\/a> from the body by forming and excreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4725\">ureters<\/a> via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. The bladder stores the urine until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4708\">urea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_2526\">antidiuretic hormone<\/a> from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3467\">parathyroid hormone<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3402\">parathyroid glands<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2509\">aldosterone<\/a> from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2533\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4627\">sphincter<\/a> at the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3014\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_2989\">liver<\/a> damage, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4782\">kidney failure<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4813\">infertility<\/a>, or bladder <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2405\">pathogen<\/a>.<\/strong>\u00a0Most pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2588\">bacteria<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2571\">cardiovascular system<\/a> and plays a major role in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4552\">Lymph<\/a><\/strong>\u00a0is essentially blood plasma that has leaked from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2566\">capillaries<\/a> into tissue spaces. It includes many leukocytes, especially <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4829\">thymus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4497\">spleen<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4830\">tonsils<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2554\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2405\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2371\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_5899\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_3015\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4552\">lymph<\/a>, the spleen also filters <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_2172\">leukocytes<\/a>\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_2571\">cardiovascular system<\/a>. Lymph is similar in composition to blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_4829\">thymus<\/a>. Both the bone marrow and thymus are considered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4845\">primary lymphatic organs<\/a>.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4847\">Secondary lymphatic organs<\/a>\u00a0include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4830\">tonsils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3016\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4865\">cytokines<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_1680\">phagocytosis<\/a>.<\/span><\/p>\n<h2>Phagocytosis<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2045\">Eosinophils<\/a><\/strong> are non-phagocytic leukocytes that are related to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2067\">neutrophil<\/a>. They specialize in defending against <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4877\">allergies<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4348\">asthma<\/a>.<\/p>\n<h2>Basophils<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4881\">Mast cells<\/a><\/strong>\u00a0are non-phagocytic leukocytes that help initiate <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4860\">inflammation<\/a> by secreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4822\">adaptive immune system<\/a>, the innate system does not confer\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4884\">immunity<\/a>. The innate immune system includes surface barriers, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4860\">inflammation<\/a>, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3521\">skin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3538\">mucous membranes<\/a>, and fluids such as tears and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4711\">sweat<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4595\">saliva<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4865\">cytokines<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4868\">complement system<\/a> is a complex biochemical mechanism that helps <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2172\">leukocytes<\/a>. For example, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2067\">neutrophils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4340\">macrophages<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4875\">dendritic cells<\/a>\u00a0phagocytize pathogens. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2103\">Basophils<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4881\">mast cells<\/a>\u00a0release chemicals that trigger inflammation. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_5987\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_5697\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5697\"><div tabindex=\"-1\"><p>A signal transmitted along a nerve fiber.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_2984\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_2984\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1103\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/stroller-fit.jpg\" alt=\"12.5.1 Stroller Fit\" width=\"400\" height=\"225\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>12.5.1 It's stroller time!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Stroller Moms<\/h1>\n<\/div>\n<p>These moms (Figure 12.5.1) are setting a great example for their children by engaging in physical exercise. Adopting a habit of regular physical exercise is one of the most important ways to maintain fitness and good health. From higher self-esteem to a healthier heart, physical exercise can have a positive effect on virtually all aspects of health, including physical, mental, and emotional health.<\/p>\n<div>\n<h1>What Is Physical Exercise?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4224\">Physical exercise<\/a><\/strong> is any bodily activity that enhances or maintains physical fitness and overall health and wellness. We generally think of physical exercise as activities that are undertaken for the main purpose of improving physical fitness and health. However, physical activities that are undertaken for other purposes may also count as physical exercise. Scrubbing a floor, raking a lawn, or playing active games with young children or a pet are all activities that can have fitness and health benefits, even though they generally are not done mainly for this purpose.<\/p>\n<p>How much physical exercise should people get? In the Canada, both the Canadian Food Guide and the Canadian Society for Exercise Physiology\u00a0 recommend that every child and\u00a0 adult who is able should participate in moderate exercise for a minimum of 60 minutes a day. This might include walking, swimming, and\/or household or yard work.<\/p>\n<div>\n<h1>Types of Physical Exercise<\/h1>\n<\/div>\n<p>Physical exercise can be classified into three types, depending on the effects it has on the body: aerobic exercise, anaerobic exercise, and flexibility exercise. Many specific examples of physical exercise (including playing soccer and rock climbing) can be classified as more than one type.<\/p>\n<h2>Aerobic Exercise<\/h2>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 276px\" class=\"wp-caption alignright\"><img class=\" wp-image-1105\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Kayaking-on-PIXNIO-53266-725x483-1.jpg\" alt=\"12.5 Kayaking Aerobic Exercise\" width=\"276\" height=\"184\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.2 Kayaking is a form of aerobic exercise.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4225\">Aerobic exercise<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">is any physical activity in which muscles are used at well below their maximum contraction strength, but for long periods of time. Aerobic exercise uses a relatively high percentage of slow-twitch muscle fibres that consume a large amount of oxygen. The main goal of aerobic exercise is to increase cardiovascular endurance, although it can have many other benefits, including muscle toning. Examples of aerobic exercise include cycling, swimming, brisk walking, jumping rope, rowing, hiking, <\/span><span style=\"font-size: 1em\">tennis, <\/span><span style=\"font-size: 1em;text-align: initial\">and kayaking as shown in Figure 12.5.2 .<\/span><\/p>\n<h2>Anaerobic Exercise<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4226\">Anaerobic exercise<\/a><\/strong> is any physical activity in which muscles are used at close to their maximum contraction strength, but for relatively short periods of time. Anaerobic exercise uses a relatively high percentage of fast-twitch muscle fibres that consume a small amount of oxygen. Goals of anaerobic exercise include building and strengthening muscles, as well as improving bone strength, balance, and coordination. Examples of anaerobic exercise include push-ups, lunges, sprinting, interval training, resistance training, and weight training (such as biceps curls with a dumbbell, as pictured in Figure 12.5.3).<\/p>\n<div>\n<figure id=\"attachment_1106\" aria-describedby=\"caption-attachment-1106\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1106\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Bicep-curls.jpg\" alt=\"12.5.3 Bicep Curls\" width=\"400\" height=\"261\"><figcaption id=\"caption-attachment-1106\" class=\"wp-caption-text\"><em>Figure 12.5.3 Pitting the biceps muscle in the upper arm against a heavy weight helps to build and strengthen this muscle.<\/em><\/figcaption><\/figure>\n<\/div>\n<h2>Flexibility Exercise<\/h2>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 232px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4229\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Flexibility-exercise-by-carl-barcelo-nqUHQkuVj3c-unsplash-scaled-1.jpg\" alt=\"12.5.4 Flexibility Exercise\" width=\"232\" height=\"155\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.4 Flexibility exercise can increase range of motion and lower risk of injury.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4228\">Flexibility exercise<\/a><\/strong> is any physical activity that stretches and lengthens muscles. Goals of flexibility exercise include increasing joint flexibility, keeping muscles limber, and improving the range of motion, all of which can reduce the risk of injury. Examples of flexibility exercise include stretching, yoga (as in Figure 12.5.4), and tai chi.<\/p>\n<div>\n<h1>Health Benefits of Physical Exercise<\/h1>\n<\/div>\n<p>Many studies have shown that physical exercise is positively correlated with a diversity of health benefits. Some of these benefits include maintaining physical fitness, losing weight and maintaining a healthy weight, regulating digestive health, building and maintaining healthy bone density, increasing muscle strength, improving joint mobility, strengthening the immune system, boosting cognitive ability, and promoting psychological well-being. Some studies have also found a significant positive correlation between exercise and both quality of life and life expectancy. People who participate in moderate to high levels of physical activity have been shown to have lower mortality rates than people of the same ages who are not physically active and daily exercise has been shown to increase life expectancy up to an average of five years.<\/p>\n<p>The underlying physiological mechanisms explaining why exercise has these positive health benefits are not completely understood. However, developing\u00a0research\u00a0suggests that many of the benefits of exercise may come about because of the role of\u00a0skeletal muscles\u00a0as endocrine organs. Contracting muscles release hormones called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4230\">myokines<\/a><\/strong>, which promote tissue repair and the growth of new tissue. Myokines also have anti-inflammatory effects, which, in turn, reduce the risk of developing inflammatory diseases. Exercise also reduces levels of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2615\">cortisol<\/a>, the adrenal cortex stress\u00a0hormone\u00a0that may cause many health problems \u2014 both physical and mental \u2014 at sustained high levels.<\/p>\n<h2>Cardiovascular Benefits of Physical Exercise<\/h2>\n<p>The beneficial effects of exercise on the\u00a0cardiovascular system\u00a0are well documented. Physical inactivity has been identified as a risk factor for the\u00a0development\u00a0of <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/coronary-artery-disease\/symptoms-causes\/syc-20350613\">coronary artery disease<\/a>. There is also a direct correlation between physical inactivity and cardiovascular disease mortality. Physical exercise, in contrast, has been demonstrated to reduce several risk factors for cardiovascular disease, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4231\">hypertension<\/a> (high blood pressure), \u201cbad\u201d cholesterol (low-density lipoproteins), high total cholesterol, and excess body weight. Physical exercise has also been shown to increase \u201cgood\u201d cholesterol (high-density lipoproteins), insulin sensitivity, the mechanical efficiency of the heart, and exercise tolerance, which is the ability to perform physical activity without undue stress and fatigue.<\/p>\n<h2>Cognitive Benefits of Physical Exercise<\/h2>\n<p>Physical exercise has been shown to help protect people from developing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2007\">neurodegenerative disorders<\/a>, such as dementia. A 30-year study of almost 2,400 men found that those who exercised regularly had a 59 per cent reduction in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4233\">dementia<\/a> when compared with those who did not exercise. Similarly, a review of cognitive enrichment therapies for the elderly found that physical activity \u2014 in particular, aerobic exercise \u2014 can enhance the cognitive function of older adults. Anecdotal evidence suggests that frequent exercise may even help reverse alcohol-induced brain damage. There are several possible reasons why exercise is so beneficial for the brain. Physical exercise:<\/p>\n<ul>\n<li>Increases blood flow and oxygen availability to the brain.<\/li>\n<li>Increases growth factors that promote new brain cells and new neuronal pathways in the brain.<\/li>\n<li>Increases levels of neurotransmitters (such as serotonin), which increase memory retention, information processing, and cognition.<\/li>\n<\/ul>\n<h2>Mental Health Benefits of Physical Exercise<\/h2>\n<p>Numerous studies suggest that regular <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4225\">aerobic exercise<\/a> works as well as pharmaceutical antidepressants in treating mild-to-moderate <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4237\">depression<\/a>. A possible reason for this effect is that exercise increases the biosynthesis of at least three <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4238\">neurochemicals <\/a>that may act as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4239\">euphoriants<\/a>. The euphoric effect of exercise is well known. Distance runners may refer to it as \u201crunner\u2019s high,\u201d and people who participate in crew (as in Figure 12.5.5) may refer to it as \u201crower\u2019s high.\u201d Because of these effects, health care providers often promote the use of aerobic exercise as a treatment for depression.<\/p>\n<div>\n<figure id=\"attachment_1110\" aria-describedby=\"caption-attachment-1110\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1110\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Canadian-womens-double-scull-silver-Rio-2016-by-Gerhard-Pratt-on-flickr-.jpg\" alt=\"12.5.5 Exercise Euphoria\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1110\" class=\"wp-caption-text\"><em>Figure 12.5.5 These rowing duos are competing in the 2016 Summer Olympics in Rio, in which Canada won a silver medal.\u00a0 They are clearly exerting themselves \u2014 and no doubt increasing their euphoriant neurochemicals in the process.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Additional mental health benefits of physical exercise include reducing stress, improving body image, and promoting positive self-esteem. Conversely, there is evidence to suggest that being sedentary is associated with increased risk of anxiety.<\/p>\n<h2>Sleep Benefits of Physical Exercise<\/h2>\n<p>A recent review of published scientific research suggests that exercise generally improves sleep for most people, and helps sleep disorders, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4241\">insomnia<\/a>. In fact, exercise is the most recommended alternative to sleeping pills for people with insomnia. For sleep benefits, the optimum time to exercise may be four to eight hours before bedtime, although exercise at any time of day seems to be beneficial. The only possible exception is heavy exercise undertaken shortly before bedtime, which may actually interfere with sleep.<\/p>\n<h2>Other Benefits of Physical Exercise<\/h2>\n<p>Some studies suggest that physical activity may benefit the immune system. For example, moderate exercise has been found to be associated with a decreased incidence of upper respiratory tract infections. Evidence from many studies has found a correlation between physical exercise and reduced death rates from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2148\">cancer<\/a>, specifically breast cancer and colon cancer. Physical exercise has also been shown to reduce the risk of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3417\">type 2 diabetes<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4243\">obesity<\/a>.<\/p>\n<div>\n<h1>Variation in Responses to Physical Exercise<\/h1>\n<\/div>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4245\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Toronto-Marathon-2012-by-Marc-Roberts-on-flickr-scaled-1.jpg\" alt=\"11.5 Marathon\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.6 This participant in the Toronto Marathon is likely to have a relatively high proportion of slow-twitch muscle fibres that increase her endurance.<\/em><\/figcaption><\/figure>\n<p>Not everyone benefits equally from physical exercise. When participating in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4225\">aerobic exercise<\/a>, most people will have a moderate increase in their endurance, but some people will as much as\u00a0<em>double<\/em> their endurance. Some people, on the other hand, will show little or no increase in endurance from aerobic exercise. Genetic differences in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4184\">slow-twitch<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4185\">fast-twitch<\/a> skeletal muscle fibres may play a role in these different results. People with more slow-twitch fibres may be able to develop greater endurance, because these muscle fibres have more capillaries, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2383\">mitochondria<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4244\">myoglobin<\/a> than fast-twitch fibres. As a result, slow-twitch fibres can carry more oxygen and sustain aerobic activity for a longer period of time than fast-twitch fibres. Studies show that endurance athletes (like the marathoner pictured in Figure 12.5.6) generally do tend to have a higher proportion of slow-twitch fibres than other people.<\/p>\n<p>There is also great variation in individual responses to muscle building as a result of anaerobic exercise. Some people have a much greater capacity to increase muscle size and strength, whereas other people never develop large muscles, no matter how much they exercise them. People who have more fast-twitch than slow-twitch muscle fibres may be able to develop bigger, stronger muscles, because fast-twitch muscle fibres contribute more to muscle strength and have greater potential to increase in mass. Evidence suggests that athletes who excel at power activities (such as throwing and jumping) tend to have a higher proportion of fast-twitch fibres than do endurance athletes.<\/p>\n<div>\n<h1>Can You \u201cOverdose\u201d on Physical Exercise?<\/h1>\n<\/div>\n<p>Is it possible to exercise too much? Can too much exercise be harmful? Evidence suggests that some adverse effects may occur if exercise is extremely intense and the body is not given proper rest between exercise sessions. Athletes who train for multiple marathons have been shown to develop scarring of the heart and heart rhythm abnormalities. Doing too much exercise without prior conditioning also increases the risk of injuries to muscles and joints. Damage to muscles due to overexertion is often seen in new military recruits (see Figure 12.5.7). Too much exercise in females may cause <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/amenorrhea\/symptoms-causes\/syc-20369299#:~:text=Amenorrhea%20(uh%2Dmen%2Do,cause%20of%20amenorrhea%20is%20pregnancy.\">amenorrhea<\/a>, which is a cessation of menstrual periods. When this occurs, it generally indicates that a woman is pushing her body too hard.<\/p>\n<figure id=\"attachment_1105\" aria-describedby=\"caption-attachment-1105\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4246\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Muscle-damage-in-military-recruits-scaled-1.jpg\" alt=\"12.5 Muscle Damage\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1105\" class=\"wp-caption-text\"><em>Figure 12.5.7 New military recruits may suffer muscle damage from overexertion of unconditioned muscles. The drill instructor pictured here (in orange shirt) is doing his best to encourage these marine recruits to expend their maximum effort<\/em>.<\/figcaption><\/figure>\n<p>Many people develop <a href=\"https:\/\/en.wikipedia.org\/wiki\/Delayed_onset_muscle_soreness#:~:text=Delayed%20onset%20muscle%20soreness%20(DOMS,72%20hours%20after%20the%20exercise.\">delayed onset muscle soreness<\/a> (DOMS), which is pain or discomfort in muscles that is felt one to three days after exercising, and generally subsides two or three days later. DOMS was once thought to be caused by the buildup of lactic acid in the muscles. Lactic acid is a product of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2163\">anaerobic respiration<\/a> in muscle tissues. However, lactic acid disperses fairly rapidly, so it is unlikely to explain pain experienced several days after exercise. The current theory is that DOMS is caused by tiny tears in muscle fibres, which occur when muscles are used at too high a level of intensity.<\/p>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<p>Most people know that exercise is important for good health, and it\u2019s easy to find endless advice about exercise programs and fitness plans. What is not so easy to find is the motivation to start exercising \u2014 and to stick with it.\u00a0This is\u00a0the main reason why so many people fail to get regular exercise. Practical concerns like a busy schedule and bad\u00a0weather\u00a0can certainly make exercising more of a challenge, but the biggest barriers to adopting a regular exercise routine are mental. If you want to exercise but find yourself making excuses or getting discouraged and giving up, here are some tips that may help you get started and stay moving:<\/p>\n<ul>\n<li><strong>Avoid an all-or-nothing point of view.<\/strong> Don\u2019t think you need to spend hours sweating at the gym or training for a marathon to get healthy. Even a little bit of exercise is better than nothing at all. Start out with ten or 15 minutes of moderate activity each day. Taking a walk around your neighborhood is a great way to begin! From there, gradually increase the amount of time until you are exercising to at least 30 minutes a day, five days a week.\u00a0 Make it a routine.<\/li>\n<li><strong>Be kind to yourself, and reinforce positive behaviors with rewards. <\/strong>Don\u2019t be down on yourself because you are overweight or out of shape. Don\u2019t beat yourself up because of a supposed lack of willpower. Instead, look at any past failures as opportunities to learn and do better. When you do achieve even small exercise goals, treat yourself to something special. Did you just complete your first workout? Reward yourself with a relaxing bath or other treat.<\/li>\n<li><strong>Don\u2019t make excuses for not exercising.<\/strong>\u00a0Common complaints include being too busy or tired or not athletic enough. Such excuses are not valid reasons to avoid exercising, and they will sabotage any plans to improve your fitness. If you can\u2019t find a 30-minute period to work out, try to find\u00a0ten\u00a0minutes, three times a day. If you\u2019re feeling tired, know that exercise can actually reduce fatigue and boost your\u00a0energy level. If you feel clumsy and uncoordinated, remind yourself that you don\u2019t need to be athletic to take a walk or engage in vigorous house or yard work.<\/li>\n<li><strong>Find an activity that you truly enjoy doing.<\/strong>\u00a0Don\u2019t think you have to lift weights or run on a treadmill to exercise your muscles. If you find such activities boring or unpleasant, you won\u2019t stick with them. Any activity that increases your heart rate and uses large muscles can provide a workout, especially if you\u2019re not in the habit of exercising, so find something you like to do. Do you like to dance? Put on some music and dance up a sweat! Do you enjoy gardening? Get out in the yard and dig up some dirt! Still not interested? Try an activity-based video game, such as Wii or Kinect. You may find it so much fun that it doesn\u2019t seem like exercise until you realize you\u2019ve worked up a sweat.<\/li>\n<li><strong>Make yourself accountable.<\/strong>\u00a0Tell friends and family members that you\u2019re going to start exercising. You\u2019ll be letting them \u2014 as well as yourself \u2014 down if you don\u2019t follow through. Some people find that keeping an exercise log to track their progress is a good way to be accountable and stick to an exercise program. Perhaps the best way to keep at it is to find an exercise partner. If you\u2019ve got someone waiting to exercise with you, you will be less likely to make excuses for not exercising.<\/li>\n<li><strong>Add more physical activity to your daily life.<\/strong>\u00a0You don\u2019t need to follow a structured exercise program to increase your activity level. Do your house or yard work briskly for a workout. Park your car\u00a0further\u00a0than necessary from work or the mall, and walk the extra\u00a0distance. If you live close enough, leave the car at home and walk to and from your destination. Rather than taking elevators or escalators, walk up and down stairs. When you take breaks at work, take a walk instead of sitting. Every time a commercial comes on while you\u2019re watching TV, take a quick exercise break \u2014 run in place or do some curls with hand weights.<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4224\">Physical exercise<\/a> is any bodily activity that enhances or maintains physical fitness and overall health. Activities such as household chores may count as physical exercise, even if they are not done for their health benefits.\u00a0Current\u00a0recommendations for adults are 30 minutes a day of moderate exercise.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4225\">Aerobic exercise<\/a> is any physical activity that uses muscles at less than their maximum contraction strength, but for long periods of time. This type of exercise uses a relatively high percentage of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4184\">slow-twitch muscle fibres<\/a> that consume large amounts of oxygen. Aerobic exercises increase cardiovascular endurance and include cycling and brisk walking.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4226\">Anaerobic exercise<\/a> is any physical activity that uses muscles at close to their maximum contraction strength, but for short periods of time. This type of exercise uses a relatively high percentage of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4185\">fast-twitch muscle fibres<\/a> that consume small amounts of oxygen. Anaerobic exercises increase muscle and bone mass and strength, and they include push-ups and sprinting.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4228\">Flexibility exercise<\/a> is any physical activity that stretches and lengthens muscles, thereby improving range of motion and reducing risk of injury. Examples include stretching and yoga.<\/li>\n<li>Many studies have shown that physical exercise is positively correlated with a diversity of physical, mental, and emotional health benefits. Physical exercise also increases quality of life and life expectancy.<\/li>\n<li>Many of the benefits of exercise may come about because contracting muscles release hormones called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4230\">myokines<\/a>, which promote tissue repair and growth and have anti-inflammatory effects.<\/li>\n<li>Physical exercise can reduce risk factors for\u00a0cardiovascular disease, including hypertension and excess body weight. Physical exercise can also increase factors associated with\u00a0cardiovascular health, such as mechanical\u00a0efficiency\u00a0of the heart.<\/li>\n<li>Physical exercise has been shown to offer protection from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4233\">dementia<\/a> and other cognitive problems, perhaps because it increases\u00a0blood\u00a0flow or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3056\">neurotransmitters<\/a>\u00a0in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2554\">brain<\/a>, among other potential effects.<\/li>\n<li>Numerous studies suggest that regular aerobic exercise works as well as pharmaceutical antidepressants in treating mild-to-moderate depression, possibly because it increases synthesis of natural euphoriants in the brain.<\/li>\n<li>Research\u00a0shows that physical exercise generally improves sleep for most people and helps sleep disorders, such as insomnia. Other health benefits of physical exercise include better immune system function and reduced risk of type 2\u00a0diabetes\u00a0and\u00a0obesity.<\/li>\n<li>There is great variation in individual responses to exercise, partly due to genetic differences in proportions of slow-twitch and fast-twitch skeletal muscle fibres. People with more slow-twitch fibres may be able to develop greater endurance from aerobic exercise, whereas people with more fast-twitch fibres may be able to develop greater muscle size and strength from anaerobic exercise.<\/li>\n<li>Some adverse effects may occur if exercise is extremely intense and the body is not given proper rest between exercise sessions. Many people who overwork their muscles develop delayed onset muscle soreness (DOMS), which may be caused by tiny tears in muscle fibres.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>How do we define physical exercise?<\/li>\n<li>What are current recommendations for physical exercise for adults?<\/li>\n<li>\n<div id=\"h5p-227\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-227\" class=\"h5p-iframe\" data-content-id=\"227\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"12.5 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Define flexibility exercise, and state its benefits. What are two examples of flexibility exercises?<\/li>\n<li>In general, how does physical exercise affect health, quality of life, and longevity?<\/li>\n<li>What mechanism may\u00a0underlie many of the general health benefits of physical exercise?<\/li>\n<li>Relate physical exercise to\u00a0cardiovascular disease risk.<\/li>\n<li>What may explain the positive benefits of physical exercise on cognition?<\/li>\n<li>How does physical exercise compare with antidepressant drugs in the treatment of depression?<\/li>\n<li>Identify several other health benefits of physical exercise.<\/li>\n<li>Explain how genetics may influence the way individuals respond to physical exercise.<\/li>\n<li>Can too much physical exercise be harmful?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=hmFQqjMF_f0<\/p>\n<p style=\"text-align: center\">How playing sports benefits your body ... and your brain - Leah Lagos and Jaspal Ricky Singh, TED-Ed, 2016.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=rLsimrBoYXc&amp;t=12s<\/p>\n<p style=\"text-align: center\">The surprising reason our muscles get tired - Christian Moro, TED-Ed, 2019.<\/p>\n<p>https:\/\/youtu.be\/2tM1LFFxeKg<\/p>\n<p style=\"text-align: center\">What makes muscles grow? - Jeffrey Siegel, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=QeIrdqU0o9s<\/p>\n<p style=\"text-align: center\">Why some people find exercise harder than others | Emily Balcetis, TED, 2014.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Attack_of_the_stroller_Moms_(4665101120).jpg\" rel=\"cc:attributionURL\">stroller fit<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/67958110@N00\" rel=\"nofollow\">Serge Melki<\/a> from Indianapolis, USA on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\" rel=\"license\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0) license.<\/p>\n<p><strong>Figure 12.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/pixnio.com\/sport\/canoeing-and-kayaking-pictures\/children-kayaking-young-sport#\" rel=\"cc:attributionURL\">Children kayaking young sport<\/a> by <span style=\"font-size: 1em\">Hagerty Ryan, USFWS <\/span>on <a href=\"https:\/\/pixnio.com\/sport\/canoeing-and-kayaking-pictures\/children-kayaking-young-sport#\">Pixnio<\/a> is used under a <a title=\"public domain\" href=\"https:\/\/creativecommons.org\/licenses\/publicdomain\/\" target=\"_blank\" rel=\"license nofollow noopener noreferrer\">public domain (CC0) Certification<\/a> (https:\/\/creativecommons.org\/licenses\/publicdomain\/).<\/p>\n<p><strong>Figure 12.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/www.acc.af.mil\/News\/Photos\/igphoto\/2000849716\/\" rel=\"cc:attributionURL\">Bicep curls<\/a> [photo] by Senior Airman Jarrod Grammel from <a href=\"https:\/\/www.acc.af.mil\/News\/Photos\/igphoto\/2000849716\/\">U.S. Moody Air Force Base<\/a> is released into the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 12.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/nqUHQkuVj3c\" rel=\"cc:attributionURL\">Flexibility exercise by carl-barcelo-nqUHQkuVj3c<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@barcelocarl\">Carl Barcelo<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the <a href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p><strong>Figure 12.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/gerhardpratt\/29956941214\/\" rel=\"cc:attributionURL\">Canadian women\u2019s double scull silver Rio 2016 <\/a>by <a class=\"owner-name truncate\" title=\"Go to Gerhard Pratt's photostream\" href=\"https:\/\/www.flickr.com\/photos\/gerhardpratt\/\" data-track=\"attributionNameClick\">Gerhard Pratt<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 12.5.6<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/marcs-album\/8321816093\/\" rel=\"cc:attributionURL\">Toronto Marathon 2012<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/marcs-album\/\" rel=\"dc:creator\">Marc Roberts<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" rel=\"license\">CC BY-NC-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/) license.<\/p>\n<p><strong>Figure 12.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/www.mcrdsd.marines.mil\/News\/Photos\/igphoto\/2000017386\/\" rel=\"cc:attributionURL\">Muscle damage in military recruits<\/a> by Lance Cpl. Bridget M. Keane from the United States <a href=\"https:\/\/www.mcrdsd.marines.mil\/News\/Photos\/igphoto\/2000017386\/\">Marine Corps Recruit Depot<\/a> is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Elwood, P., Galante, J., Pickering, J., Palmer, S., Bayer, A., Ben-Shlomo, Y., Longley, M., &amp; Gallacher, J. (2013). Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study. <em>PloS one, 8<\/em>(12), e81877. https:\/\/doi.org\/10.1371\/journal.pone.0081877<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Amenorrhea [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/amenorrhea\/symptoms-causes\/syc-20369299#<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Coronary artery disease [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/coronary-artery-disease\/symptoms-causes\/syc-20350613<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, June 28). How playing sports benefits your body ... and your brain - Leah Lagos and Jaspal Ricky Singh. YouTube. https:\/\/www.youtube.com\/watch?v=hmFQqjMF_f0&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, April 18). The surprising reason our muscles get tired - Christian Moro. YouTube. https:\/\/www.youtube.com\/watch?v=rLsimrBoYXc&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, November 3). What makes muscles grow? - Jeffrey Siegel. YouTube https:\/\/www.youtube.com\/watch?v=2tM1LFFxeKg&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2014, November 14). Why some people find exercise harder than others | Emily Balcetis, YouTube. https:\/\/www.youtube.com\/watch?v=QeIrdqU0o9s&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, August 1). Delayed onset muscle soreness. In\u00a0<i>Wikipedia<\/i>. https:\/\/en.wikipedia.org\/w\/index.php?title=Delayed_onset_muscle_soreness&amp;oldid=970682631<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_2985\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_2985\"><div tabindex=\"-1\"><p>Image shows a diagram of locations in the body where the effects of anemia are experienced.  Some of these include: Central nervous system: fatigue, dizziness and possibly fainting.  Low blood pressure. In the heart: heart palpitations, rapid heart rate, chest palpitations, in extreme cases chest pain, angina and heart attack. Enlargement of the spleen.  Changed stool (poo) colour. Muscular weakness. Shortness of breath. Pale, cold and\/or yellowing skin.  Yellowing eyes.  <\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5931\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_5965\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5965\"><div tabindex=\"-1\"><p>An extension of the cell body of a neuron that receives nerve impulses from other neurons.\u00a0 A neuron will have several dendrites extending from the cell body.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5901\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_3028\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3028\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1821\" aria-describedby=\"caption-attachment-1821\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5318\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/a-nurse-giving-a-young-girl-a-vaccine-shot-or-scaled-1.jpg\" alt=\"18.9.1 Vaccine against Cervical Cancer\" width=\"400\" height=\"265\"><figcaption id=\"caption-attachment-1821\" class=\"wp-caption-text\"><em>Figure 18.9.1 An ounce of prevention is worth a pound of cure.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Vaccinating Against Cancer<\/h1>\n<\/div>\n<p>Can a vaccine prevent<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2148\"> cancer<\/a>? In the case of cervical cancer, it\u00a0<em>can<\/em>. Cervical cancer is one of three disorders of the female reproductive system described in detail in this concept. Of the three, only cervical cancer can be prevented with a vaccine.<\/p>\n<div>\n<h1>Cervical Cancer<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5319\">Cervical cancer<\/a><\/strong> occurs when cells of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a> (neck of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>) grow abnormally and develop the ability to invade nearby tissues or spread to other parts of the body, such as the abdomen or lungs. Figure 18.9.2 shows the location of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a> and the appearance of normal and abnormal cervical cells when examined with a microscope.<\/p>\n<figure id=\"attachment_1821\" aria-describedby=\"caption-attachment-1821\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-1814\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0221_CervicalDysplasia.png\" alt=\"18.9.2 Cervical Cancer\" width=\"1024\" height=\"768\"><figcaption id=\"caption-attachment-1821\" class=\"wp-caption-text\"><em>Figure 18.9.2 Cancer of the cervix \u2014 the location of which is shown in the drawings on the left and top right \u2014 can be identified by abnormal cervical cells, as shown on the bottom right. CIN stands for cervical intraepithelial neoplasia, which means cancerous cells within the epithelium of the cervix. The designations CIN 1, CIN 2, and CIN 3 refer to the severity of the abnormal cells, with CIN 1 being the least severe, and CIN 3 being the most severe.<\/em><\/figcaption><\/figure>\n<h1>Cervical Cancer Prevalence and Death Rates<\/h1>\n<p>Worldwide, cervical <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2148\">cancer<\/a> is the second most common type of cancer in females (after breast cancer) and the fourth-most common cause of cancer death in females. In Canada and other high-income nations, the widespread use of cervical cancer screening has detected many cases of precancerous cervical changes and has dramatically reduced rates of cervical cancer deaths. About 75% of cervical cancer cases occur in developing countries, where routine screening is less likely because of cost and other factors. Cervical cancer is also the most common cause of cancer death in low-income countries.<\/p>\n<h2>Symptoms of Cervical Cancer<\/h2>\n<p>Early in the development of cervical cancer, there are typically no symptoms. As the disease progresses, however, symptoms are likely to occur. The symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse. Unfortunately, by the time symptoms start to occur, cervical cancer has typically progressed to a stage at which treatment is less likely to be successful.<\/p>\n<h2>Cervical Cancer Causes and Risk Factors<\/h2>\n<p>More than 90 per cent of cases of cervical cancer are caused at least in part by <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5324\">human papillomavirus<\/a> (HPV)<\/strong>, which is a sexually transmitted virus that also causes genital warts. Figure 18.9.3 shows how HPV infection can cause cervical cancer by interfering with a normal cell division checkpoint. When HPV is not present, cervical cells containing mutations are not allowed to divide, so the cervix remains healthy. When HPV is present, however, cervical cells with mutations may be allowed to divide, leading to uncontrolled growth of mutated cells and the formation of a tumor.<\/p>\n<figure id=\"attachment_1821\" aria-describedby=\"caption-attachment-1821\" style=\"width: 857px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1816\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/HPV-and-Cervical-Cancer-by-OpenStax.jpg\" alt=\"18.9.3 HPV and Cervical Cancer\" width=\"857\" height=\"465\"><figcaption id=\"caption-attachment-1821\" class=\"wp-caption-text\"><em>Figure 18.9.3 The presence of HPV may allow cervical cells with mutations to divide, resulting in the formation of a tumor.<\/em><\/figcaption><\/figure>\n<p>Other risk factors for cervical cancer include smoking, a weakened immune system (for example, due to HIV infection), use of birth control pills, becoming sexually active at a young age, and having many sexual partners. However, these risk factors are less important than HPV infection. Instead, the risk factors are more likely to increase the risk of cervical cancer in females who are <em>already<\/em> infected with HPV. For example, among HPV-infected women, current and former smokers have roughly two to three times the incidence of cervical cancer as non-smokers. Passive smoking, or secondhand smoke, is also associated with an increased risk of cervical cancer, but to a lesser extent.<\/p>\n<h2>Diagnosis of Cervical Cancer<\/h2>\n<p>Diagnosis of cervical cancer is typically made by looking for microscopic abnormal cervical cells in a smear of cells scraped off the cervix. This is called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5326\">Pap smear<\/a>.<\/strong>\u00a0If cancerous cells are detected or suspected in the smear, this test is usually followed up with a biopsy to confirm the Pap smear results. Medical imaging (by CT scan or MRI, for example) is also likely to be done to provide more information, such as whether the cancer has spread.<\/p>\n<h2>Prevention of Cervical Cancer<\/h2>\n<p>It is now possible to prevent HPV infection with a vaccine. The first HPV vaccine was approved by the U.S. Food and Drug Administration in 2006. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4353\">vaccine<\/a> protects against the strains of HPV that have the greatest risk of causing cervical cancer. It is thought that widespread use of the vaccine will prevent up to 90% of cervical cancer cases. Current recommendations are for females to be given the vaccine between the ages of nine and 26. (Boys should be vaccinated against HPV, as well, because the virus may also cause cancer of the penis and certain other male cancers.) The vaccine is effective only if it is given <em>before <\/em>HPV infection has occurred. Using condoms during sexual intercourse can also help prevent HPV infection and cervical cancer, in addition to\u00a0preventing pregnancy and sexually transmitted infections (such as HIV).<\/p>\n<p>Even in women who have received the HPV vaccine, there is still a small risk of developing cervical cancer. Therefore, it is recommended that women continue to be examined with regular Pap smears.<\/p>\n<h2>Treatment of Cervical Cancer<\/h2>\n<p>Treatment of cervical cancer generally depends on the stage at which the cancer is diagnosed, but it is likely to include some combination of surgery, radiation therapy, and\/or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5029\">chemotherapy<\/a>. Outcomes of treatment depend largely on how early the cancer is diagnosed and treated. For surgery to cure cervical cancer, the entire tumor must be removed with no cancerous cells found at the margins of the removed tissue on microscopic examination. If cancer is found and treated very early when it is still in the microscopic stage, the five-year survival rate is virtually 100%.<\/p>\n<div>\n<h1>Vaginitis<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5328\">Vaginitis<\/a><\/strong>\u00a0is inflammation of the vagina \u2014 and sometimes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a>, as well. Symptoms may include a discharge that is yellow, gray, or green; itching; pain; and a burning sensation. There may also be a foul vaginal odor and pain or irritation with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5149\">sexual intercourse<\/a>.<\/p>\n<h2>Causes of Vaginitis<\/h2>\n<p>About 90% of cases of vaginitis are caused by infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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\">. Most commonly, vaginal infections are caused by the yeast <\/span><em style=\"text-align: initial;font-size: 1em\">Candida albicans<\/em><span style=\"text-align: initial;font-size: 1em\"> (see Figure 18.9.4). Such infections are referred to as vaginal <\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5332\">candidiasis<\/a> <\/strong>or more commonly as a yeast infection.<span style=\"text-align: initial;font-size: 1em\">\u00a0<em>Candida albicans <\/em>is one of the most common opportunistic infections in the world and can affect not only the vagina, but any of the mucus membranes and skin.\u00a0 Other possible causes of vaginal infections include bacteria, especially <\/span><em style=\"text-align: initial;font-size: 1em\">Gardnerella vaginalis<\/em><span style=\"text-align: initial;font-size: 1em\">, and some single-celled parasites, notably the protist parasite\u00a0<\/span><em style=\"text-align: initial;font-size: 1em\">Trichomonas vaginalis<\/em><span style=\"text-align: initial;font-size: 1em\">, which is usually transmitted through vaginal intercourse. The risk of vaginal infections may be greater in women who wear tight clothing, are taking antibiotics for another condition, use birth control pills, or have improper hygiene. Poor\u00a0hygiene\u00a0allows organisms that are normally present in the stool (such as yeast) to contaminate the vagina.<\/span><\/p>\n<div>\n<figure id=\"attachment_1817\" aria-describedby=\"caption-attachment-1817\" style=\"width: 792px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1817\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Candida-by-NIH-on-Flickr.jpg\" alt=\"18.9.3 Candida\" width=\"792\" height=\"396\"><figcaption id=\"caption-attachment-1817\" class=\"wp-caption-text\"><em>Figure 18.9.4 The yeast Candida albicans \u2014 shown here growing on a culture plate \u2014 is one of the most common causes of vaginitis.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Most of the remaining cases of vaginitis are due to irritation by \u2014 or allergic reactions to \u2014 various products. These irritants may include condoms, spermicides, soaps, douches, lubricants, and even semen. Using tampons or soaking in hot tubs may be additional causes of this type of vaginitis.<\/p>\n<h2>Diagnosis of Vaginitis<\/h2>\n<p>Diagnosis of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5328\">vaginitis<\/a> typically begins with symptoms reported by the patient. This may be followed by a microscopic examination or culture of the vaginal discharge in order to identify the specific cause. The colour, consistency, acidity, and other characteristics of the discharge may be predictive of the causative agent. For example, infection with <em>Candida albicans<\/em>\u00a0may cause a cottage cheese-like discharge with a low <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4330\">pH<\/a>, whereas infection with\u00a0<em>Gardnerella vaginalis<\/em>\u00a0may cause a discharge with a fish-like odor and a high pH.<\/p>\n<h2>Prevention of Vaginitis<\/h2>\n<p>Prevention of vaginitis includes wearing loose cotton underwear that helps keep the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a> dry.\u00a0Yeasts and bacteria that may cause vaginitis tend to grow best in a moist environment. It is also important to avoid the use of perfumed soaps, personal hygiene sprays, and douches, all of which may upset the normal pH and bacterial balance in the vagina. To help avoid vaginitis caused by infection with\u00a0<em>Trichomonas vaginalis<\/em>, the use of condoms during sexual intercourse is advised.<\/p>\n<h2>Treatment of Vaginitis<\/h2>\n<p>The appropriate treatment of vaginitis depends on the cause. In many cases of vaginitis, there is more than one cause, and all of the causes must be treated to ensure a cure.<\/p>\n<ul>\n<li>Yeast infections of the vagina are typically treated with topical anti-fungal medications, which are available over the counter. The medications may be in the form of tablets or creams that are inserted into the vagina. Depending on the particular medication used, treatment may involve one, three, or seven days of applications.<\/li>\n<li>Bacterial infections of the vagina are usually treated with antibiotics. These may be taken orally as pills, or applied topically to the vagina in creams.<\/li>\n<li><em>Trichomonas vaginalis<\/em> infections of the vagina are generally treated with a single dose of an oral antibiotic. Sexual partners should be treated at the same time, and intercourse should be avoided for at least a week until both partners have completed treatment, and have been followed-up by a physician.<\/li>\n<\/ul>\n<div>\n<h1>Endometriosis<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5333\">Endometriosis<\/a><\/strong> is a disease in which endometrial tissue, which normally grows inside the uterus, grows outside it, as shown in Figure 18.9.5. Most often, the endometrial tissue grows around the ovaries, Fallopian tubes, and uterus. In rare instances, the tissue may grow elsewhere in the body. The areas of endometriosis typically bleed each month during the menstrual period, and this often results in inflammation, pain, and scarring. An estimated six to ten per cent of women are believed to have endometriosis. It is most common in women during their thirties and forties, and only rarely occurs before menarche or after menopause.<\/p>\n<figure id=\"attachment_1821\" aria-describedby=\"caption-attachment-1821\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1818\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0349_Endometriosis.png\" alt=\"18.9.5 Endometriosis\" width=\"1024\" height=\"791\"><figcaption id=\"caption-attachment-1821\" class=\"wp-caption-text\"><em>Figure 18.9.5 In endometriosis, endometrial tissue may grow outside the uterus and cause health problems such as pain, bleeding, scarring, and infertility.<\/em><\/figcaption><\/figure>\n<h2>Signs and Symptoms of Endometriosis<\/h2>\n<p>The main symptom of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5333\">endometriosis<\/a> is pelvic pain, which may range from mild to severe. There appears to be little or no relationship between the amount of endometrial tissue growing outside the uterus and the severity of the pain. For many women with the disease, the pain occurs mainly during <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5310\">menstruation<\/a>. However, nearly half of those affected have chronic pelvic pain. The pain of endometriosis may be caused by bleeding in the pelvis, which triggers <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4860\">inflammation<\/a>. Pain can also occur from internal scar tissue that binds internal organs to each other.<\/p>\n<p>Another problem often associated with endometriosis is infertility, or the inability to conceive or bear children. Among women with endometriosis, up to half may experience infertility. Infertility can be related to scar formation or to anatomical distortions due to the abnormal endometrial tissue. Other possible symptoms of endometriosis may include diarrhea or constipation, chronic fatigue, nausea and vomiting, headaches, and heavy or irregular menstrual bleeding.<\/p>\n<h2>Causes of Endometriosis<\/h2>\n<p>The causes of endometriosis are not known for certain, but several risk factors have been identified, including a family history of endometriosis. Daughters or sisters of women with endometriosis have about six times the normal risk of developing the disease themselves. It has been suggested that endometriosis results from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2381\">mutation<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\">\u00a0in several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2035\">gene<\/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\">. It is likely that endometriosis is multifactorial, involving the interplay of several factors.<\/span><\/p>\n<p>At the physiological level, the predominant idea for how endometriosis comes about is retrograde menstruation. This\u00a0happens\u00a0when some of the endometrial debris from a woman\u2019s menstrual flow exits the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a> through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviduct<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\">, rather than through the <\/span><span style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. The debris then attaches itself to the outside of organs in the abdominal cavity, or to the lining of the abdominal cavity itself. Retrograde menstruation, however, does not explain all cases of endometriosis, so other factors are apparently involved. Suggestions include environmental toxins and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5006\">autoimmune<\/a> responses.<\/span><\/p>\n<h2>Diagnosis of Endometriosis<\/h2>\n<p>Diagnosis of endometriosis is usually based on self-reported symptoms and a physical examination by a doctor, often combined with medical imaging, such as ultrasonography. The only way to definitively diagnose endometriosis, however, is through visual inspection of the endometrial tissue. This can be done with a surgical procedure called laparoscopy, shown in Figure 18.9.6, in which a tiny camera is inserted into the abdomen through a small incision. The camera allows the physician to visually inspect the area where endometrial tissue is suspected.<\/p>\n<figure id=\"attachment_1821\" aria-describedby=\"caption-attachment-1821\" style=\"width: 516px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1821\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0602_Laparoscopy_02.png\" alt=\"18.9.6 Laparoscopy\" width=\"516\" height=\"516\"><figcaption id=\"caption-attachment-1821\" class=\"wp-caption-text\"><em>Figure 18.9.6 Visually inspecting the abdomen for endometrial growths is the most reliable way to diagnose endometriosis.<\/em><\/figcaption><\/figure>\n<h2>Treatment of Endometriosis<\/h2>\n<p>The most common treatments for endometriosis are medications to control the pain, and surgery to remove the abnormal tissue. Frequently used pain medications are non-steroidal inflammatory drugs (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4686\">NSAIDS<\/a>), such as naproxen. Opiates may be used in cases of severe pain. Laparoscopy can be used to surgically treat endometriosis, as well as to diagnose the condition. In this type of surgery, an additional small incision is made to insert instruments that the surgeon can manipulate externally in order to burn (cauterize) or cut away the endometrial growths. In younger women who want to have children, surgery is conservative to keep the reproductive organs intact and functional. However, with conservative surgery, endometriosis recurs in 20\u201340% of cases within five years of the surgery. In older women who have completed childbearing, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5336\">hysterectomy<\/a> may be undertaken to remove all or part of the internal reproductive organs. This is the only procedure that is likely to cure endometriosis and prevent relapses.<\/p>\n<div>\n<h1>Feature: My Human Body<\/h1>\n<\/div>\n<p>A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5326\">Pap smear<\/a> is a method of cervical cancer screening used to detect potentially pre-cancerous and cancerous cells in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a>. It is the most widely used screening test for this type of cancer, and it is very effective. The test may also detect vaginal infections and abnormal endometrial cells, but it is not designed for these purposes.<\/p>\n<p>According to <a href=\"https:\/\/www.healthlinkbc.ca\/medical-tests\/hw5266\">HealthLink BC<\/a>, females should start receiving routine Pap smears by age 25. Because most cases of cervical cancer are caused by infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5324\">human papillomavirus (HPV)<\/a>, which is a sexually transmitted infection, there is little or no benefit to screening people who have not had sexual contact. Starting at age 25, general guidelines are for Pap smears to be repeated every three years until age 69. Screening may be discontinued after 69 years of age, if the last three Pap smears were normal. If a woman has a complete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5336\">hysterectomy<\/a>, she no longer has a cervix and there is no need for further Pap smears. On the other hand, if a woman has had a history of abnormal Pap smears or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2148\">cancer<\/a>, she will likely be screened more frequently. Pap smears can be done safely during the first several months of pregnancy, and resumed about three months after childbirth. Generally, better results are obtained if Pap smears are not done during menstruation.<\/p>\n<p>If you\u2019ve never had a Pap smear, knowing what to expect may help prepare you for the procedure. The patient lies on the examining table with her feet in \u201cstirrups\u201d to hold the legs up and apart. An instrument called a speculum is inserted into the vagina to hold back the vaginal walls and give access to the cervix. A tiny amount of tissue is brushed off the cervix and smeared onto a microscope slide. The speculum is then removed, and the procedure is over. The slide is later examined under a microscope for abnormal cells. Some women experience light spotting or mild diarrhea after a Pap smear, but most have no lasting effects.<\/p>\n<p>Pap smears are uncomfortable and may be somewhat painful for some women. If you experience pain during a Pap smear, tell your health care provider. Many steps can be taken to minimize the pain, which might include using a smaller speculum, using warm instruments and a lubricant, and applying a topical anesthetic such as lidocaine to the cervix before obtaining the smear. Any pain is generally very brief, and the potential reward is worth it. Pap tests are estimated to reduce up to 80% of cervical cancer deaths. One of the lives saved could be your own.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.9 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_4805_5319\">Cervical cancer<\/a> occurs when cells of the cervix grow abnormally and develop the ability to invade nearby tissues or spread to other parts of the body. Worldwide, cervical cancer is the second-most common type of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2148\">cancer<\/a> in females and the fourth-most common cause of cancer death in females. Early on, cervical cancer often has no symptoms. Later, symptoms (such as abnormal vaginal bleeding and pain) are likely.<\/li>\n<li>Most cases of cervical cancer occur because of infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5324\">human papillomavirus (HPV)<\/a>, so the HPV vaccine is expected to greatly reduce the incidence of the disease. Other risk factors include smoking and a weakened immune system. A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5326\">Pap smear<\/a> can diagnose cervical cancer at an early stage. Where Pap smears are done routinely, cervical cancer death rates have fallen dramatically. Treatment of cervical cancer generally includes surgery, which may be followed by radiation therapy or chemotherapy.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5328\">Vaginitis<\/a> is inflammation of the vagina. A discharge is likely, and there may be itching and pain. About 90% of cases of vaginitis are caused by infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2371\">microorganisms<\/a>, typically by the yeast <em>Candida albicans<\/em>. A minority of cases are caused by irritants or allergens in soaps, spermicides, or douches.<\/li>\n<li>Diagnosis of vaginitis may be based on characteristics of the discharge, which can be examined microscopically or cultured. Treatment of vaginitis depends on the cause and is usually an oral or topical anti-fungal or antibiotic medication.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5333\">Endometriosis<\/a> is a disease in which endometrial tissue grows outside the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>. This tissue may bleed during the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5310\">menstrual period<\/a> and cause inflammation, pain, and scarring. The main symptom of endometriosis is pelvic pain, which may be severe. Endometriosis may also lead to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4813\">infertility<\/a>.<\/li>\n<li>Endometriosis is thought to have multiple causes, including genetic mutations. Retrograde menstruation may be the immediate cause of endometrial tissue escaping the uterus and entering the pelvic cavity. Endometriosis is usually treated with surgery to remove the abnormal tissue and medication for pain. If surgery is more conservative than hysterectomy, endometriosis may recur.<\/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\">18.9 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is cervical cancer? Worldwide, how prevalent is it, and how does it rank as a cause of cancer deaths?<\/li>\n<li>Identify symptoms of cervical cancer. What are causes of \u2014 and risk factors for \u2014 cervical cancer?<\/li>\n<li>What roles can Pap smears and HPV vaccines play in preventing cervical cancer cases and cervical cancer deaths?<\/li>\n<li>How is cervical cancer treated?<\/li>\n<li>Define vaginitis and identify its symptoms.<\/li>\n<li>What are some of the causes of vaginitis? Which cause is responsible for most of the cases?<\/li>\n<li>How is vaginitis diagnosed and treated?<\/li>\n<li>What is endometriosis, and what are its symptoms?<\/li>\n<li>Discuss possible causes of endometriosis.<\/li>\n<li>How is endometriosis treated? Which treatment is most likely to prevent recurrence of the disorder?<\/li>\n<li>\n<div id=\"h5p-359\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-359\" class=\"h5p-iframe\" data-content-id=\"359\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.9 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>In the case of infection with <em>Trichomonas vaginalis<\/em>, why is the woman\u2019s sexual partner usually treated at the same time?<\/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\">18.9 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/KOz-bNhEHhQ<\/p>\n<p style=\"text-align: center\">What is HPV and how can you protect yourself from it? - Emma Bryce, TED-Ed, 2019.<\/p>\n<p>https:\/\/youtu.be\/6HeQ4iEqAUk<\/p>\n<p style=\"text-align: center\">Endometriosis - The Mystery Disease of Women | C\u00e9cile Real | TEDxBinnenhof, TEDx Talks, 2016.<\/p>\n<p>https:\/\/youtu.be\/ryNjSP5VVI8<\/p>\n<p style=\"text-align: center\">The brain and ovarian hormones | Marwa Azab | TEDxMontrealWomen, TEDxTalks, 2015.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.9.1<\/strong><\/p>\n<p><a href=\"http:\/\/www.freestockphotos.biz\/stockphoto\/16727\" rel=\"cc:attributionURL\">a-nurse-giving-a-young-girl-a-vaccine-shot-or<\/a> by CDC\/ Judy Schmidt from <a href=\"https:\/\/phil.cdc.gov\/Details.aspx?pid=9424\">Public Health Image Library (PHIL) #9424<\/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 18.9.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0221_CervicalDysplasia.png\" rel=\"cc:attributionURL\">1024px-Blausen_0221_CervicalDysplasia<\/a> by <a class=\"extiw\" title=\"en:Blausen medical\" href=\"https:\/\/en.wikipedia.org\/wiki\/Blausen_medical\">Blausen Medical Communications, Inc.<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY\u00a0 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 18.9.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_28_02_08.JPG\" rel=\"cc:attributionURL\">HPV and Cervical Cancer by OpenStax<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-2-anatomy-and-physiology-of-the-female-reproductive-system\">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 18.9.4<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/nihgov\/27341966932\" rel=\"cc:attributionURL\">Candida by NIH on Flickr<\/a> from the <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 under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 18.9.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0349_Endometriosis.png\" rel=\"cc:attributionURL\">Blausen_0349_Endometriosis<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY\u00a0 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 18.9.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0602_Laparoscopy_02.png\" rel=\"cc:attributionURL\">1024px-Blausen_0602_Laparoscopy_02<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY\u00a0 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\">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 <\/span><span class=\"os-number\">27.16<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"21419\" class=\"os-title\" data-type=\"title\">Development of cervical cancer [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 27.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-2-anatomy-and-physiology-of-the-female-reproductive-system<\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">HealthLink BC. (n.d.). Pap test: British Columbia specific information. https:\/\/www.healthlinkbc.ca\/medical-tests\/hw5266<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, July 9). What is HPV and how can you protect yourself from it? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=KOz-bNhEHhQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2016, April 14). Endometriosis - The mystery disease of women | C\u00e9cile Real | TEDxBinnenhof.\u00a0 YouTube. https:\/\/www.youtube.com\/watch?v=6HeQ4iEqAUk&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2015, July 27). The brain and ovarian hormones | Marwa Azab | TEDxMontrealWomen. YouTube. https:\/\/www.youtube.com\/watch?v=ryNjSP5VVI8&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_4805_3049\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3049\"><div tabindex=\"-1\"><p>Image shows several baguettes laying on a counter<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3041\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3041\"><div tabindex=\"-1\"><p>Image shows a blood pressure monitor meant to be worn on the wrist.  It displays systolic and diastolic blood pressure, pulse and the date and time.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3025\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3025\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1767\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/1024px-Cattien_stone_yoni.png\" alt=\"18.6.1\" width=\"400\" height=\"302\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.1 Yep, that's a vagina.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Fertility Symbol<\/h1>\n<\/div>\n<p>The geometric design on the ancient stone carving in Figure 18.6.1 represents a powerful symbol of female fertility: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a>. The symbol is called <em>yoni<\/em> in Hindu, and it reflects the value placed by Hindu culture on the ability of females to give birth. The vagina is one of several organs in the\u00a0female reproductive system.<\/p>\n<div>\n<h1>Female Reproductive Organs<\/h1>\n<\/div>\n<p>The female reproductive system is made up of internal and external organs that function to produce haploid female gametes called ova (or oocytes), secrete female sex hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a>), and carry and give birth to a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5086\">fetus<\/a>. The internal female reproductive organs include the vagina, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviduct<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\">, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a>. The external organs \u2014 collectively called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a> \u2014 include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5153\">clitoris<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5154\">labia<\/a>.<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a><\/strong> is an elastic, muscular canal leading from its opening in the vulva to the neck of the uterus, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a>. It is about 7.5 cm (about 3 in) long at the front, and about 9 cm (3.5 in) long at the back. The vagina accommodates the penis and is the site where <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2506\">sperm<\/a> are usually ejaculated during sexual intercourse. In the context of pregnancy and natural (vaginal) childbirth, the vagina is referred to as the birth canal. In addition, it channels the flow of menstrual blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>.<\/p>\n<h2>Structure of the Vagina<\/h2>\n<p>Muscles and ligaments support the vagina within the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2992\">pelvic cavity<\/a>. The vagina itself is made up of several layers of fibrous and muscular tissues and lined with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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\">. Folds in the mucosa provide the vagina with extra surface area so it can stretch in both length and width during intercourse or childbirth. The elasticity of the vagina and the extra mucosa allow it to stretch to many times its normal diameter in order to deliver a baby.<\/span><\/p>\n<h2>Bacteria\u00a0and\u00a0pH\u00a0in the Vagina<\/h2>\n<p>A healthy <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a> is home to many <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2428\">symbiotic<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> that help prevent pathogens (such as yeast) from colonizing the vagina. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4330\">pH<\/a> in the vagina is normally between 3.8 and 4.5, and this acidity also helps keep pathogenic microorganisms from colonizing it. The vagina constantly sheds its epithelium, so it is considered self-cleaning. As a consequence, there is no need for douching to clean it. Physicians actually discourage the practice, as it may upset the normal bacterial and pH balance in the vagina, although washing the vulva with a mild soap is good practice.<\/p>\n<div>\n<h1>Uterus<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a><\/strong> (commonly called the womb) is a pear-shaped, muscular organ that is about 7.6 cm (about 3 in) long. It is located above the vagina and behind the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">bladder<\/a> in the centre of the pelvis. The position of the uterus in the pelvis is stabilized by several ligaments and bands of supportive tissue. The uterus is where a fetus develops during gestation, and the organ provides mechanical protection and support for the developing offspring. Contractions of the muscular wall of the uterus are responsible for pushing the fetus out of the uterus during childbirth.<\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 368px\" class=\"wp-caption alignright\"><img class=\" wp-image-1768\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Gray1167.svg_.png\" alt=\"18.6.2 Uterus and Vagina\" width=\"368\" height=\"400\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.2 The cervix of the uterus opens into the vagina. The body of the uterus lies above the cervix.<\/em><\/figcaption><\/figure>\n<h2>Parts of the Uterus<\/h2>\n<p>As shown in Figure 18.6.2, the lower end of the uterus forms the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a>,<\/strong> which is also called the neck of the uterus. The cervix is about 2.5 cm (almost 1 in) long and protrudes downward into the vagina. A small canal runs the length of the cervix, connecting the uterine cavity with the lumen of the vagina. This allows semen deposited in the vagina to enter the uterus, and a baby to pass from the uterus into the vagina during birth. Glands in the cervix secrete mucus that varies in water content and thickness, so it can function either as a barrier to keep <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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\">\u00a0out of the uterus during\u00a0pregnancy, or as a transport medium to help\u00a0sperm\u00a0enter the uterus around the time of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5239\">ovulation<\/a>. The rest of the uterus above the cervix is called the body of the uterus. The upper end of the uterus is connected with the two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviduct<\/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\">.<\/span><\/p>\n<h2>Tissues of the Uterus<\/h2>\n<p>As indicated in Figure 18.6.3, the uterus consists of three tissue layers, called the endometrium, myometrium, and perimetrium.<\/p>\n<ul>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5241\">endometrium<\/a><\/strong> is the innermost tissue layer of the uterus. It consists of epithelial tissue, including mucous membranes. This layer thickens during each menstrual cycle and, unless an egg is fertilized, sloughs off during the following menstrual period. If an ovum is fertilized, the thickened endometrium is maintained by hormones and provides nourishment to the embryo. As gestation progresses, the endometrium develops into the maternal portion of the placenta.<\/li>\n<li>The <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5242\">placenta<\/a><\/strong>\u00a0is a temporary organ that consists of a mass of maternal and fetal\u00a0blood vessels\u00a0through which the mother\u2019s and fetus\u2019s\u00a0blood\u00a0exchange substances.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5243\">myometrium<\/a><\/strong>\u00a0is the middle layer of the uterus. It consists mostly of a thick layer of smooth muscle tissue. Powerful contractions of the smooth muscle allow the uterus to contract and expel an infant during childbirth.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5244\">perimetrium<\/a><\/strong>\u00a0is the outermost layer of the uterus. It covers\u00a0the\u00a0outer surface of the uterus. This layer actually consists of two layers of epithelium that secrete fluid into the space between them. The fluid allows for small movements of the uterus within the pelvis, without\u00a0causing it to rub\u00a0against other organs.<\/li>\n<\/ul>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 380px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1769 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Uterine_anatomy.-e1593113913396.jpg\" alt=\"18.6.3 Layers of the Uterus\" width=\"380\" height=\"260\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.3 The thick walls of the uterus are composed of layers of tissues known as endometrium, myometrium, and perimetrium (not shown in this image).<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.424em\">Oviducts<\/span><\/p>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviduct<\/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\"> (often referred to as Fallopian tubes) are two thin tubes that lie between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>. The oviducts are not attached to the ovaries, but their broad upper ends \u2014 called infundibula \u2014 lie very close to the ovaries. The infundibula also have fringe-like extensions called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5247\">fimbriae<\/a> that move in a waving motion to help guide eggs from the ovaries into the oviducts. The lower ends of the oviducts are attached to the upper part of the body of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a> on either side of the body. They open into the uterus.<\/span><\/p>\n<p>The oviducts are made up of multiple tissue layers. The innermost layer consists of mucosal epithelium. The epithelium is covered with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1597\">cilia<\/a>, which can move in a sweeping motion to help ova move through the tube from the ovary to the uterus. In between the ciliated cells of the epithelium are cells that secrete a fluid called tubular fluid. This fluid contains nutrients for sperm, ova, and zygotes. The secretions in tubular fluid also remove certain molecules from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1996\">plasma membrane<\/a> of sperm so they are better able to penetrate an egg. Other layers of the oviducts consist of connective tissue and smooth muscle. Contractions of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2982\">smooth muscle<\/a> allow <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> to help move eggs through the tubes.<\/p>\n<div>\n<h1>Ovaries<\/h1>\n<\/div>\n<p>Like the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3486\">testes<\/a> in males, the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a><\/strong>\u00a0in females are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3408\">gonad<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\">\u00a0that produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2694\">gamete<\/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\"> and secrete sex <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2218\">hormones<\/a>. The gametes produced by the ovaries are called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5099\">ova<\/a>, or oocytes. The main sex hormone secreted by the ovaries is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a>. The position of the paired ovaries relative to the other reproductive system organs is shown in Figure 18.6.4. Each ovary lies along one side of the uterus and is about 4 cm (a little more than 1.5 in) long. Fibrous ligaments attach one end of each ovary to its nearby oviduct and the other and to its side of the uterus. These ligaments keep the ovaries in place within the pelvis.<\/span><\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 689px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1770 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Sites_of_tubo_ovarian_abscess-e1593120204450.png\" alt=\"18.6.4 Placement of the Ovaries\" width=\"689\" height=\"482\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.4 The placement of the two ovaries within the pelvis allows eggs from each ovary to enter a Fallopian tube and travel to the uterus.<\/em><\/figcaption><\/figure>\n<h2>Ovarian Follicles<\/h2>\n<p>The ovary consists of two main layers, called the ovarian medulla (the inner layer) and the ovarian cortex (the outer layer). The ovary also contains\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2448\">blood<\/a>\u00a0and lymphatic vessels. The ovarian cortex consists primarily of the functional units of the ovaries, which are called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5253\">ovarian follicle<\/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\"> The follicles are nests of epithelial cells, within each of which is an ovum. The photomicrograph in Figure 18.6.5 shows an ovarian follicle and the developing ovum inside it. If an ovum and follicle complete maturation, the follicle ruptures and the ovum is released from the ovary. This event is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5239\">ovulation<\/a>.<\/span><\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1772\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Ovarian_follicle.png\" alt=\"18.6.4 Ovarian Follicle\" width=\"800\" height=\"480\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.5 An ovum within its nest of follicular cells inside an ovary.<\/em><\/figcaption><\/figure>\n<h2>Ova in the Ovaries<\/h2>\n<p>Whereas the male <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3486\">testes<\/a> produce sperm continuously after\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5155\">puberty<\/a>, the female ovary already contains all the ova it will ever produce by the time a female is born. At birth, a baby girl\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a> contain at least a million eggs, each of which is contained within a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5253\">follicle<\/a>. Only about 500 of these eggs will eventually mature and be ovulated. This process starts at puberty and typically continues at monthly intervals until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5255\">menopause<\/a> occurs around age 52. The remaining eggs never mature, and their number declines as the woman ages. By menopause, a woman\u2019s reserve of eggs is nearly depleted, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5239\">ovulation<\/a> no longer occurs.<\/p>\n<div>\n<h1>Vulva<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a><\/strong> is a general term for all of the external female reproductive organs. The vulva includes the clitoris, labia, and external openings for the urethra and vagina.<\/p>\n<h2>Labia<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5154\">labia<\/a><\/strong> (singular, labium) refer to the \u201clips\u201d of the vulva, which are folds of tissue that contain and protect the other, more delicate structures of the vulva (as shown in Figure 18.6.6). There are two pairs of labia: the outer and larger labia majora, and the inner and smaller labia minora. The labia minora contain numerous sebaceous glands. These glands release secretions that help lubricate the labia and vulvar area.<\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 361px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1773\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/HumanVulva-NewText-PhiloViv.jpg\" alt=\"18.6.5 Vulva Labeled\" width=\"361\" height=\"256\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.6 The vulva includes the external features of the female reproductive system including the labia, clitoris and clitoral hood, and the openings from the urethra and to the vagina.<\/em><\/figcaption><\/figure>\n<h2>Clitoris<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5153\">clitoris<\/a>,<\/strong>\u00a0is located at the front of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a> where the labia minora meet. The visible portion of the clitoris is called the glans clitoris. It is roughly the size and shape of a pea. It is highly sensitive, because it contains many nerve endings. A hood of tissue called the clitoral hood (shown in Figure 18.6.5 above), or prepuce, normally covers and protects the clitoris. The clitoris is the homologue to the male penis, and they both contain spongy tissue.\u00a0\u00a0<span style=\"font-size: 1em\">Stimulation of the glans clitoris during sexual activity generally results in sexual arousal in females, and may lead to orgasm.<\/span><span style=\"font-size: 1em\"> The glans clitoris is the only part of the overall clitoris visible externally, but this spongy tissue extends down either side of the openings to the urethra and vagina, as seen in Figure 18.6.7.<\/span><\/p>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 729px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1774\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Vulva.jpg\" alt=\"18.6.6 Clitoris\" width=\"729\" height=\"428\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.7 While the glans clitoris is the only externally visible part of the clitoris, this spongy tissue extends dorsally into the corpus cavernosum, which flanks the left and right sides of the opening to the vagina.<\/em><\/figcaption><\/figure>\n<h2>Other Vulvar Structures<\/h2>\n<p>The area between the two labia minora is called the vestibule of the vulva. Both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4732\">urethra<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a> have openings to the outside of the body in the vestibule. As you can see in Figure 18.6.7 above, the urethral opening (or meatus) is located just in front of, and is much smaller than, the vaginal opening. Both openings are protected by the labia. Two glands \u2014 called Bartholin\u2019s glands \u2014 open on either side of the vaginal opening. These glands secrete mucus and a vaginal and vulvar lubricant.<\/p>\n<div>\n<h1>Breasts<\/h1>\n<\/div>\n<figure id=\"attachment_1775\" aria-describedby=\"caption-attachment-1775\" style=\"width: 350px\" class=\"wp-caption alignright\"><img class=\"size-full wp-image-1775\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Breast-Diagram.gif\" alt=\"18.6.7 Breasts\" width=\"350\" height=\"274\"><figcaption id=\"caption-attachment-1775\" class=\"wp-caption-text\"><em>Figure 18.6.8 The breasts are not really reproductive organs, but they play a reproductive role as mammary glands that can produce milk to feed an infant.<\/em><\/figcaption><\/figure>\n<p>The breasts are not directly involved in\u00a0reproduction, but because they contain\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3432\">mammary gland<\/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\"> they can provide nourishment to an infant after birth. The breasts overlay major muscles in the chest from which they project outward in a conical shape. The two main types of tissues in the breast are adipose (fat) tissue and glandular tissue that produces milk. As shown in Figure 18.6.8, each mature breast contains many lobules, where milk is produced and stored during pregnancy. During breastfeeding (or lactation), the milk drains into ducts and sacs, which in turn converge at the nipple. Milk exits the breast through the nipple in response to the suckling action of an infant and is regulated by a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2962\">positive feedback loop<\/a>. The nipple is surrounded by a more darkly pigmented area called the areola. The areola contains glands that secrete an oily fluid, which lubricates and protects the nipple during breastfeeding.<\/span><\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.6 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The\u00a0female reproductive system\u00a0is made up of internal and external organs that function to produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2484\">haploid<\/a> female <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2694\">gametes<\/a> called ova, secrete female sex hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a>), and carry and give birth to a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5086\">fetus<\/a>.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a> is an elastic, muscular canal that can accommodate the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5091\">penis<\/a>. It is also where sperm are usually ejaculated during <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5149\">sexual intercourse<\/a>. The vagina is the birth canal, and it channels the flow of menstrual blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>. A healthy vagina has a balance of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2428\">symbiotic<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> and an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2258\">acidic<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4330\">pH<\/a>.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a> is a muscular organ above the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a> where a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5086\">fetus<\/a> develops. Its muscular walls contract to push out the fetus during childbirth. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a> is the neck of the uterus that extends down into the vagina. It contains a canal connecting the vagina and uterus for sperm, or for an infant to pass through. The innermost layer of the uterus \u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5241\">endometrium<\/a> \u2014 thickens each month in preparation for an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5262\">embryo<\/a>, but is shed in the following menstrual period if\u00a0fertilization does not occur.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviducts<\/a>\u00a0extend from the uterus to the ovaries. Waving <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5247\">fimbriae<\/a> at the ovary ends of the oviducts guide ovulated eggs into the tubes where <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2677\">fertilization<\/a> may occur as the ova travel to the uterus. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1597\">Cilia<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> help ova move through the tubes. Tubular fluid helps nourish sperm as they swim up the tubes toward ova.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a> are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3408\">gonads<\/a> that produce ova and secrete sex hormones, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a>. Nests of cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5253\">follicles<\/a> in the ovarian cortex are the functional units of ovaries. Each follicle surrounds an immature ovum. At birth, a baby girl\u2019s ovaries contain at least a million ova, and they will not produce any more during her lifetime. During a woman\u2019s reproductive years, one ova typically matures and is ovulated each month.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a> is a general term for external female reproductive organs. The vulva includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5153\">clitoris<\/a>, two pairs of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5154\">labia<\/a>, and openings for the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4732\">urethra<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a>. Secretions from mucosal glands near the vaginal opening lubricate the vulva.<\/li>\n<li>The breasts are not technically reproductive organs, but their <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3432\">mammary glands<\/a> produce milk to feed an infant after birth. Milk drains through ducts and sacs, and out through the nipple when a\u00a0 baby sucks during breastfeeding.<\/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\">18.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-351\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-351\" class=\"h5p-iframe\" data-content-id=\"351\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>State the general functions of the female reproductive system.<\/li>\n<li>Describe the vagina and its reproductive functions.<\/li>\n<li>Outline the structure and basic functions of the uterus.<\/li>\n<li>What is the endometrium? How does it change during the monthly cycle?<\/li>\n<li>Why are breasts included in discussions of reproduction, if they are not organs of the female reproductive system?<\/li>\n<li>What is the function of the folds in the mucous membrane lining of the vagina?<\/li>\n<li>What are two ways in which the female reproductive system protects itself from pathogens?<\/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\">18.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/SkB4gG8ke7Q<\/p>\n<p style=\"text-align: center\">The uncomplicated truth about women's sexuality | Sarah Barmak, TED, 2019.<\/p>\n<p>https:\/\/youtu.be\/9rs2gNchQig<\/p>\n<p style=\"text-align: center\">Human Physiology - Functional Anatomy of the Female Reproductive System, Janux, 2015.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"content\" class=\"site-content\">\n<section class=\"standard post-956 chapter type-chapter status-publish hentry focusable\" data-type=\"chapter\">\n<h2>Attributes<\/h2>\n<p><strong>Figure 18.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Cattien_stone_yoni.png\" rel=\"cc:attributionURL\">1024px-Cattien_stone_yoni<\/a> by <a title=\"User:Binh Giang\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Binh_Giang\">Binh Giang<\/a> on Wikimedia Commons is in the \u00a0<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\/en:public_domain).<\/p>\n<p><strong>Figure 18.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gray1167.svg\" rel=\"cc:attributionURL\">1000px-Gray1167.svg<\/a> by <a href=\"https:\/\/en.wikipedia.org\/wiki\/Henry_Vandyke_Carter\">Henry Vandyke Carter<\/a>\u00a0(1831-1897) on Wikimedia Commons is in the \u00a0<a class=\"extiw\" title=\"en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a>\u00a0(https:\/\/en.wikipedia.org\/wiki\/public_domain). (<a class=\"extiw\" title=\"en:Bartleby.com\" href=\"https:\/\/en.wikipedia.org\/wiki\/Bartleby.com\">Bartleby.com<\/a>:\u00a0<a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/\" rel=\"nofollow\">Gray\u2019s Anatomy<\/a>, <a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/illus1167.html\" rel=\"nofollow\">Plate 1167<\/a>).<\/p>\n<p><strong>Figure 18.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Uterine_anatomy..jpg\" rel=\"cc:attributionURL\">Uterine_anatomy.<\/a> from <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK27042\/bin\/Teixeira01.jpg\">Uterine Stem cells<\/a> by <a href=\"http:\/\/www.stembook.org\">The Stem Cell Research Community, StemBook<\/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 18.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sites_of_tubo_ovarian_abscess.PNG\" rel=\"cc:attributionURL\">Sites_of_tubo_ovarian_abscess<\/a> by <a title=\"User:Bfpage\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Bfpage\">Bfpage<\/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 18.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Ovarian_follicle.png\" rel=\"cc:attributionURL\">Ovarian_follicle<\/a> by <a title=\"User:TiagoLubiana\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:TiagoLubiana\">TiagoLubiana<\/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-sa\/4.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 18.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:HumanVulva-NewText-PhiloViv.jpg#file\" rel=\"cc:attributionURL\">HumanVulva-NewText-PhiloViv<\/a> by <a title=\"User:Amphis\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Amphis\">Amphis<\/a> (edited) on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en\" rel=\"license\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en) license. (<span style=\"text-align: initial;font-size: 1em\">Original \u00a0<a class=\"extiw\" title=\"en:Image:HumanVulva-NoText-PhiloVivero.jpg\" href=\"https:\/\/en.wikipedia.org\/wiki\/Image:HumanVulva-NoText-PhiloVivero.jpg\">en:Image:HumanVulva-NoText-PhiloVivero.jpg<\/a> by <\/span><a class=\"extiw\" style=\"text-align: initial;font-size: 1em\" title=\"en:user:PhiloVivero\" href=\"https:\/\/en.wikipedia.org\/wiki\/user:PhiloVivero\">en:user:PhiloVivero<\/a>)<\/p>\n<p><strong>Figure 18.6.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_28_02_02.jpg\" rel=\"cc:attributionURL\">Vulva<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-2-anatomy-and-physiology-of-the-female-reproductive-system\">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 18.6.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Breast-Diagram.gif\" rel=\"cc:attributionURL\">Breast-Diagram<\/a> by <a href=\"https:\/\/www.womenshealth.gov\/cancer\/breast-cancer\">Women's Health<\/a> (NCI\/ NIH) on Wikimedia Commons is in 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\/en:Public_domain).<\/p>\n<p>&nbsp;<\/p>\n<div class=\"media-atttributions\">\n<p><span style=\"font-size: 1.424em;font-weight: bold;color: #333333\">References<\/span><\/p>\n<\/div>\n<\/section>\n<\/div>\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\">27.10<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"33336\" class=\"os-title\" data-type=\"title\">The vulva [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 27.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-2-anatomy-and-physiology-of-the-female-reproductive-system<\/span><\/p>\n<p class=\"hanging-indent\">Janux. (2015, January 10). Human physiology - Functional anatomy of the female reproductive system. YouTube. https:\/\/www.youtube.com\/watch?v=9rs2gNchQig&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2019, March 22). The uncomplicated truth about women's sexuality | Sarah Barmak. YouTube.\u00a0 https:\/\/www.youtube.com\/watch?v=SkB4gG8ke7Q&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Teixeira, J., Rueda, B.R., and Pru, J.K. (September 30, 2008). Figure 1 Uterine anatomy. In <em>Uterine Stem Cells<\/em> (StemBook, ed.). The Stem Cell Research Community, StemBook, doi\/10.3824\/stembook.1.16.1, http:\/\/www.stembook.org<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5915\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5915\"><div tabindex=\"-1\"><p>The central nervous system organ inside the skull that is the control center of the nervous system.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3010\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3010\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1545\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Steak-and-Kidney-Pie-by-Charles-Haynes-on-flickr.jpg\" alt=\"16.4.1 Kidney Pie\" width=\"400\" height=\"356\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.1 Steak and kidney pie!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Kidneys on the Menu<\/h1>\n<\/div>\n<p>Pictured in Figure 16.4.1 is a steak and kidney pie; this savory dish is a British favorite. When kidneys are on a menu, they typically come from sheep, pigs, or cows. In these animals (as in the human animal), kidneys are the main organs of excretion.<\/p>\n<div>\n<h1>Location\u00a0of the Kidneys<\/h1>\n<\/div>\n<p>The two bean-shaped\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a><\/strong>\u00a0are located high in the back of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2475\">abdominal cavity<\/a>, one on each side of the spine. Both kidneys sit just below the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4292\">diaphragm<\/a>, the large\u00a0breathing\u00a0muscle that separates the abdominal and thoracic cavities. As you can see in the\u00a0following\u00a0figure, the right kidney is slightly smaller and lower than the left kidney. The right kidney is behind the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2989\">liver<\/a>, and the left kidney is behind the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4497\">spleen<\/a>. The\u00a0location\u00a0of the liver explains why the right kidney is smaller and lower than the left.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 455px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1547\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gray-Kidneys.png\" alt=\"16.4.2 Classic Kidney Illustration from Gray's Anatomy\" width=\"455\" height=\"600\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.2 This classic illustration of the abdominal cavity provides a view of the internal organs from the back of the body. It clearly shows the locations of the right and left kidney, as well as the large blood vessels that connect the kidneys to the body\u2019s main artery (aorta) and vein (inferior vena cava). The ureter exiting each kidney is also shown in the diagram.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Kidney Anatomy<\/span><\/p>\n<p>The shape of each kidney gives it a convex side (curving outward) and a concave side (curving inward). You can see this clearly in the detailed diagram of kidney anatomy shown in Figure 16.4.3. The concave side is where the renal artery enters the kidney, as well as where the renal vein and ureter leave the kidney. This area of the kidney is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4739\">hilum<\/a><\/strong>. The entire kidney is surrounded by tough fibrous tissue \u2014 called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4740\">renal capsule<\/a><\/strong>\u00a0\u2014 which, in turn, is surrounded by two layers of protective, cushioning fat.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 765px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1549\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0592_KidneyAnatomy_01.png\" alt=\"16.4.3 Kidney Anatomy\" width=\"765\" height=\"574\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.3 This diagram shows the location and relative size of the two kidneys, as well as the internal structure of each kidney.<\/em><\/figcaption><\/figure>\n<p>Internally, each kidney is divided into two major layers: the outer <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4741\"><strong>renal cortex<\/strong><\/a> and the inner <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4742\"><strong>renal medulla<\/strong><\/a> (see Figure 16.4.3 above). These layers take the shape of many cone-shaped renal lobules, each containing renal cortex surrounding a portion of medulla called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4743\"><strong>renal pyramid<\/strong><\/a>. Within the renal pyramids are the structural and functional units of the kidneys, the tiny <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4718\">nephron<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. Between the renal pyramids are projections of cortex called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4744\"><strong>renal columns<\/strong><\/a>. The tip, or papilla, of each pyramid empties urine into a minor calyx (chamber). Several minor calyces empty into a major calyx, and the latter empty into the funnel-shaped cavity called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4724\">renal pelvis<\/a>, which becomes the ureter as it leaves the kidney.<\/span><\/p>\n<div>\n<h3>Renal\u00a0Circulation<\/h3>\n<\/div>\n<p>The renal circulation is an important part of the kidney\u2019s primary function of filtering waste products from the blood. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2702\">Blood<\/a> is supplied to the kidneys via the renal arteries. The right renal artery supplies the right kidney, and the left renal artery supplies the left kidney. These two arteries branch directly from the aorta, which is the largest artery in the body. Each kidney is only about 11 cm (4.4 in) long, and has a mass of just 150 grams (5.3 oz), yet it receives about ten per cent of the total output of blood from the heart. Blood is filtered through the kidneys every 3 minutes, 24 hours a day, every day of your life.<\/p>\n<p>As indicated in Figure 16.4.4, each renal artery carries blood with waste products into the kidney. Within the kidney, the renal artery branches into increasingly smaller <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4385\">arteries<\/a> that extend through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4744\">renal columns<\/a> between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4743\">renal pyramids<\/a>. These arteries, in turn, branch into arterioles that penetrate the renal pyramids. Blood in the arterioles passes through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4718\">nephrons<\/a>, the structures that actually filter the blood. After blood passes through the nephrons and is filtered, the clean blood moves through a network of venules that converge into small <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4386\">veins<\/a>. Small veins merge into increasingly larger ones, and ultimately into the renal vein, which carries clean blood away from the kidney to the inferior <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4410\">vena cava<\/a>.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 683px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1551\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_how_the_kidneys_work_CRUK_138.svg_.png\" alt=\"16.4.4 Kidney and Nephron\" width=\"683\" height=\"719\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.4 The renal artery and renal vein carry blood to and from the kidney, respectively. As blood passes through a nephron within the kidney, it is filtered. Substances filtered from the blood are eventually collected in a tubule (collecting duct).<\/em><\/figcaption><\/figure>\n<div>\n<h1>Nephron Structure and Function<\/h1>\n<\/div>\n<p>Figure 16.4.4 gives an indication of the complex structure of a nephron. The <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4718\">nephron<\/a><\/strong>\u00a0is the basic structural and functional unit of the kidney, and each kidney typically contains at least a million of them. As blood flows through a nephron, many materials are filtered out of the blood, needed materials are returned to the blood, and the remaining materials form urine. Most of the waste products removed from the blood and excreted in urine are byproducts of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2368\">metabolism<\/a>. At least half of the waste is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4708\">urea<\/a>, a waste product produced by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2422\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2299\">catabolism<\/a>. Another important waste is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4709\">uric\u00a0acid<\/a>, produced in\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4727\">nucleic acid<\/a>\u00a0catabolism.<\/p>\n<h2>Components of a Nephron<\/h2>\n<p>Figure 16.4.5 shows in greater detail the components of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4718\">nephron<\/a>. Each nephron is composed of an initial filtering component that consists of a network of capillaries called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4747\">glomerulus<\/a><\/strong>\u00a0(plural, glomeruli), which is surrounded by a space within a structure\u00a0called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4748\">glomerular capsule<\/a> <\/strong>(also known as the Bowman's capsule). Extending from glomerular capsule is the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4749\">renal tubule<\/a><\/strong>. The proximal end (nearest glomerular capsule) of the renal tubule is called the <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4750\">proximal convoluted (coiled) tubule<\/a><\/strong>. From here, the renal tubule continues as a loop (known as the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4751\"><strong>loop of Henle<\/strong><\/a>) (also known as the loop of the nephron), which in turn becomes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4752\"><strong>distal convoluted tubule<\/strong><\/a>. The latter finally joins with a collecting duct. As you can see in the diagram, arterioles surround the total length of the renal tubule in a mesh called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4753\"><strong>peritubular capillary network<\/strong><\/a>.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 425px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1554\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blood_Flow_in_the_Nephron.jpg\" alt=\"16.4.5 Nephron\" width=\"425\" height=\"600\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.5 This model of an individual nephron shows each of the structures that are involved in filtering blood, returning needed materials to blood, or excreting wastes that form urine.<\/em><\/figcaption><\/figure>\n<div><\/div>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 257px\" class=\"wp-caption alignright\"><img class=\"size-medium wp-image-1556\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Physiology_of_Nephron-257x300.png\" alt=\"16.4.6 Urine Formation at the Nephron\" width=\"257\" height=\"300\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\">Figure 16.4.6 This diagram of a nephron shows the parts of the nephron where different stages of nephron function take place. These stages are filtration, reabsorption, secretion, and excretion.<\/figcaption><\/figure>\n<h2>Function of a Nephron<\/h2>\n<p>The simplified diagram of a nephron in Figure 16.4.6 shows an overview of how the nephron functions. Blood enters the nephron through an arteriole called the afferent arteriole. Next, some of the blood passes through the capillaries of the glomerulus. Any blood that doesn\u2019t pass through the glomerulus \u2014 as well as blood after it passes through the glomerular capillaries \u2014 continues on through an arteriole called the efferent arteriole. The efferent arteriole follows the renal tubule of the nephron, where it continues\u00a0playing a role\u00a0in nephron functioning.<\/p>\n<p>&nbsp;<\/p>\n<h3>Filtration<\/h3>\n<p>As blood from the afferent arteriole flows through the glomerular capillaries, it is under pressure. Because of the pressure, water and solutes are filtered out of the blood and into the space made by glomerular capsule, almost like the water you cook pasta is is filtered out through a strainer. This is the filtration stage of nephron function. The filtered substances \u2014 called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1971\">filtrate<\/a><\/strong> \u2014 pass into glomerular capsule, and from there into the proximal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4749\">renal tubule<\/a>.\u00a0 Anything too large to move through the pores in the glomerulus, such as blood cells, large proteins, etc., stay in the cardiovascular system.\u00a0 At this stage, filtrate (fluid in the nephron) includes water, salts, organic solids (such as nutrients), and waste products of metabolism (such as urea).<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 403px\" class=\"wp-caption alignright\"><img class=\" wp-image-1557\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nephron_Secretion_Reabsorption.jpg\" alt=\"16.4.7 Nephron Secretion and Reabsorption\" width=\"403\" height=\"769\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.7 Secretion and reabsorption happen along the length of the renal tubule as the nephron balances blood pH and volume and maintains homeostasis of ions in the blood. Reabsorption is the movement of substance back into the bloodstream and secretion is movement of substances from the blood into the nephron for excretion.<\/em><\/figcaption><\/figure>\n<h3>Reabsorption and Secretion<\/h3>\n<p>As filtrate moves through the renal tubule, some of the substances it contains are reabsorbed from the filtrate back into the blood in the efferent arteriole (via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4753\">peritubular capillary network<\/a>). This is the reabsorption stage of nephron function and it is about returning \"the good stuff\" back to the blood so that it doesn't exit the body in urine. About two-thirds of the filtered salts and water, and all of the filtered organic solutes (mainly <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1945\">glucose<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2279\">amino acid<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">) are reabsorbed from the filtrate by the blood in the peritubular capillary network. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4757\">Reabsorption<\/a> occurs mainly in the proximal convoluted tubule and the loop of Henle, as seen in Figure 16.4.7.<\/span><\/p>\n<p>At the distal end of the renal tubule, some additional reabsorption generally occurs. This is also the region of the tubule where other substances from the blood are added to the filtrate in the tubule. The addition of other substances to the filtrate from the blood is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4758\">secretion<\/a><\/strong>. Both reabsorption and secretion (shown in Figure 16.4.7) in the distal convoluted tubule are largely under the control of endocrine hormones that maintain <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2350\">homeostasis<\/a> of water and mineral salts in the blood. These hormones work by controlling what is reabsorbed into the blood from the filtrate and what is secreted from the blood into the filtrate to become urine. For example, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3467\">parathyroid hormone<\/a> causes more calcium to be reabsorbed into the blood and more phosphorus to be secreted into the filtrate.<\/p>\n<h2>Collection of Urine and Excretion<\/h2>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 219px\" class=\"wp-caption alignleft\"><img class=\" wp-image-1558\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Weewee.jpg\" alt=\"16.4.8 Urine\" width=\"219\" height=\"478\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.8 Fresh urine is typically yellow or amber in colour.<\/em><\/figcaption><\/figure>\n<p>By the time the filtrate has passed through the entire renal tubule, it has become the\u00a0liquid\u00a0waste known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a>. Urine empties from the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4749\">renal tubule<\/a> into a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4759\">collecting duct<\/a><\/strong>. From there, the urine flows into increasingly larger collecting ducts. As urine flows through the system of collecting ducts, more water may be reabsorbed from it. This will occur in the presence of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2050\">antidiuretic\u00a0hormone\u00a0<\/a>from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a>. This\u00a0hormone\u00a0makes the collecting ducts permeable to water, allowing water molecules to pass through them into capillaries by\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2221\">osmosis<\/a>, while preventing the passage of ions or other solutes. As much as 75% of the water may be reabsorbed from urine in the collecting ducts, making the urine more concentrated.<\/p>\n<p>Urine finally exits the largest collecting ducts through the renal papillae. It empties into the renal calyces, and finally into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4724\">renal pelvis<\/a>. From there, it travels through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4725\">ureter<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a> for eventual excretion from the body. An average of roughly 1.5 litres (a little over 6 cups) of urine is excreted each day. Normally, urine is yellow or amber in colour (see <span style=\"font-size: 1em\">Figure 16.4.8<\/span><span style=\"text-align: initial;font-size: 1em\">). The darker the colour, generally speaking, the more concentrated the urine is.<\/span><\/p>\n<p>&nbsp;<\/p>\n<div><span style=\"font-size: 1.602em;font-weight: bold\">Other Functions of the Kidneys<\/span><\/div>\n<p>Besides filtering blood and forming urine for excretion of soluble wastes, the kidneys have several vital functions in maintaining body-wide\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2350\">homeostasis<\/a>. Most of these functions are related to the\u00a0composition\u00a0or volume of urine formed by the kidneys. The kidneys must maintain the proper balance of water and salts in the body, normal\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4480\">blood pressure<\/a>, and the correct range of blood\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4330\">pH<\/a>. Through the processes of absorption and secretion by nephrons, more or less water, salt ions, acids, or bases are returned to the blood or excreted in urine, as needed, to maintain homeostasis.<\/p>\n<h2>Blood Pressure\u00a0Regulation<\/h2>\n<p>The kidneys do not control homeostasis all alone. As indicated above, endocrine hormones are also involved. Consider the regulation of\u00a0blood pressure\u00a0by the kidneys. Blood pressure is the pressure exerted by blood on the walls of the arteries. The regulation of blood pressure is part of a complex system, called the renin-angiotensin-aldosterone system. This system regulates the\u00a0concentration\u00a0of sodium in the blood to control blood pressure.<\/p>\n<figure id=\"attachment_1559\" aria-describedby=\"caption-attachment-1559\" style=\"width: 736px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1559\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Renin_Angiotensin_System-01.jpg\" alt=\"16.4.9 Regulation of Blood Pressure\" width=\"736\" height=\"336\"><figcaption id=\"caption-attachment-1559\" class=\"wp-caption-text\"><em>Figure 16.4.9 This diagram summarizes the processes that occur in the regulation of blood pressure by the renin-angiotensin-aldosterone system. The final step on the far right occurs in the nephrons and collecting ducts of the kidneys, where aldosterone stimulates increased reabsorption of sodium and water into the blood.<\/em><\/figcaption><\/figure>\n<p>The renin-angiotensin-aldosterone system is put into play when the\u00a0concentration\u00a0of sodium ions in the blood falls lower than normal. This causes the kidneys to secrete an\u00a0enzyme\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4762\">renin<\/a> into the blood. It also causes the liver to secrete a\u00a0protein\u00a0called angiotensinogen. Renin changes angiotensinogen into a proto-hormone\u00a0called\u00a0angiotensin I. This is converted to angiotensin II by an\u00a0enzyme\u00a0(angiotensin-converting enzyme) in lung capillaries.<\/p>\n<p>Angiotensin II is a potent hormone that causes arterioles to constrict. This, in turn, increases blood pressure. Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the kidneys to increase the reabsorption of sodium ions and water from the filtrate into the blood. This returns the\u00a0concentration\u00a0of sodium ions in the blood to normal. The increased water in the blood also increases blood volume and blood pressure.<\/p>\n<h2>Other Kidney Hormones<\/h2>\n<p>Hormones other than renin are also produced and secreted by the kidneys. These include calcitriol and erythropoietin.<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4763\">Calcitriol<\/a><\/strong>\u00a0is secreted by the kidneys in response to low levels of calcium in the blood. This hormone stimulates uptake of calcium by the intestine, thus raising blood levels of calcium.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4764\">Erythropoietin<\/a><\/strong> is secreted by the kidneys in response to low levels of oxygen in the blood. This hormone stimulates erythropoiesis, which is the production of\u00a0 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4398\">erythrocytes<\/a>\u00a0in bone marrow. Extra red blood cells increase the level of oxygen carried in the blood.<\/li>\n<\/ul>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<p>Kidney failure is a complication of common disorders including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2771\">diabetes mellitus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4231\">hypertension<\/a>. It is estimated that approximately 12.5% of Canadians have some form of kidney disease.\u00a0 If the disease is serious, the patient must either receive a donated kidney or have frequent hemodialysis, a medical procedure in which the blood is artificially filtered through a machine. Transplant generally results in better outcomes than hemodialysis, but demand for organs far outstrips the supply. The average time on the organ donation waitlist for a kidney is four years.\u00a0 There are over 3,000 Canadians on the wait list for a kidney transplant and some will die waiting for a kidney to become available.<\/p>\n<p>For the past decade, Dr. William Fissell, a kidney specialist at Vanderbilt University, has been working to create an implantable part-biological and part-artificial kidney. Using microchips like those used in computers, he has produced an artificial kidney small enough to implant in the patient\u2019s body in place of the failed kidney. According to Dr. Fissell, the artificial kidney is \u201c... a bio-hybrid device that can mimic a kidney to remove enough waste products, salt, and water to keep a patient off [hemo]dialysis.\u201d<\/p>\n<p>The filtration system in the artificial kidney consists of a stack of 15 microchips. Tiny pores in the microchips act as a scaffold for the growth of living kidney\u00a0cells\u00a0that can mimic the natural functions of the kidney. The living cells form a membrane to filter the patient\u2019s blood as a biological kidney would, but with less risk of rejection by the patient\u2019s immune system, because they are embedded within the device. The new kidney doesn\u2019t need a power source, because it uses the natural pressure of blood flowing through arteries to push the blood through the filtration system. A major part of the design of the artificial organ was devoted to fine tuning the fluid dynamics so blood flows through the device without clotting.<\/p>\n<p>Because of the potential life-saving benefits of the device, the implantable kidney was given fast-track approval for testing in people by the U.S. Food and Drug Administration. The artificial kidney is expected to be tested in pilot trials by 2018. Dr. Fissell says he has a long list of patients eager to volunteer for the trials.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The two bean-shaped kidneys are located high in the back of the abdominal cavity on either side of the spine. A renal artery connects each kidney with the aorta, and transports unfiltered blood to the kidney. A renal vein connects each kidney with the inferior vena cava and transports filtered blood back to the\u00a0circulation.<\/li>\n<li>The kidney has two main layers involved in the filtration of blood and formation of urine: the outer cortex and inner medulla. At least a million nephrons \u2014 which are the tiny functional units of the kidney \u2014 span the cortex and medulla. The entire kidney is surrounded by a fibrous capsule and protective fat layers.<\/li>\n<li>As blood flows through a nephron, many materials are filtered out of the blood, needed materials are returned to the blood, and the remaining materials are used to form urine.<\/li>\n<li>In each nephron, the glomerulus and surrounding Bowman\u2019s capsule form the unit that filters blood. From Bowman\u2019s capsule, the material filtered from blood (called filtrate) passes through the long renal tubule. As it does, some substances are reabsorbed into the blood, and other substances are secreted from the blood into the filtrate, finally forming urine. The urine empties into collecting ducts, where more water may be reabsorbed.<\/li>\n<li>The kidneys control homeostasis with the help of endocrine hormones.\u00a0The kidneys, for example, are part of the renin-angiotensin-aldosterone system that regulates the concentration of sodium in the blood to control blood pressure. In this system, the\u00a0enzyme\u00a0renin secreted by the kidneys works with hormones from the liver and adrenal gland to stimulate nephrons to reabsorb more sodium and water from urine.<\/li>\n<li>The kidneys also secrete endocrine hormones, including calcitriol \u2014 which helps control the level of calcium in the blood \u2014 and erythropoietin, which stimulates bone marrow to produce red blood\u00a0cells.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-316\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-316\" class=\"h5p-iframe\" data-content-id=\"316\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"16.4 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Contrast the renal artery and renal vein.<\/li>\n<li>Identify the functions of a nephron.\u00a0Describe in detail what happens to fluids (blood, filtrate, and urine) as they pass through the parts of a nephron.<\/li>\n<li>Identify two endocrine hormones secreted by the kidneys, along with the functions they control.<\/li>\n<li>Name two regions in the kidney where water is reabsorbed.<\/li>\n<li>Is the blood in the glomerular capillaries more or less filtered than the blood in the peritubular capillaries? Explain your answer.<\/li>\n<li>What do you think would happen if\u00a0blood flow to the kidneys is blocked?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">16.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/FN3MFhYPWWo<\/p>\n<p style=\"text-align: center\">How do your kidneys work? - Emma Bryce, TED-Ed, 2015.<\/p>\n<p>https:\/\/youtu.be\/es-t8lO1KpA<\/p>\n<p style=\"text-align: center\">Urine Formation, Hamada Abass, 2013.<\/p>\n<p>https:\/\/youtu.be\/bX3C201O4MA<\/p>\n<p style=\"text-align: center\">Printing a human kidney - Anthony Atala, TED-Ed, 2013.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 16.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/haynes\/3403969320\" rel=\"cc:attributionURL\">Steak and Kidney Pie<\/a> by <a class=\"owner-name truncate\" title=\"Go to Charles Haynes's photostream\" href=\"https:\/\/www.flickr.com\/photos\/haynes\/\" data-track=\"attributionNameClick\">Charles Haynes<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\" rel=\"license\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/p>\n<p><strong>Figure 16.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gray1120.png\" rel=\"cc:attributionURL\">Gray Kidneys<\/a> by\u00a0<a href=\"https:\/\/en.wikipedia.org\/wiki\/Henry_Vandyke_Carter\">Henry Vandyke Carter<\/a>\u00a0(1831-1897) on Wikimedia Commons is in the \u00a0<a class=\"extiw\" title=\"en:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/public_domain). (<a class=\"extiw\" title=\"en:Bartleby.com\" href=\"https:\/\/en.wikipedia.org\/wiki\/Bartleby.com\">Bartleby.com<\/a>:\u00a0<a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/\" rel=\"nofollow\">Gray\u2019s Anatomy<\/a>, <a class=\"external text\" href=\"http:\/\/www.bartleby.com\/107\/illus1120.html\" rel=\"nofollow\">Plate 1120<\/a>).<\/p>\n<p><strong>Figure 16.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0592_KidneyAnatomy_01.png\" rel=\"cc:attributionURL\">Blausen_0592_KidneyAnatomy_01<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a>\u00a0on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_how_the_kidneys_work_CRUK_138.svg\" rel=\"cc:attributionURL\">Diagram_showing_how_the_kidneys_work_CRUK_138.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 16.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2611_Blood_Flow_in_the_Nephron.jpg\" rel=\"cc:attributionURL\">Blood_Flow_in_the_Nephron<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Physiology_of_Nephron.png\" rel=\"cc:attributionURL\">1024px-Physiology_of_Nephron<\/a> by <a title=\"User:Madhero88\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Madhero88\">Madhero88<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2618_Nephron_Secretion_Reabsorption.jpg\" rel=\"cc:attributionURL\">Nephron_Secretion_Reabsorption<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-6-tubular-reabsorption\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 16.4.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Weewee.JPG\" rel=\"cc:attributionURL\">Urine<\/a> by <a class=\"extiw\" title=\"en:User:Markhamilton\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Markhamilton\">User:Markhamilton<\/a> at <a class=\"extiw\" title=\"en:Main Page\" href=\"https:\/\/en.wikipedia.org\/wiki\/Main_Page\">English Wikipedia<\/a> on Wikimedia Commons is in the <a href=\"https:\/\/en.wikipedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 16.4.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2712_Renin_Angiotensin_System-01.jpg\" rel=\"cc:attributionURL\">Renin_Angiotensin_System-01<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/26-3-electrolyte-balance\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">25.10<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"4696\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">Blood flow in the nephron [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 25.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-3-gross-anatomy-of-the-kidney<\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">25.17<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"26834\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text last focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\">Locations of secretion and reabsorption in the nephron <span id=\"4696\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597634737557\" data-highlight-id=\"78b92c1f-19a8-4f25-a51f-bbc8324f8001\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 25.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/25-6-tubular-reabsorption<\/span><\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">26.14<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"41702\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597635408675\" data-highlight-id=\"1dfb4674-6d07-43f5-aeac-06bacc555bc7\" data-highlighted=\"true\">The renin-angiotensin system <span id=\"26834\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text last focus\" data-timestamp=\"1597635089440\" data-highlight-id=\"44eee2fb-aa0d-4804-9be2-6a8facf0058f\" data-highlighted=\"true\"><span id=\"4696\" class=\"os-title\" data-type=\"title\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 26.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/26-3-electrolyte-balance<\/span><\/span><\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014.\u00a0<i>WikiJournal of Medicine<\/i>\u00a0<b>1<\/b>\u00a0(2).\u00a0DOI:10.15347\/wjm\/2014.010.\u00a0ISSN\u00a02002-4436<\/p>\n<p class=\"hanging-indent\">Hamada Abass. (2013). Urine formation. YouTube. https:\/\/www.youtube.com\/watch?v=es-t8lO1KpA&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 9). How do your kidneys work? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=FN3MFhYPWWo&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, March 15). Printing a human kidney - Anthony Atala. YouTube. https:\/\/www.youtube.com\/watch?v=bX3C201O4MA&amp;feature=youtu.be<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3030\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_2506\">sperm<\/a> from entering the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_5149\">sexual intercourse<\/a> occurs and must be placed over the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_5364\">vasectomy<\/a>.<\/strong> In this surgery, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5095\"><em>vas deferens<\/em><\/a> from each <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_5090\">epididymis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_5239\">ovulation<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3031\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3031\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1864\" aria-describedby=\"caption-attachment-1864\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1861\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Pregnancy-test-by-Esparta-Palma-on-Flickr.jpg\" alt=\"18.12.1 Pregnancy Test\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-1864\" class=\"wp-caption-text\"><em>Figure 18.12.1 Success!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study Conclusion: Trying to Conceive<\/h1>\n<\/div>\n<p>The woman in Figure 18.12.1 is holding a home pregnancy test. The two pink lines in the middle are the type of result that Alicia and Victor are desperately hoping to see themselves one day \u2014 a positive pregnancy test. In the beginning of the chapter you learned that Alicia and Victor have been actively trying to get pregnant for a year, which, as you now know, is the time frame necessary for infertility to be diagnosed.<\/p>\n<p>Alicia and Victor tried having <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5149\">sexual intercourse<\/a> on day 14 of her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5293\">menstrual cycle<\/a> to optimize their chances of having his <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2506\">sperm<\/a> meet her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5099\">ovum<\/a>. Why might this not be successful, even if they do <em>not<\/em> have fertility problems? Although the average menstrual cycle is 28 days, with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5239\">ovulation<\/a> occurring around day 14, many women vary widely from these averages (either consistently or variably) from month to month.\u00a0Recall, for example, that menstrual cycles may vary from 21 to 45 days in length, and a woman\u2019s cycle is considered to be regular if it varies within as many as eight days from shortest to longest cycle. This variability means that ovulation often does not occur on or around day 14, particularly if the woman has significantly shorter, longer, or irregular cycles \u2014 like Alicia does. Therefore, by aiming for day 14 without knowing when Alicia is actually ovulating, they may not be successful in helping Victor\u2019s sperm encounter Alicia\u2019s egg.<\/p>\n<p>Lack of ovulation entirely can also cause variability in menstrual cycle length. As you have learned, the regulation of the menstrual cycle depends on an interplay of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2218\">hormones<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5206\">FSH<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5306\">LH<\/a> from the pituitary and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3411\">progesterone<\/a> from the ovary \u2014 specifically from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5253\">follicle <\/a>which surrounds the maturing egg and becomes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5277\">corpus luteum<\/a> after ovulation. Shifts in these hormones and processes can affect ovulation and menstrual cycle length. This is why Alicia was concerned about her long and irregular menstrual cycles. If they are a sign that she is not ovulating, that could be the reason why she is having trouble getting pregnant.<\/p>\n<p>In order to get a better idea of whether Alicia is ovulating, Dr. Bashir recommended that she take her basal body temperature (BBT) each morning before getting out of bed, and track it throughout her menstrual cycle. As you have learned, BBT typically rises slightly and stays high after ovulation. While tracking BBT is not a particularly effective form of contraception, since the temperature rise occurs only after ovulation, it can be a good way to see whether a woman is ovulating at all. Although not every woman will see a clear shift in BBT after ovulation, it is a relatively easy way to start assessing a woman\u2019s fertility and is used as part of a more comprehensive fertility assessment by some physicians.<\/p>\n<figure id=\"attachment_1864\" aria-describedby=\"caption-attachment-1864\" style=\"width: 357px\" class=\"wp-caption alignright\"><img class=\" wp-image-1862\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Ovulatietest.jpg\" alt=\"18.12.2 Ovulation Test Strips\" width=\"357\" height=\"268\"><figcaption id=\"caption-attachment-1864\" class=\"wp-caption-text\"><em>Figure 18.12.2 Ovulation test strips. The pink line towards the right in both strips is the control line that is used as a comparison to the test line that detects LH in the woman\u2019s urine, located to the left of the control line. In the top strip, the test line is barely visible, indicating that LH levels are low. In the bottom strip, the light pink line on the left indicates that the woman\u2019s level of LH is starting to increase. When the test line is equal in intensity or darker than the control line, the LH surge is likely occurring.<\/em><\/figcaption><\/figure>\n<p>Dr. Bashir also recommended that Alicia use a home ovulation predictor kit. This is another relatively cheap and easy way to assess ovulation. Most ovulation predictor kits work by detecting the hormone LH in urine using test strips, like the ones shown in Figure 18.12.2. Why can this predict ovulation? Think about what you have learned about how ovulation is triggered. Rising levels of estrogen from the maturing follicle in the ovary causes a surge in the level of LH secreted from the pituitary gland, which triggers ovulation. This surge in LH can be detected by the home kit, which compares the level of LH in a woman\u2019s urine to that of a control on the strip. After the LH surge is detected, ovulation will typically occur within one to two days.<\/p>\n<p>By tracking her BBT and using the ovulation predictor kit, Alicia has learned that she is most likely ovulating, but not in every cycle, and sometimes she ovulates much later than day 14. Because frequent anovulatory cycles can be a sign of an underlying hormonal disorder, such as polycystic ovary syndrome (PCOS) or problems with the pituitary or other glands that regulate the reproductive system, Dr. Bashir orders blood tests for Alicia and sets up an appointment for a physical exam.<\/p>\n<p>However, because Alicia is sometimes ovulating, the problem may not lie solely with her. Recall that infertility occurs in similar proportions in men and women, and can be due to problems in both partners. This is why it is generally recommended that both partners get assessed for fertility issues when they are having trouble getting pregnant after a year of trying.<\/p>\n<p>Therefore, Victor proceeds with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4885\">semen<\/a> analysis that Dr. Bashir recommended. In this process, the man provides a semen sample by ejaculating into a cup or special condom, and the semen is then examined under a microscope. The semen is then checked for sperm number, shape, and motility. Sperm with an abnormal shape or trouble moving will likely have trouble reaching and fertilizing an egg. A low number of sperm will also reduce the chances of conception. In this way, semen analysis can provide insight into the possible underlying causes of infertility. For instance, a low sperm count could indicate problems in sperm production or a blockage in the male reproductive tract that is preventing sperm from being emitted from the penis. Further testing would have to be done to distinguish between these two possible causes.<\/p>\n<figure id=\"attachment_1864\" aria-describedby=\"caption-attachment-1864\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1864\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Sperm-Count-.png\" alt=\"18.12.3 Sperm Count\" width=\"500\" height=\"327\"><figcaption id=\"caption-attachment-1864\" class=\"wp-caption-text\"><em>Figure 18.12.3 When conducting a sperm count, a lab technician will look at a sample of semen under the microscope and count the number of sperm in the field of view, as well as note an abnormalities with respect to sperm morphology (shape) and swimming patterns.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>Victor had been worried that past injuries to his testes may have affected his fertility. You may remember the testes are where sperm are produced, and because they are external to the body, they are vulnerable to injury. In addition to physical damage to the testes and other parts of the male reproductive tract, a testicular injury could potentially cause the creation of antibodies against a man\u2019s own sperm. As you have learned, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5169\">Sertoli cell<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\">\u00a0lining the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5160\">seminiferous tubules<\/a> are tightly packed so that the developing sperm are normally well-separated from the body\u2019s immune system. However, in the case of an injury, this barrier can be breached, which can cause the creation of antisperm antibodies. These antibodies can hamper fertility by killing the sperm, or otherwise interfering with their ability to move or fertilize an egg. When infertility is due to such antibodies, it is called \u201cimmune infertility.\u201d<\/span><\/p>\n<p>Victor\u2019s semen analysis shows that he has normal numbers of healthy sperm. Dr. Bashir recommends that while they investigate whether Alicia has an underlying medical issue, she continue to track her BBT and use ovulation predictor kits to try to pinpoint when she is ovulating. She recommends that once Alicia sees an LH surge, the couple try to have intercourse within three days to maximize their chances of conception. If Alicia is found to have a medical problem that is inhibiting ovulation, depending on what it is, they may either address the problem directly, or she can take medication that stimulates ovulation, such as clomiphene citrate (often sold under the brand name Clomid). This medication works by increasing the amount of FSH secreted by the pituitary.<\/p>\n<p>Fortunately, tracking ovulation at home and timing intercourse appropriately was all Alicia and Victor needed to do to finally get pregnant! After their experience, they, like you, now have a much deeper understanding of the intricacies of the reproductive system and the complex biology that is involved in the making of a new human organism.<\/p>\n<div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 18 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you learned about the male and female reproductive systems. Specifically, you learned that:<\/p>\n<ul>\n<li>The reproductive system is the human organ system responsible for the production and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2677\">fertilization<\/a> of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2694\">gametes<\/a>\u00a0and, in females, the carrying of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5086\">fetus<\/a>.<\/li>\n<li>Both male and female reproductive systems have organs called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3408\">gonads<\/a>\u00a0(<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3486\">testes<\/a> in males, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a> in females) that produce gametes (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2506\">sperm<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5099\">ova<\/a>) and sex hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3409\">testosterone<\/a> in males and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2659\">estrogen<\/a> in females). Sex hormones are endocrine hormones that control prenatal development of sex organs, sexual maturation at <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5155\">puberty<\/a>, and reproduction after puberty.<\/li>\n<li>The reproductive system is the only organ system that is significantly different between males and females. A Y-chromosome gene called SRY is responsible for undifferentiated embryonic tissues developing into a male reproductive system. Without a Y chromosome, the undifferentiated embryonic tissues develop into a female reproductive system.<\/li>\n<li>Male and female reproductive systems are different at birth, but immature and nonfunctioning. Maturation of the reproductive system occurs during puberty when hormones from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2937\">hypothalamus<\/a> and pituitary gland stimulate the gonads to produce sex hormones again. The sex hormones, in turn, cause the physical changes experienced during puberty.<\/li>\n<li>Male reproductive system organs include the testes, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5090\">epididymis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5091\">penis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5095\"><em>vas deferens<\/em><\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5096\">prostate gland<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5097\">seminal vesicles<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The two testes are sperm- and testosterone-producing male gonads. They are contained within the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5089\">scrotum<\/a>, a pouch that hangs down behind the penis. The testes are filled with hundreds of tiny, tightly coiled seminiferous tubules, where sperm are produced. The tubules contain sperm in different stages of development, as well as Sertoli cells, which secrete substances needed for sperm production. Between the tubules are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5171\">Leydig cells<\/a>, which secrete testosterone.<\/li>\n<li>The two epididymides are contained within the scrotum. Each epididymis is a tightly coiled tubule where sperm mature and are stored until they leave the body during an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5150\">ejaculation<\/a>.<\/li>\n<li>The two <em>vas deferens<\/em> are long, thin tubes that run from the scrotum up into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2992\">pelvic cavity<\/a>. During ejaculation, each <em>vas deferens<\/em> carries sperm from one of the epididymides to one of the pair of ejaculatory ducts.<\/li>\n<li>The two seminal vesicles are glands within the pelvis that secrete fluid through ducts into the junction of each <em>vas deferens<\/em> and ejaculatory duct. This alkaline fluid makes up about 70% of semen, the sperm-containing fluid that leaves the penis during ejaculation. Semen contains substances and nutrients that sperm need to survive and \u201cswim\u201d in the female reproductive tract.<\/li>\n<li>The prostate gland is located just below the seminal vesicles and surrounds the urethra and its junction with the ejaculatory ducts. The prostate secretes an alkaline fluid that makes up close to 30% of semen. Prostate fluid contains a high concentration of zinc, which sperm need to be healthy and motile.<\/li>\n<li>The ejaculatory ducts form where the <em>vas deferens<\/em> joins with the ducts of the seminal vesicles in the prostate gland. They connect the <em>vas deferens<\/em> with the urethra. The ejaculatory ducts carry sperm from the vas deferens, and secretions from the seminal vesicles and prostate gland that together form semen.<\/li>\n<li>The paired <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5183\">bulbourethral glands<\/a>\u00a0are located just below the prostate gland. They secrete a tiny amount\u00a0of fluid into semen. The secretions help lubricate the urethra and neutralize any acidic urine it may contain.<\/li>\n<li>The penis is the external male organ that has the reproductive function of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5203\">intromission<\/a>, which is delivering sperm to the female reproductive tract. The penis also serves as the organ that excretes urine. The urethra passes through the penis and carries urine or semen out of the body. Internally, the penis consists largely of columns of spongy tissue that can fill with blood and make the penis stiff and erect. This is necessary for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5149\">sexual intercourse<\/a> so intromission can occur.<\/li>\n<\/ul>\n<\/li>\n<li>Parts of a mature sperm include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5196\">head<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5197\">acrosome<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5198\">midpiece<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2151\">flagellum<\/a>. The process of producing sperm is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2507\">spermatogenesis<\/a>. This normally starts during puberty and continues uninterrupted until death.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Spermatogenesis occurs in the seminiferous tubules in the testes, and requires high concentrations of testosterone. Sertoli cells in the testes play many roles in spermatogenesis, including concentrating testosterone under the influence of follicle stimulating hormone (FSH) from the pituitary gland.<\/li>\n<li>Spermatogenesis begins with a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2103\">diploid<\/a> stem cell called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5199\">spermatogonium<\/a>, which undergoes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1987\">mitosis<\/a> to produce a primary spermatocyte. The primary spermatocyte undergoes meiosis I to produce haploid secondary spermatocytes, and these cells in turn, undergo meiosis II to produce spermatids. After the spermatids grow a tail and undergo other changes, they become sperm.<\/li>\n<li>Before sperm are able to \u201cswim,\u201d they must mature in the epididymis. The mature sperm are then stored in the epididymis until ejaculation occurs.<\/li>\n<\/ul>\n<\/li>\n<li>Ejaculation is the process in which semen is propelled by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> in the <em>vas deferens<\/em> and ejaculatory ducts from the urethra in the penis.<\/li>\n<li>Leydig cells in the testes secrete testosterone under the control of luteinizing hormone (LH) from the pituitary gland. Testosterone is needed for male sexual development at puberty and to maintain normal spermatogenesis after puberty. It also plays a role in prostate function and the ability of the penis to become erect.<\/li>\n<li>Disorders of the male reproductive system include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5213\">erectile dysfunction<\/a> (ED), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1983\">epididymitis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5227\">prostate cancer<\/a>, and<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5230\"> testicular cancer<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>ED is a disorder characterized by the regular and repeated inability of a sexually mature male to obtain and maintain an erection. ED is a common disorder that occurs when normal blood flow to the penis is disturbed or there are problems with the nervous control of penile engorgement or arousal.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Possible physiological causes of ED include aging, illness, drug use, tobacco smoking, and obesity, among others. Possible psychological causes of ED include stress, performance anxiety, and mental disorders.<\/li>\n<li>Treatments for ED may include lifestyle changes, such as stopping smoking and adopting a healthier diet and regular exercise. However, the first-line treatment is prescription drugs such as Viagra\u00ae or Cialis\u00ae that increase blood flow to the penis. Vacuum pumps or penile implants may be used to treat ED if other types of treatment fail.<\/li>\n<\/ul>\n<\/li>\n<li>Epididymitis is inflammation of the epididymis. It is a common disorder, especially in young men. It may be acute or chronic and is often caused by a bacterial infection. Treatments may include antibiotics, anti-inflammatory drugs, and painkillers. Treatment is important to prevent the possible spread of infection, permanent damage to the epididymis or testes, and even infertility.<\/li>\n<li>Prostate cancer is the most common type of cancer in men and the second leading cause of cancer death in men. If there are symptoms, they typically involve urination, such as frequent or painful urination. Risk factors for prostate cancer include older age, family history, a high-meat diet, and sedentary lifestyle, among others.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Prostate cancer may be detected by a physical exam or a high level of prostate-specific antigen (PSA) in the blood, but a biopsy is required for a definitive diagnosis. Prostate cancer is typically diagnosed relatively late in life, and is usually slow growing, so no treatment may be necessary. In younger patients or those with faster-growing tumors, treatment is likely to include surgery to remove the prostate, followed by chemotherapy and\/or radiation therapy.<\/li>\n<\/ul>\n<\/li>\n<li>Testicular cancer, or cancer of the testes, is the most common cancer in males between the ages of 20 and 39 years. It is more common in males of European than African ancestry. A lump or swelling in one testis, fluid in the scrotum, and testicular pain or tenderness are possible signs and symptoms of testicular cancer.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Testicular cancer can be diagnosed by a physical exam and diagnostic tests, such as ultrasound or blood tests. Testicular cancer has one of the highest cure rates of all cancers. It is typically treated with surgery to remove the affected testis, and this may be followed by radiation therapy, and\/or chemotherapy. Normal male reproductive functions are still possible after one testis is removed, if the remaining testis is healthy.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>The female reproductive system is made up of internal and external organs that function to produce haploid female gametes called ova, secrete female sex hormones (such as estrogen), and carry and give birth to a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5086\">fetus<\/a>.<\/li>\n<li>Female reproductive system organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3487\">ovaries<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5101\">oviducts<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5102\">uterus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5143\">vagina<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5153\">clitoris<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5154\">labia<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The vagina is an elastic, muscular canal that can accommodate the penis. It is where sperm are usually ejaculated during sexual intercourse. The vagina is also the birth canal, and it channels the flow of menstrual blood from the uterus. A healthy vagina has a balance of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2428\">symbiotic<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> and an acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4330\">pH<\/a>.<\/li>\n<li>The uterus is a muscular organ above the vagina where a fetus develops. Its muscular walls contract to push out the fetus during childbirth. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5235\">cervix<\/a> is the neck of the uterus that extends down into the vagina. It contains a canal connecting the vagina and uterus for sperm or an infant to pass through. The innermost layer of the uterus, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5241\">endometrium<\/a>, thickens each month in preparation for an embryo but is shed in the following menstrual period if fertilization does not occur.<\/li>\n<li>The oviducts extend from the uterus to the ovaries. Waving <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5247\">fimbriae<\/a> at the ovary ends of the oviducts guide ovulated ova into the tubes where fertilization may occur as the ova travel to the uterus. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1597\">Cilia<\/a> and peristalsis help eggs move through the tubes. Tubular fluid helps nourish sperm as they swim up the tubes toward eggs.<\/li>\n<li>The ovaries are gonads that produce eggs and secrete sex hormones including estrogen. Nests of cells called follicles in the ovarian cortex are the functional units of ovaries. Each follicle surrounds an immature ovum. At birth, a baby girl\u2019s ovaries contain at least a million eggs, and they will not produce any more during her lifetime. One egg matures and is typically ovulated each month during a woman\u2019s reproductive years.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5152\">vulva<\/a> is a general term for external female reproductive organs. The vulva includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5153\">clitoris<\/a>, two pairs of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5154\">labia<\/a>, and openings for the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4732\">urethra<\/a> and vagina. Secretions from Bartholin\u2019s glands near the vaginal opening lubricate the vulva.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5288\">breasts<\/a>\u00a0are technically not reproductive organs, but their <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3432\">mammary glands<\/a>\u00a0produce milk to feed an infant after birth. Milk drains through ducts and sacs and out through the nipple when a baby sucks.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2509\">Oogenesis<\/a> is the process of producing eggs in the ovaries of a female fetus. Oogenesis begins when a diploid oogonium divides by mitosis to produce a diploid primary <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5274\">oocyte<\/a>. The primary oocyte begins meiosis I and then remains at this stage in an immature ovarian follicle until after birth.<\/li>\n<li>After puberty, one follicle a month matures and its primary oocyte completes meiosis I to produce a secondary oocyte, which begins meiosis II. During ovulation, the mature follicle bursts open and the secondary oocyte leaves the ovary and enters a oviducts.<\/li>\n<li>While a follicle is maturing in an ovary each month, the endometrium in the uterus is building up to prepare for an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5262\">embryo<\/a>. Around the time of ovulation, cervical mucus becomes thinner and more alkaline to help sperm reach the secondary oocyte.<\/li>\n<li>If the secondary oocyte is fertilized by a sperm, it quickly completes meiosis II and forms a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2103\">diploid<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2471\">zygote<\/a>, which will continue through the oviducts. The zygote will go through multiple cell divisions before reaching and implanting in the uterus. If the secondary oocyte is not fertilized, it will not complete meiosis II, and will soon disintegrate.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5280\">Pregnancy<\/a> is the carrying of one or more offspring from fertilization until birth. The maternal organism must provide all the nutrients and other substances needed by the developing offspring, and also remove its wastes. She should also avoid exposures that could potentially damage the offspring, especially early in the pregnancy when organ systems are developing.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The average duration of pregnancy is 40 weeks (from the first day of the last menstrual period) and is divided into three trimesters of about three months each. Each trimester is associated with certain events and conditions that a pregnant woman may expect, such as morning sickness during the first trimester, feeling fetal movements for the first time during the second trimester, and rapid weight gain in both fetus and mother during the third trimester.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5286\">Labour<\/a>, which is the general term for the birth process, usually begins around the time the amniotic sac breaks and its fluid leaks out. Labour occurs in three stages: dilation of the cervix, birth of the baby, and delivery of the placenta (afterbirth).<\/li>\n<\/ul>\n<\/li>\n<li>The physiological function of female breasts is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5289\">lactation<\/a>, or the production of breast milk to feed an infant. Sucking on the breast by the infant stimulates the release of the hypothalamic hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3093\">oxytocin<\/a> from the posterior pituitary, which causes the flow of milk. The release of milk stimulates the baby to continue sucking, which in turn keeps the milk flowing. This is one of the few examples of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2962\">positive feedback<\/a> in the human organism.<\/li>\n<li>The ovaries produce female sex hormones, including estrogen and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3411\">progesterone<\/a>. Estrogen is responsible for sexual maturation and secondary sex characteristics at puberty. It is also needed to help regulate the menstrual cycle and ovulation after puberty until menopause. Progesterone prepares the uterus for pregnancy each month during the menstrual cycle, and helps maintain the pregnancy if fertilization occurs.<\/li>\n<li>The menstrual cycle refers to natural changes that occur in the female reproductive system each month during the reproductive years, except when a woman is pregnant. The cycle is necessary for the production of ova and the preparation of the uterus for pregnancy. It involves changes in both the ovaries and uterus and is controlled by pituitary hormones (FSH and LH) and ovarian hormones (estrogen and progesterone).<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The female reproductive period is delineated by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5300\">menarche<\/a>, or the first menstrual period, which usually occurs around age 12 or 13; and by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5255\">menopause<\/a>, or the cessation of menstrual periods, which typically occurs around age 52. A typical menstrual cycle averages 28 days in length but may vary normally from 21 to 45 days. The average menstrual period is five days long, but may vary normally from two to seven days. These variations in the menstrual cycle may occur both between women and within individual women from month to month.<\/li>\n<li>The events of the menstrual cycle that take place in the ovaries make up the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5301\">ovarian cycle<\/a>. It includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5303\">follicular phase<\/a>, when a follicle and its ovum mature due to rising levels of FSH; ovulation, when the ovum is released from the ovary due to a rise in estrogen and a surge in LH; and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5305\">luteal phase<\/a>, when the follicle is transformed into a structure called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5277\">corpus luteum<\/a> that secretes progesterone. In a 28-day menstrual cycle, the follicular and luteal phases typically average about two weeks in length, with ovulation generally occurring around day 14 of the cycle.<\/li>\n<li>The events of the menstrual cycle that take place in the uterus make up the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5308\">uterine cycle<\/a>. It includes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5310\">menstruation<\/a>, which generally occurs on days 1 to 5 of the cycle and involves shedding of endometrial tissue that built up during the preceding cycle; the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5311\">proliferative phase<\/a>, during which the endometrium builds up again until ovulation occurs; and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5312\">secretory phase<\/a>, which follows ovulation and during which the endometrium secretes substances and undergoes other changes that prepare it to receive an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5262\">embryo<\/a>.<\/li>\n<\/ul>\n<\/li>\n<li>Disorders of the female reproductive system include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5319\">cervical cancer<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5328\">vaginitis<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5333\">endometriosis<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Cervical cancer occurs when cells of the cervix grow abnormally and develop the ability to invade nearby tissues, or spread to other parts of the body. Worldwide, cervical cancer is the second-most common type of cancer in females and the fourth-most common cause of cancer death in females. Early on, cervical cancer often has no symptoms; later, symptoms such as abnormal vaginal bleeding and pain are likely.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Most cases of cervical cancer occur because of infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5324\">human papillomavirus (HPV)<\/a>, so the HPV vaccine is expected to greatly reduce the incidence of the disease. Other risk factors include smoking and a weakened immune system. A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5326\">Pap smear<\/a> can diagnose cervical cancer at an early stage. Where Pap smears are done routinely, cervical cancer death rates have fallen dramatically. Treatment of cervical cancer generally includes surgery, which may be followed by radiation therapy or chemotherapy.<\/li>\n<\/ul>\n<\/li>\n<li>Vaginitis is inflammation of the vagina. A discharge is likely, and there may be itching and pain. About 90% of cases of vaginitis are caused by infection with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2371\">microorganisms<\/a>, typically by the yeast <em>Candida albicans<\/em>. A minority of cases are caused by irritants or allergens in products such as soaps, spermicides, or douches.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Diagnosis of vaginitis may be based on characteristics of the discharge, which can be examined microscopically or cultured. Treatment of vaginitis depends on the cause, and is usually an oral or topical anti-fungal or antibiotic medication.<\/li>\n<\/ul>\n<\/li>\n<li>Endometriosis is a disease in which endometrial tissue grows outside the uterus. This tissue may bleed during the menstrual period and cause inflammation, pain, and scarring. The main symptom of endometriosis is pelvic pain, which may be severe. Endometriosis may also lead to infertility.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Endometriosis is thought to have multiple causes, including genetic mutations. Retrograde menstruation may be the immediate cause of endometrial tissue escaping the uterus and entering the pelvic cavity. Endometriosis is usually treated with surgery to remove the abnormal tissue and medication for pain. If surgery is more conservative than hysterectomy, endometriosis may recur.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4813\">Infertility<\/a> is the inability of a sexually mature adult to reproduce by natural means. It is defined scientifically and medically as the failure to achieve a successful pregnancy after at least one year of regular, unprotected sexual intercourse.<\/li>\n<li>About 40% of infertility in couples is due to female infertility, and another 30% is due to male infertility. In the remaining cases, a couple\u2019s infertility is due to problems in both partners or to unknown causes.<\/li>\n<li>Male infertility occurs when there are no or too few healthy, motile sperm. This may be caused by problems with spermatogenesis or by blockage of the male reproductive tract that prevents sperm from being ejaculated. Risk factors for male infertility include heavy alcohol use, smoking, certain medications, and advancing age, to name just a few.<\/li>\n<li>Female infertility occurs due to failure to produce viable ova by the ovaries or structural problems in the oviducts or uterus. Polycystic ovary syndrome is the most common cause of failure to produce viable eggs. Endometriosis and uterine fibroids are possible causes of structural problems in the oviducts and uterus. Risk factors for female infertility include smoking, stress, poor diet, and older age, among others.<\/li>\n<li>Diagnosing the cause(s) of a couple\u2019s infertility generally requires testing both the man and the woman for potential problems. For men, semen is likely to be examined for adequate numbers of healthy, motile sperm. For women, signs of ovulation are monitored, for example, with an ovulation test kit or ultrasound of the ovaries. For both partners, the reproductive tract may be medically imaged to look for blockages or other abnormalities.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Treatments for infertility depend on the cause. For example, if a medical problem is interfering with sperm production, medication may resolve the underlying problem so sperm production is restored. Blockages in either the male or the female reproductive tract can often be treated surgically. If there are problems with ovulation, hormonal treatments may stimulate ovulation.<\/li>\n<li>Some cases of infertility are treated with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5345\">assisted reproductive technology (ART)<\/a>. This is a collection of medical procedures in which eggs and sperm are taken from the couple and manipulated in a lab to increase the chances of fertilization occurring and an embryo forming. Other approaches for certain causes of infertility include the use of a surrogate mother, gestational carrier, or sperm donation.<\/li>\n<\/ul>\n<\/li>\n<li>Infertility can negatively impact a couple socially and psychologically, and it may be a major cause of marital friction or even divorce. Infertility treatments may raise ethical issues relating to the costs of the procedures and the status of embryos that are created\u00a0<em>in vitro<\/em>\u00a0but not used for pregnancy. Infertility is an under-appreciated problem in developing countries where birth rates are high and children have high economic as well as social value. In these countries, poor health care is likely to lead to more problems with infertility and fewer options for treatment.<\/li>\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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5351\">barrier methods<\/a>, hormonal methods, intrauterine devices, behavioural methods, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_5363\">sterilization<\/a>. Except for sterilization, all of the methods are reversible.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Barrier methods are devices that block sperm from entering the uterus. They include condoms and diaphragms. Of all birth control methods, only condoms can also prevent the spread of sexually transmitted infections.<\/li>\n<li>Hormonal methods involve the administration of hormones to prevent ovulation. Hormones can be administered in various ways, such as in an injection, through a skin patch, or, most commonly, 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 intrauterine device (IUD) 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, the penis is withdrawn from the vagina before ejaculation occurs. Behavioural methods are the least effective methods of contraception.<\/li>\n<li>Sterilization is the most effective contraceptive method, but it requires a surgical procedure and may be irreversible. Male sterility is usually achieved with a vasectomy, 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 tubal ligation, in which the oviducts are clamped or cut to prevent sperm from reaching and fertilizing eggs.<\/li>\n<li>Emergency contraception is any form of contraception that is 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<\/li>\n<\/ul>\n<p>In this chapter, you learned how the male and female reproductive systems work together to produce a zygote. In the next chapter, you will learn about how the human organism grows and develops throughout life \u2014 from a zygote all the way through old age.<\/p>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 18 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-369\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-369\" class=\"h5p-iframe\" data-content-id=\"369\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 18 Review\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Which glands produce the non-sperm fluids that make up semen? What is the rough percentage of each fluid in semen?<\/li>\n<li>What is one reason why semen's alkalinity assists in reproduction?<\/li>\n<li>What are three things that pass through the cervical canal of females, going in either direction?<\/li>\n<li>Other than where the cancer originates, what is one difference between prostate and testicular cancer?<\/li>\n<li>If a woman is checking her basal body temperature each morning as a form of contraception, and today is day 12 of her menstrual cycle and her basal body temperature is still low, is it safe for her to have unprotected sexual intercourse today? Why or why not?<\/li>\n<li>\n<div id=\"h5p-370\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-370\" class=\"h5p-iframe\" data-content-id=\"370\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 18 Review Part 2\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Where is a diaphragm placed? How does it work to prevent pregnancy?<\/li>\n<li>Why are the testes located outside of the body?<\/li>\n<li>Why is it important to properly diagnose the causative agent when a woman has vaginitis?<\/li>\n<li>Describe two ways in which sperm can move through the male and\/or female reproductive tracts.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.12.1<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/7Q8YoN\">Pregnancy test\/ Dos rayitas<\/a> by <a title=\"Go to Esparta Palma's photostream\" href=\"https:\/\/www.flickr.com\/photos\/esparta\/\" data-track=\"attributionNameClick\">Esparta Palma<\/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<p><strong>Figure 18.12.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Ovulatietest.jpg\">1024px-Ovulatietest<\/a> by <a title=\"User:Sapp (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sapp&amp;action=edit&amp;redlink=1\">Sapp<\/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 18.12.3<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.12\/\">Sperm Count<\/a>\u00a0by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.12\/\">CK-12 Foundation<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\">CC BY-NC 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/) license.<\/p>\n<div><img src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/logo_ck12.png\" alt=\"\"> <span style=\"font-size: 1em\">\u00a9<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/\">CK-12 Foundation<\/a> <span style=\"font-size: 1em\">Licensed under\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\"><img class=\"alignnone size-full wp-image-8217\" title=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/icon_licence.png\" alt=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\"><\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/terms-of-use\/?_ga=2.204818768.1988667202.1598996862-1392032960.1592870652\">Terms of Use<\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/attribution\/\">Attribution<\/a><\/div>\n<\/div>\n<h2>References<\/h2>\n<div>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2016). Figure 3 Normal vs. low sperm count [digital image]. In <em>CK-12 College Human Biology<\/em> (Section 20.12) [online Flexbook]. CK12.org.\u00a0 https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.12\/<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3032\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3032\"><div tabindex=\"-1\"><p>Image shows a burger, with the beef patty, an eff, slices of ham, and two slices of melted cheese.  The burger is so packed with fillings and toppings that it needs a wooden stick in it to keep it from falling over.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5713\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5713\"><div tabindex=\"-1\"><p>A solute pump that pumps potassium into cells while pumping sodium out of cells, both against their concentration gradients. This pumping is active and occurs at the ratio of 2 potassium for every 3 calcium.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3040\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3040\"><div tabindex=\"-1\"><p>Image shows a leg affect by PAD.  Plaques in the leg arteries have caused reduced blood flow to the leg.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3056\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3056\"><div tabindex=\"-1\"><p>Image shows a pictomicrograph of the layers of the GI tract.  Each of the mucosa, submucosa, muscularis and serosa are differentiated with respect to colouration and cell shape\/size.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3052\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3052\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<p>&nbsp;<\/p>\n<div>\n<figure id=\"attachment_4539\" aria-describedby=\"caption-attachment-4539\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4539\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Bread-by-sergio-arze-cWXibBbXx44-unsplash-scaled-2.jpg\" alt=\"15.1.1 Bread\" width=\"400\" height=\"274\"><figcaption id=\"caption-attachment-4539\" class=\"wp-caption-text\"><em>Figure 15.1.1 Bread \u2014 Are you a glutton for gluten?<\/em><\/figcaption><\/figure>\n<h1>Case Study: Please Don\u2019t Pass the Bread<\/h1>\n<\/div>\n<p>Angela and Saloni are college students who met in physics class. They decide to study together for their upcoming midterm, but first, they want to grab some lunch. Angela says there is a particular restaurant she would like to go to, because they are able to accommodate her dietary restrictions. Saloni agrees and they head to the restaurant.<\/p>\n<p>At lunch, Saloni asks Angela what is special about her diet. Angela tells her that she can\u2019t eat <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4541\">gluten<\/a>. Saloni says, \u201cMy cousin did that for a while because she heard that gluten is bad for you. But it was too hard for her to not eat bread and pasta, so she gave it up.\u201d Angela tells Saloni that avoiding gluten isn\u2019t optional for her \u2014 she has <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4542\">celiac disease<\/a>. Eating even very small amounts of gluten could damage her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2913\">digestive system<\/a>.\u00a0 It can be difficult for people living with celiac disease to find foods when eating out.<\/p>\n<p>You have probably heard of gluten, but what is it, and why is it harmful to people with celiac disease? Gluten is a protein present in wheat and some other grains (such as barley, rye, and oats), so it is commonly found in foods like bread, pasta, baked goods, and many packaged foods, like the ones pictured in Figure 15.1.2.<\/p>\n<div id=\"h5p-181\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-181\" class=\"h5p-iframe\" data-content-id=\"181\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cell Variation\"><\/iframe><\/div>\n<\/div>\n<p><em>Figure 15.1.2 Gluten is a protein present in foods like bread, pasta, and baked goods.<\/em><\/p>\n<p>For people with celiac disease, eating gluten causes an autoimmune reaction that results in damage to the small, finger-like <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4543\">villi<\/a> lining the small intestine, causing them to become inflamed and flattened (see Figure 15.1.3). This damage interferes with the digestive process, which can result in a wide variety of symptoms including diarrhea, anemia, skin rash, bone pain, depression, and anxiety, among others. The degree of damage to the villi can vary from mild to severe, with more severe damage generally resulting in more significant symptoms and complications. Celiac disease can have serious long-term consequences, such as osteoporosis, problems in the nervous and reproductive systems, and the development of certain types of cancers.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_4544\" aria-describedby=\"caption-attachment-4544\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-4544\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Inflammed_mucous_layer_of_the_intestinal_villi_depicting_Celiac_disease-1.jpg\" alt=\"15.1.2\" width=\"1024\" height=\"576\"><figcaption id=\"caption-attachment-4544\" class=\"wp-caption-text\"><em>Figure 15.1.3 How celiac disease can affect the villi of the small intestine. Here, the villi on the right represent the expected structure of healthy villi. The villi on the bottom right are celiac-affected villi; inflammation has caused them to deform, reducing their ability to function efficiently, if at all.<\/em><\/figcaption><\/figure>\n<p>Why does\u00a0celiac disease cause so many different types of symptoms and have such significant negative health consequences? As you read this chapter and learn about how the digestive system works, you will see just how important the villi of the small intestine are to the body as a whole. At the end of the chapter, you will learn more about celiac disease, why it can be so serious, and whether it is worth avoiding gluten for people who do not have a diagnosed medical issue with it.<\/p>\n<div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter Overview: Digestive System<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you will learn about the digestive system, which processes food so that our bodies can obtain nutrients. Specifically, you will learn about:<\/p>\n<ul>\n<li>The structures and organs of the gastrointestinal (GI) tract through which food directly passes. This includes the mouth, pharynx, esophagus, stomach, small intestine, and large intestine.<\/li>\n<li>The functions of the GI tract, including mechanical and chemical digestion, absorption of nutrients, and the elimination of solid waste.<\/li>\n<li>The accessory organs of digestion \u2014 the liver, gallbladder, and pancreas \u2014 which secrete substances needed for digestion into the GI tract, in addition to performing other important functions.<\/li>\n<li>Specializations of the tissues of the digestive system that allow it to carry out its functions.<\/li>\n<li>How different types of nutrients (such as carbohydrates, proteins, and fats) are digested and absorbed by the body.<\/li>\n<li>Beneficial bacteria that live in the GI tract and help us digest food, produce vitamins, and protect us from harmful pathogens and toxic substances.<\/li>\n<li>Disorders of the digestive system, including inflammatory bowel diseases, ulcers, diverticulitis, and gastroenteritis (commonly known as \u201cstomach flu\u201d).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<p>As you read this chapter, think about the following questions related to celiac disease:<\/p>\n<ol>\n<li>What are the general functions of the small intestine? What do the villi in the small intestine do?<\/li>\n<li>Why do you think celiac disease causes so many different types of symptoms and potentially serious complications?<\/li>\n<li>What are some other autoimmune diseases that involve the body attacking its own digestive system?<\/li>\n<\/ol>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.1.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/cWXibBbXx44\" rel=\"cc:attributionURL\">Bread<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@sergich\">Sergio Arze<\/a> on <a href=\"http:\/\/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 15.1.2<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/unsplash.com\/photos\/7zfQ6sbWVyE\">Paste cu sos de ro\u0219ii<\/a> by <a href=\"https:\/\/unsplash.com\/@inasestrjevitovschii\">Sestrjevitovschii Ina<\/a> on <a href=\"http:\/\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/dLNu65g0jMA\">Cookies and More<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@sarah_elizabeth\">Sarah Shaffer<\/a>\u00a0on <a href=\"http:\/\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/vWjvnhkjziI\">Raspberry waffles<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@belleam\">Izabelle Acheson<\/a>\u00a0on <a href=\"http:\/\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/d4hPtKyQkoc\">Homemade croissant &amp; pain au chocolat<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@crispinto\">Cristiano Pinto<\/a> on <a href=\"http:\/\/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).<\/li>\n<\/ul>\n<p><strong>Figure 15.1.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Inflammed_mucous_layer_of_the_intestinal_villi_depicting_Celiac_disease.jpg\" rel=\"cc:attributionURL\">Inflammed_mucous_layer_of_the_intestinal_villi_depicting_Celiac_disease<\/a>\u00a0by <a href=\"https:\/\/www.scientificanimations.com\/wiki-images\/\">www.scientificanimations.com<\/a> (image 140\/191) 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>&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_4805_3053\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3053\"><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_4805_5913\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_2929\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_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_4805_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_4805_2484\">haploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_2471\">zygote<\/a><\/strong>. A zygote is a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2103\">diploid<\/a><\/strong>\u00a0(or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_2153\">homologous (paired) chromosomes<\/a> separate, and four <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_2468\">sexual reproduction<\/a>, two parents produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2694\">gametes<\/a> that unite in the process of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2677\">fertilization<\/a>\u00a0to form a single-celled <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2471\">zygote<\/a>. Gametes are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_2506\">sperm<\/a> in a process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2507\">spermatogenesis<\/a>, and females produce gametes called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2467\">eggs<\/a> in the process known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2509\">oogenesis<\/a>.<\/li>\n<li>Sexual reproduction produces genetically unique offspring. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2500\">Crossing-over<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_5939\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_5451\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5451\"><div tabindex=\"-1\"><p>Glucose (also called dextrose) is a simple sugar with the molecular formula C6H12O6. Glucose is the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using energy from sunlight.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5941\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5941\"><div tabindex=\"-1\"><p>The largest part of the brain that controls conscious functions such as reasoning and sight.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3095\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3095\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4656\" aria-describedby=\"caption-attachment-4656\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4656\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Scleral_Icterus-1.jpg\" alt=\"15.6.1 Jaundiced eye\" width=\"400\" height=\"223\"><figcaption id=\"caption-attachment-4656\" class=\"wp-caption-text\"><em>Figure 15.6.1 \"Look deep into my eyes.\"<\/em><\/figcaption><\/figure>\n<div>\n<h1>Jaundiced Eyes<\/h1>\n<\/div>\n<p>Did you ever hear of a person looking at something or someone with a \u201cjaundiced eye\u201d? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.<\/p>\n<div>\n<h1>What Are\u00a0Accessory Organs of Digestion?<\/h1>\n<\/div>\n<figure id=\"attachment_4657\" aria-describedby=\"caption-attachment-4657\" style=\"width: 438px\" class=\"wp-caption alignright\"><img class=\" wp-image-4657\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-1-1.png\" alt=\"15.6.2 Accessory Organs of the Digestive System\" width=\"438\" height=\"876\"><figcaption id=\"caption-attachment-4657\" class=\"wp-caption-text\"><em>Figure 15.6.2 The liver, gallbladder, and pancreas are the major accessory organs of digestion. In this figure, the pink tubular structure that starts at the lower stomach and wraps around the pancreas is the duodenum of the small intestine. This is where the accessory organs secrete their digestive substances.<\/em><\/figcaption><\/figure>\n<p>Accessory organs of digestion\u00a0are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4599\">bile<\/a>, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.<\/p>\n<h2>Structure of the Liver<\/h2>\n<p>The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.<\/p>\n<p>As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.<\/p>\n<figure id=\"attachment_4658\" aria-describedby=\"caption-attachment-4658\" style=\"width: 495px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4658\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg_-1.png\" alt=\"15.6.3 Hepatic and Portal vessels\" width=\"495\" height=\"502\"><figcaption id=\"caption-attachment-4658\" class=\"wp-caption-text\"><em>Figure 15.6.3 The portal vein supplies the liver with wastes filtered out of the blood in the spleen, as well as nutrients from the gastrointestinal tract. Oxygen-rich blood enters the liver via the hepatic artery.<\/em><\/figcaption><\/figure>\n<h2>Functions of the Liver<\/h2>\n<p>The main digestive function of the liver is the production of bile.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4659\">hepatocyte<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. The rest are extracted from the\u00a0blood.<\/span><\/p>\n<p>As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.<\/p>\n<figure id=\"attachment_4660\" aria-describedby=\"caption-attachment-4660\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4660\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder-by-NIH-Image-Gallery-on-Flickr-CC-BY-NC-24312875104_e6ab50150b_h-1.jpg\" alt=\"15.6.4\" width=\"789\" height=\"526\"><figcaption id=\"caption-attachment-4660\" class=\"wp-caption-text\"><em>Figure 15.6.4 The common bile duct carries bile from the liver and gallbladder to the duodenum.<\/em><\/figcaption><\/figure>\n<p>Besides its roles in digestion, the liver has many other vital functions:<\/p>\n<ul>\n<li>The liver synthesizes glycogen from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3359\">glucose<\/a> and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.<\/li>\n<li>The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the\u00a0minerals\u00a0iron and copper.<\/li>\n<li>The liver synthesizes numerous <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3721\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3615\">amino acids<\/a>\u00a0needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.<\/li>\n<li>The liver synthesizes many important\u00a0lipids, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3439\">cholesterol<\/a>,\u00a0triglycerides, and lipoproteins.<\/li>\n<li>The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the\u00a0kidneys, which excrete them in urine.<\/li>\n<\/ul>\n<p>The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic\u00a0location\u00a0and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.<\/p>\n<div>\n<h1>Gallbladder<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4586\">gallbladder<\/a><\/strong> is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.<\/p>\n<figure id=\"attachment_4662\" aria-describedby=\"caption-attachment-4662\" style=\"width: 563px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4662\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder_organ-1-1.png\" alt=\"15.6.5 Gallbladder\" width=\"563\" height=\"563\"><figcaption id=\"caption-attachment-4662\" class=\"wp-caption-text\"><em>Figure 15.6.5 The gallbladder is connected to the common duct by the cystic duct. It stores bile secreted by the liver.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Pancreas<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3877\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3893\">endocrine system<\/a>. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.<\/p>\n<figure id=\"attachment_4665\" aria-describedby=\"caption-attachment-4665\" style=\"width: 519px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4665\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0698_PancreasAnatomy-1.png\" alt=\"15.6.6\" width=\"519\" height=\"519\"><figcaption id=\"caption-attachment-4665\" class=\"wp-caption-text\"><em>Figure 15.6.6 Pancreatic digestive enzymes and bicarbonate travel to the duodenum through the pancreatic ducts. The main pancreatic duct joins with the common bile duct before the latter enters the duodenum.<\/em><\/figcaption><\/figure>\n<p>As an endocrine gland, the pancreas secretes several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3569\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3951\">glucagon<\/a>, which circulate in the blood. The\u00a0endocrine hormones\u00a0are secreted by clusters of\u00a0cells\u00a0called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive\u00a0enzymes\u00a0and also bicarbonate, which helps neutralize acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3197\">pancreas<\/a> is a glandular organ that secretes both\u00a0endocrine hormones\u00a0and digestive\u00a0enzymes. As an endocrine gland, the pancreas secretes insulin and glucagon to regulate blood sugar. As a digestive organ, the pancreas secretes digestive enzymes into the duodenum through ducts. Pancreatic digestive enzymes include amylase (starches) trypsin and chymotrypsin (proteins), lipase (lipids), and ribonucleases and deoxyribonucleases (RNA\u00a0and DNA).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Name three accessory organs of digestion. How do these organs differ from digestive organs that are part of the GI tract?<\/li>\n<li>\n<div id=\"h5p-407\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-407\" class=\"h5p-iframe\" data-content-id=\"407\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Describe the liver and its blood supply.<\/li>\n<li>Explain the main digestive function of the liver and describe the components of bile and it's importance in the digestive process.<\/li>\n<li>What type of secretions does the pancreas release as part of each body system?<\/li>\n<li>List pancreatic enzymes that work in the duodenum, along with the substances they help digest.<\/li>\n<li>What are two substances produced by accessory organs of digestion that help neutralize chyme in the small intestine? Where are they produced?<\/li>\n<li>People who have their gallbladder removed sometimes have digestive problems after eating high-fat meals. Why do you think this happens?<\/li>\n<li>Which accessory organ of digestion synthesizes cholesterol?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/8dgoeYPoE-0<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed. 2015.<\/p>\n<p>https:\/\/youtu.be\/wbh3SjzydnQ<\/p>\n<p style=\"text-align: center\">What does the liver do? - Emma Bryce, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/a0d1yvGcfzQ<\/p>\n<p style=\"text-align: center\">Scar wars: Repairing the liver, nature video, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scleral_Icterus.jpg\" rel=\"cc:attributionURL\">Scleral_Icterus<\/a> by <a class=\"new\" title=\"User:Sedooka (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sedooka&amp;action=edit&amp;redlink=1\">Sheila J. Toro<\/a> on Wikimedia Commons is used under a \u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0428_Gallbladder-Liver-Pancreas_Location.png\" rel=\"cc:attributionURL\">Blausen_0428_Gallbladder-Liver-Pancreas_Location<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> \u00a0(https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 15.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/D3rQHN\" rel=\"cc:attributionURL\">Gallbladder<\/a> by <a class=\"owner-name truncate\" title=\"Go to NIH Image Gallery's photostream\" href=\"https:\/\/www.flickr.com\/photos\/nihgov\/\" data-track=\"attributionNameClick\">NIH Image Gallery<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 15.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gallbladder_(organ).png\" rel=\"cc:attributionURL\">Gallbladder_(organ) (1)<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license. (See a\u00a0<a class=\"external text\" href=\"http:\/\/blausen.com\/?Topic=1252\" rel=\"nofollow\">full animation<\/a> of this medical topic at blausen.com.)<\/p>\n<p><strong>Figure 15.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0698_PancreasAnatomy.png\" rel=\"cc:attributionURL\">Blausen_0698_PancreasAnatomy<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https:\/\/www.youtube.com\/watch?v=a0d1yvGcfzQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=wbh3SjzydnQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;feature=youtu.be<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_2937\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_2937\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-455\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Free_Awesome_Girl_With_Braces_Close_Up.jpg\" alt=\"\" width=\"400\" height=\"409\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.1 Brace yourself!\u00a0<\/em><\/figcaption><\/figure>\n<h1>Oh, the Agony!<\/h1>\n<p>Wearing braces can be very uncomfortable, but it is usually worth it. Braces and other orthodontic treatments can re-align the teeth and jaws to improve bite and appearance. Braces can change the position of the teeth and the shape of the jaws because the human body is malleable. Many phenotypic traits \u2014 even those that have a strong genetic basis \u2014 can be molded by the environment. Changing the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2477\">phenotype<\/a> in response to the environment is just one of several ways we respond to environmental stress.<\/p>\n<div>\n<h1>Types of Responses to Environmental Stress<\/h1>\n<\/div>\n<p>There are four different types of responses that humans may make to cope with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2653\">environmental stress<\/a>:<\/p>\n<ol>\n<li>Adaptation<\/li>\n<li>Developmental adjustment<\/li>\n<li>Acclimatization<\/li>\n<li>Cultural responses<\/li>\n<\/ol>\n<p>The first three types of responses are biological in nature, and the fourth type is cultural. Only adaptation involves genetic change and occurs at the level of the population or species. The other three responses do not require genetic change, and they occur at the individual level.<\/p>\n<div>\n<h1>Adaptation<\/h1>\n<\/div>\n<p>An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2486\">adaptation<\/a><\/strong>\u00a0is a genetically-based trait that has evolved because it helps living things survive and reproduce in a given environment. Adaptations generally evolve in a population over many generations in response to stresses that last for a long period of time. Adaptations come about through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2633\">natural selection<\/a>. Those individuals who inherit a trait that confers an advantage in coping with an environmental stress are likely to live longer and reproduce more. As a result, more of their genes pass on to the next generation. Over many generations, the genes and the trait they control become more frequent in the population.<\/p>\n<h2>A Classic Example: Hemoglobin S and Malaria<\/h2>\n<p>Probably the most frequently-cited example of a genetic adaptation to an environmental stress is sickle cell trait. As you read in the previous section, people with sickle cell trait have one abnormal allele (S) and one normal allele (A) for hemoglobin, the red blood cell protein that carries oxygen in the blood. Sickle cell trait is an adaptation to the environmental stress of malaria, because people with the trait have resistance to this parasitic disease. In areas where malaria is endemic (present year-round), the sickle cell trait and its <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1942\">allele<\/a> have evolved to relatively high frequencies. \u00a0It is a classic example of natural selection favoring <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2474\">heterozygotes<\/a> for a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2035\">gene<\/a> with two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1942\">alleles<\/a>. This type of selection keeps both alleles at relatively high frequencies in a population.<\/p>\n<h2>To Taste or Not to Taste<\/h2>\n<p>Another example of an adaptation in humans is the ability to taste bitter compounds. Plants produce a variety of toxic compounds in order to protect themselves from being eaten, and these toxic compounds often have a bitter taste. The ability to taste bitter compounds is thought to have evolved as an adaptation, because it prevented people from eating poisonous plants. Humans have many different genes that code for bitter taste receptors, allowing us to taste a wide variety of bitter compounds.<\/p>\n<p>A harmless bitter compound\u00a0called\u00a0<strong>phenylthiocarbamide (PTC)<\/strong>\u00a0is not found naturally in plants, but it is similar to toxic bitter compounds that\u00a0<em>are<\/em> found in plants. Humans' ability to taste this harmless substance has been tested in many different populations. In virtually every population studied, there are some people who can taste PTC (called tasters), and some people who cannot taste PTC, (called nontasters). The ratio of tasters to non-tasters varies among populations, but on average, 75 per cent of people can taste PTC and 25 per cent cannot.<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 272px\" class=\"wp-caption alignright\"><img class=\" wp-image-456\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Tongue.jpg\" alt=\"Tongue\" width=\"272\" height=\"288\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.2 The tiny red dots on the surface of the tongue consist of clumps of taste buds that contain receptor proteins for certain chemicals. We can taste those chemicals that bind strongly with any of the receptors.<\/em><\/figcaption><\/figure>\n<p>Like many scientific discoveries, human variation in PTC-taster status was discovered by chance. Around 1930, a chemist named Arthur Fox was working with powdered PTC in his lab. Some of the powder accidentally blew into the air. Another lab worker noticed that the powdered PTC tasted bitter, but Fox couldn't detect any taste at all. Fox wondered\u00a0how to explain\u00a0this difference in PTC-tasting ability. Geneticists soon determined that PTC-taster status is controlled by a single <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2035\">gene<\/a> with two common alleles, usually represented by the letters\u00a0<em>T<\/em>\u00a0and\u00a0<em>t<\/em>. The\u00a0<em>T<\/em> allele encodes a chemical receptor protein (found in taste buds on the tongue, as illustrated in Figure 6.4.2) that can strongly bind to PTC. The other allele, <em>t<\/em>, encodes a version of the receptor protein that cannot bind as strongly to PTC. The particular combination of these two alleles that a person inherits determines whether the person finds PTC to taste very bitter (<em>TT<\/em>), somewhat bitter\u00a0<em>(Tt),<\/em>\u00a0or not bitter at all\u00a0<em>(tt).<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>If the ability to taste bitter compounds is advantageous, why does every human population studied contain a significant percentage of people who are nontasters?\u00a0Why has the nontasting allele been preserved in human populations at all? Some scientists hypothesize that the nontaster allele actually confers the ability to taste some other, yet-to-be identified, bitter compound in plants. People who inherit both alleles would presumably be able to taste a wider range of bitter compounds, so they would have the greatest ability to avoid plant toxins. In other words, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2474\">heterozygote<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2715\">genotype<\/a> for the taster gene would be the most fit and favored by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2633\">natural selection<\/a>.<\/p>\n<p>Most people no longer have to worry whether the plants they eat contain toxins. The produce you grow in your garden or buy at the supermarket consists of known varieties that are safe to eat. However, natural selection may still be at work in human populations for the PTC-taster gene, because PTC tasters may be more sensitive than nontasters to bitter compounds in tobacco and vegetables in the cabbage family (that is, cruciferous vegetables, such as the broccoli, cauliflower, and cabbage pictured in Figure 6.4.3).<\/p>\n<ul>\n<li>People who find PTC to taste very bitter are less likely to smoke tobacco, presumably because tobacco smoke has a stronger bitter taste to these individuals. In this case, selection would favor taster genotypes, because tasters would be more likely to avoid smoking and its serious health risks.<\/li>\n<li>Strong tasters find cruciferous vegetables to taste bitter. As a result, they may avoid eating these vegetables (and perhaps other foods, as well), presumably resulting in a diet that is less varied and nutritious. In this scenario, natural selection\u00a0might\u00a0work against taster genotypes.<\/li>\n<\/ul>\n<p><span style=\"text-align: initial;font-size: 1em\"><\/p>\n<div id=\"h5p-86\">\n<div class=\"h5p-content\" data-content-id=\"86\"><\/div>\n<\/div>\n<p><\/span><\/p>\n<p><em>Figure 6.4.3 Cruciferous vegetables.<\/em><\/p>\n<div>\n<h1>Developmental Adjustment<\/h1>\n<\/div>\n<p>It takes a relatively long time for genetic change in response to environmental stress to produce a population with adaptations. Fortunately, we can adjust to some environmental stresses more quickly by changing in nongenetic ways. One type of nongenetic response to stress is\u00a0<strong>developmental adjustment.<\/strong>\u00a0This refers to phenotypic change that occurs during development in infancy or childhood, and that may persist into adulthood. This type of change may be irreversible by adulthood.<\/p>\n<h2>Phenotypic Plasticity<\/h2>\n<p>Developmental adjustment is possible because humans have a high degree of\u00a0<strong>phenotypic plasticity,<\/strong>\u00a0which is\u00a0the ability to alter\u00a0the<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2477\"> phenotype<\/a> in response to changes in the environment. Phenotypic plasticity allows us to respond to changes that occur within our lifetime, and it is particularly important for species\u00a0(like our own)\u00a0that have a long generation time. With long generations, evolution of genetic adaptations may occur too slowly to keep up with changing environmental stresses.<\/p>\n<h2>Developmental Adjustment and Cultural Practices<\/h2>\n<p>Developmental adjustment may be the result of naturally occurring environmental stresses or cultural practices, including medical or dental treatments. Like our example at the beginning of this section, using braces to change the shape of the jaw and the position of the teeth is an example of a dental practice that brings about a developmental adjustment. Another example of developmental adjustment is the use of a back brace to treat scoliosis (see images in <em>Figure 6.4.4<\/em>). Scoliosis is an abnormal curvature from side to side in the spine. If the problem is not too severe, a brace, if worn correctly, should prevent the curvature from worsening as a child grows, although it cannot straighten a curve that is already present. Surgery may be required to do that.<\/p>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 651px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-457\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg.png\" alt=\"\" width=\"651\" height=\"342\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.4 Scoliosis can be prevented from worsening by shaping the phenotype with a back brace.<\/em><\/figcaption><\/figure>\n<h2>Developmental Adjustment and Nutritional Stress<\/h2>\n<p>An important example of developmental adjustment that results from a naturally occurring environmental stress is the cessation of physical growth that occurs in children who are under nutritional stress. Children who lack adequate food to fuel both growth and basic metabolic processes are likely to slow down in their growth rate \u2014 or even to stop growing entirely. Shunting all available calories and nutrients into essential life functions may keep the child alive at the expense of increasing body size.<\/p>\n<p>Table 6.4.1 shows the effects of inadequate diet on children's' growth in several countries worldwide. For each country, the table gives the prevalence of <strong>stunting<\/strong>\u00a0in children under\u00a0the age of five. Children are considered stunted if their height is at least two standard deviations below the median height for their age in an international reference population.<\/p>\n<p><strong>Table 6.4.1<\/strong><\/p>\n<p><em>Percentage of Stunting in Young Children in Selected Countries (2011-2015)<\/em><\/p>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 53.0094%;height: 142px\" border=\"0\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 52.9369%;text-align: center\" colspan=\"2\"><strong>Percentage of Stunting in Young Children in Selected Countries (2011-2015)<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 16px\">\n<td style=\"height: 16px;width: 22.19%\"><strong>Country<\/strong><\/td>\n<td style=\"height: 16px;width: 30.7469%\"><strong>Per cent of Children Under Age 5 with Stunting<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">United States<\/td>\n<td style=\"height: 14px;width: 30.7469%\">2.1<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Turkey<\/td>\n<td style=\"height: 14px;width: 30.7469%\">9.5<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Mexico<\/td>\n<td style=\"height: 14px;width: 30.7469%\">13.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Thailand<\/td>\n<td style=\"height: 14px;width: 30.7469%\">16.3<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Iraq<\/td>\n<td style=\"height: 14px;width: 30.7469%\">22.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Philippines<\/td>\n<td style=\"height: 14px;width: 30.7469%\">33.6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Pakistan<\/td>\n<td style=\"height: 14px;width: 30.7469%\">45.0<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 22.19%\">Papua New Guinea<\/td>\n<td style=\"height: 14px;width: 30.7469%\">49.5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>After a growth slow-down occurs and if adequate food becomes available, a child may be able to make up the loss of growth. If food is plentiful, the child may grow more rapidly than normal until the original, genetically-determined growth trajectory is reached. If the inadequate diet persists, however, the failure of growth may become chronic, and the child may never reach his or her full potential adult size.<\/p>\n<p>Phenotypic plasticity of body size in response to dietary change has been observed in successive generations within populations. For example, children in Japan were taller, on average, in each successive generation\u00a0after\u00a0the end of World War II. Boys aged 14-15 years old in 1986 were an average of about 18 cm (7 in.) taller than boys of the same age in 1959, a generation earlier. This is a highly significant difference, and it occurred too quickly to be accounted for by genetic change. Instead, the increase in height is a developmental adjustment, thought to be largely attributable to changes in the Japanese diet since World War II. During this period, there was an increase in the amount of animal protein and fat, as well as in the total calories consumed.<\/p>\n<div>\n<h1>Acclimatization<\/h1>\n<\/div>\n<p>Other responses to environmental stress are reversible and not permanent, whether they occur in childhood or adulthood. The development of reversible changes to environmental stress is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2483\">acclimatization<\/a>.<\/strong>\u00a0Acclimatization generally develops over a relatively short period of time.\u00a0It may take just a few days or weeks to attain a maximum response to a stress. When the stress is no longer present, the acclimatized state declines, and the body returns to its normal baseline state. Generally, the shorter the time for acclimatization to occur, the more quickly the condition is reversed when the environmental stress is removed.<\/p>\n<h2>Acclimatization to UV Light<\/h2>\n<p>A common example of acclimatization is tanning of the skin (see Figure 6.4.5). This occurs in many people in response to exposure to ultraviolet radiation from the sun. Special pigment cells in the skin, called melanocytes, produce more of the brown pigment melanin when exposed to sunlight. The melanin collects near the surface of the skin where it absorbs UV radiation so it cannot penetrate and potentially damage deeper skin structures. Tanning is a reversible change in the phenotype that helps the body deal temporarily with the environmental stress of high levels of UV radiation. When the skin is no longer exposed to the sun\u2019s rays, the tan fades, generally over a period of a few weeks or months.<\/p>\n<div id=\"h5p-87\">\n<div class=\"h5p-content\" data-content-id=\"87\"><\/div>\n<\/div>\n<p><em>Figure 6.4.5 Tanning of the skin occurs in many people in response to exposure to ultraviolet radiation from the sun.<\/em><\/p>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Acclimatization to Heat<\/span><\/p>\n<\/div>\n<p>Another common example of acclimatization occurs in response to heat. Changes that occur with heat acclimatization include increased sweat output and earlier onset of sweat production, which helps the body stay cool because evaporation of sweat takes heat from the body\u2019s surface in a process called evaporative cooling. It generally takes a couple of weeks for maximum heat acclimatization to come about by gradually working out harder and longer at high air temperatures. The changes that occur with acclimatization just as quickly subside when the body is no longer exposed to excessive heat.<\/p>\n<h2>Acclimatization to High Altitude<\/h2>\n<figure id=\"attachment_458\" aria-describedby=\"caption-attachment-458\" style=\"width: 420px\" class=\"wp-caption alignleft\"><img class=\" wp-image-458\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nepalese-base-camp-by-Mark-Horrell-on-Flickr-CC-BY-NC-SA-.jpg\" alt=\"Base camp in Nepal\" width=\"420\" height=\"315\"><figcaption id=\"caption-attachment-458\" class=\"wp-caption-text\"><em>Figure 6.4.6 Mountaineers must spend 4-5 days acclimatizing to high altitude before attempting to climb to the summit of Mount Everest.<\/em><\/figcaption><\/figure>\n<p>Short term acclimatization to high altitude occurs as a response to low levels of oxygen in the blood.\u00a0 This reduced level of oxygen is detected by carotid bodies, which will trigger in increase in breathing and heart rate.\u00a0 Over a period of weeks the body will compensate by increasing red blood cell production, thereby improving the oxygen-carrying capacity of the blood.\u00a0 This is why mountaineers wishing to climb to the peak of Mount Everest must complete the full climb in portions; it is recommended that climbers spend 2-3 days acclimatizing for every 600 metres of elevation increase.\u00a0 In addition, the higher to altitude, the longer it make take to acclimatize; climbers are advised to spend 4-5 days acclimatizing at base camp (whether the base camp in Nepal or China) before completing the final leg of the climb to the peak.\u00a0 The concentration of red blood cells gradually decreases to normal levels once a climber returns to their normal elevation.<\/p>\n<div>\n<h1>Cultural Responses<\/h1>\n<\/div>\n<p>More than any other species, humans respond to environmental stresses with learned behaviors and technology. These cultural responses allow us to change our environments to control stresses, rather than changing our bodies genetically or physiologically to cope with the stresses. Even archaic humans responded to some environmental stresses in this way. For example, Neanderthals used shelters, fires, and animal hides as clothing to stay warm in the cold climate in Europe during the last ice age. Today, we use more sophisticated technologies to stay warm in cold climates while retaining our essentially tropical-animal anatomy and physiology. We also use technology (such as furnaces and air conditioners) to avoid temperature stress and stay comfortable in hot or cold climates.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Humans may respond to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2653\">environmental stress <\/a>in four different ways: adaptation, developmental adjustment, acclimatization, and cultural responses.<\/li>\n<li>An adaptation is a genetically based trait that has evolved because it helps living things survive and reproduce in a given environment. Adaptations evolve by natural selection in populations over a relatively long period to time. Examples of adaptations include sickle cell trait as an adaptation to the stress of endemic malaria and the ability to taste bitter compounds as an adaptation to the stress of bitter-tasting toxins in plants.<\/li>\n<li>A developmental adjustment is a non-genetic response to stress that occurs during infancy or childhood, and that may persist into adulthood. This type of change may be irreversible. Developmental adjustment is possible because humans have a high degree of phenotypic plasticity. It may be the result of environmental stresses (such as inadequate food), which may stunt growth, or cultural practices (such as orthodontic treatments), which re-align the teeth and jaws.<\/li>\n<li>Acclimatization is the development of reversible changes to environmental stress that develop over a relatively short period of time. The changes revert to the normal baseline state after the stress is removed. Examples of acclimatization include tanning of the skin and physiological changes (such as increased sweating) that occur with heat acclimatization.<\/li>\n<li>More than any other species, humans respond to environmental stress with learned behaviors and technology, which are cultural responses. These responses allow us to change our environment to control stress, rather than changing our bodies genetically or physiologically to cope with stress. Examples include using shelter, fire, and clothing to cope with a cold climate.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>List four different types of responses that humans may make to cope with environmental stress.<\/li>\n<li>Define adaptation.<\/li>\n<li>\n<div id=\"h5p-88\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-88\" class=\"h5p-iframe\" data-content-id=\"88\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Human Responses to Environmental Stress\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain how natural selection may have resulted in most human populations having people who can and people who cannot taste PTC.<\/li>\n<li>What is a developmental adjustment?<\/li>\n<li>Define phenotypic plasticity.<\/li>\n<li>Explain why phenotypic plasticity may be particularly important in a species with a long generation time.<\/li>\n<li>Why may stunting of growth occur in children who have an inadequate diet? Why is stunting preferable to the alternative?<\/li>\n<li>What is acclimatization?<\/li>\n<li>How does acclimatization to heat come about, and what are two physiological changes that occur in heat acclimatization?<\/li>\n<li>Give an example of a cultural response to heat stress.<\/li>\n<li>Which is more likely to be reversible \u2014 a change due to acclimatization, or a change due to developmental adjustment? Explain your answer.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=upp9-w6GPhU<\/p>\n<p style=\"text-align: center\">Could we survive prolonged space travel? - Lisa Nip, TED-Ed, 2016.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=hRnrIpUMyZQ&amp;t=182s<\/p>\n<p style=\"text-align: center\">How this disease changes the shape of your cells - Amber M. Yates, TED-Ed, 2019.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 6.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Free_Awesome_Girl_With_Braces_Close_Up.jpg\" rel=\"cc:attributionURL\">Free_Awesome_Girl_With_Braces_Close_Up<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/40645538@N00\" rel=\"nofollow\">D. Sharon Pruitt<\/a> from Hill Air Force Base, Utah, USA on Wikimedia Commons is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\" rel=\"license\">CC BY 2.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en) license.<\/p>\n<p><strong>Figure 6.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:%D8%B2%D8%A8%D8%A7%D9%86_tongue.jpg\" rel=\"cc:attributionURL\">Tongue<\/a> by <a class=\"new\" title=\"User:Mahdiabbasinv (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Mahdiabbasinv&amp;action=edit&amp;redlink=1\">Mahdiabbasinv<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en) license.<\/p>\n<p><strong>Figure 6.4.3<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/unsplash.com\/photos\/PT-GXFtQj-s\">White cauliflower on brown wooden chopping board<\/a> by <a href=\"https:\/\/unsplash.com\/@louishansel\">Louis Hansel @shotsoflouis<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/LpHYbY6Qu_o\">Broccoli on wooden chopping board<\/a> by <a href=\"https:\/\/unsplash.com\/@louishansel\">Louis Hansel @shotsoflouis<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/knGwkn2j4ro\">Green cabbage close up<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@photoliphecjd\">Craig Dimmick<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/2Qzk3EJLNGE\">Cabbage hybrid\/ brussel sprouts<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@darkersolstice\">Solstice Hannan<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/_zV74zUnwmc\">Kale<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@lauramakoj\">Laura Johnston<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/v25z8P-CPB4\">Tiny bok choy at the Asian market<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@twoluckyspoons\">Jodie Morgan<\/a>\u00a0on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a>\u00a0(https:\/\/unsplash.com\/license).<\/li>\n<\/ul>\n<p><strong>Figure 6.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg.png\" rel=\"cc:attributionURL\">Scoliosis_patient_in_cheneau_brace_correcting_from_56_to_27_deg<\/a> by Weiss H.R. from <a href=\"https:\/\/scoliosisjournal.biomedcentral.com\/articles\/10.1186\/1748-7161-2-19\">Scoliosis Journal\/BioMed Central Ltd<\/a>. on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\" rel=\"license\">CC BY 2.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/2.0) license.<\/p>\n<p><strong>Figure 6.4.5<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/21077319@N02\/3667901661\">Tan Lines<\/a> by <a class=\"owner-name truncate\" title=\"Go to k.steudel's photostream\" href=\"https:\/\/www.flickr.com\/photos\/snaks\/\" data-track=\"attributionNameClick\">k.steudel<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/3760162521\/sizes\/l\/\">Twin tan lines (all sizes)<\/a> by <a class=\"owner-name truncate\" title=\"Go to Quinn Dombrowski's photostream\" href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/\" data-track=\"attributionNameClick\">Quinn Dombrowski<\/a>\u00a0on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/14518898810\">Wedding ring tan line<\/a> by <a class=\"owner-name truncate\" title=\"Go to Quinn Dombrowski's photostream\" href=\"https:\/\/www.flickr.com\/photos\/quinnanya\/\" data-track=\"attributionNameClick\">Quinn Dombrowski<\/a>\u00a0on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/\">CC BY-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/29333334@N06\/3792695572\">Tan<\/a> by <a class=\"owner-name truncate\" title=\"Go to Evil Erin's photostream\" href=\"https:\/\/www.flickr.com\/photos\/evilerin\/\" data-track=\"attributionNameClick\">Evil Erin<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/li>\n<\/ul>\n<p><strong style=\"text-align: initial;font-size: 1em\">Figure 6.4.6<\/strong><\/p>\n<p><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.flickr.com\/photos\/markhorrell\/18787430274\/in\/photostream\/\" rel=\"cc:attributionURL\">Nepalese base camp<\/a> by <a class=\"owner-name truncate\" title=\"Go to Mark Horrell's photostream\" href=\"https:\/\/www.flickr.com\/photos\/markhorrell\/\" data-track=\"attributionNameClick\">Mark Horrell<\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a\u00a0<\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" rel=\"license\">CC BY-NC-SA 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">TED-Ed. (2016, October 4). Could we survive prolonged space travel? - Lisa Nip. YouTube. https:\/\/www.youtube.com\/watch?v=upp9-w6GPhU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, May 6). How this disease changes the shape of your cells - Amber M. Yates. YouTube. https:\/\/www.youtube.com\/watch?v=hRnrIpUMyZQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Weiss, H. (2007). Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS)? [Figure 2 - digital photograph],\u00a0 <i>Scoliosis, <\/i>2(19).\u00a0https:\/\/doi.org\/10.1186\/1748-7161-2-19<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3096\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3096\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4656\" aria-describedby=\"caption-attachment-4656\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4656\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Scleral_Icterus-1.jpg\" alt=\"15.6.1 Jaundiced eye\" width=\"400\" height=\"223\"><figcaption id=\"caption-attachment-4656\" class=\"wp-caption-text\"><em>Figure 15.6.1 \"Look deep into my eyes.\"<\/em><\/figcaption><\/figure>\n<div>\n<h1>Jaundiced Eyes<\/h1>\n<\/div>\n<p>Did you ever hear of a person looking at something or someone with a \u201cjaundiced eye\u201d? It means to take a negative view, such as envy, maliciousness, or ill will. The expression may be based on the antiquated idea that liver bile is associated with such negative emotions as these, as well as the fact that excessive liver bile causes jaundice, or yellowing of the eyes and skin. Jaundice is likely a sign of a liver disorder or blockage of the duct that carries bile away from the liver. Bile contains waste products, making the liver an organ of excretion. Bile has an important role in digestion, which makes the liver an accessory organ of digestion, too.<\/p>\n<div>\n<h1>What Are\u00a0Accessory Organs of Digestion?<\/h1>\n<\/div>\n<figure id=\"attachment_4657\" aria-describedby=\"caption-attachment-4657\" style=\"width: 438px\" class=\"wp-caption alignright\"><img class=\" wp-image-4657\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-1-1.png\" alt=\"15.6.2 Accessory Organs of the Digestive System\" width=\"438\" height=\"876\"><figcaption id=\"caption-attachment-4657\" class=\"wp-caption-text\"><em>Figure 15.6.2 The liver, gallbladder, and pancreas are the major accessory organs of digestion. In this figure, the pink tubular structure that starts at the lower stomach and wraps around the pancreas is the duodenum of the small intestine. This is where the accessory organs secrete their digestive substances.<\/em><\/figcaption><\/figure>\n<p>Accessory organs of digestion\u00a0are organs that secrete substances needed for the chemical digestion of food, but through which food does not actually pass as it is digested. Besides the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2989\">liver<\/a>, the major accessory organs of digestion are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4586\">gallbladder<\/a> and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4292\">diaphragm<\/a>, to the right of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4599\">bile<\/a>, but the liver has a wide range of additional functions unrelated to digestion. In fact, some estimates put the number of functions of the liver at about 500! A few of them are described below.<\/p>\n<h2>Structure of the Liver<\/h2>\n<p>The liver is a reddish brown, wedge-shaped structure. In adults, the liver normally weighs about 1.5 kg (about 3.3 lb). It is both the heaviest internal organ and the largest gland in the human body. The liver is divided into four lobes of unequal size and shape. Each lobe, in turn, is made up of lobules, which are the functional units of the liver. Each lobule consists of millions of liver cells, called hepatic cells (or hepatocytes). They are the basic metabolic cells that carry out the various functions of the liver.<\/p>\n<p>As shown in Figure 15.6.3, the liver is connected to two large blood vessels: the hepatic artery and the portal vein. The hepatic artery carries oxygen-rich blood from the aorta, whereas the portal vein carries blood that is rich in digested nutrients from the GI tract and wastes filtered from the blood by the spleen. The blood vessels subdivide into smaller arteries and capillaries, which lead into the liver lobules. The nutrients from the GI tract are used to build many vital biochemical compounds, and the wastes from the spleen are degraded and excreted.<\/p>\n<figure id=\"attachment_4658\" aria-describedby=\"caption-attachment-4658\" style=\"width: 495px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4658\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg_-1.png\" alt=\"15.6.3 Hepatic and Portal vessels\" width=\"495\" height=\"502\"><figcaption id=\"caption-attachment-4658\" class=\"wp-caption-text\"><em>Figure 15.6.3 The portal vein supplies the liver with wastes filtered out of the blood in the spleen, as well as nutrients from the gastrointestinal tract. Oxygen-rich blood enters the liver via the hepatic artery.<\/em><\/figcaption><\/figure>\n<h2>Functions of the Liver<\/h2>\n<p>The main digestive function of the liver is the production of bile.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4659\">hepatocyte<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. The rest are extracted from the\u00a0blood.<\/span><\/p>\n<p>As shown in Figure 15.6.4, bile is secreted into small ducts that join together to form larger ducts, with just one large duct carrying bile out of the liver. If bile is needed to digest a meal, it goes directly to the duodenum through the common bile duct. In the duodenum, the bile neutralizes acidic chyme from the stomach and emulsifies fat globules into smaller particles (called micelles) that are easier to digest chemically by the enzyme lipase. Bile also aids with the absorption of vitamin K. Bile that is secreted when digestion is not taking place goes to the gallbladder for storage until the next meal. In either case, the bile enters the duodenum through the common bile duct.<\/p>\n<figure id=\"attachment_4660\" aria-describedby=\"caption-attachment-4660\" style=\"width: 789px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4660\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder-by-NIH-Image-Gallery-on-Flickr-CC-BY-NC-24312875104_e6ab50150b_h-1.jpg\" alt=\"15.6.4\" width=\"789\" height=\"526\"><figcaption id=\"caption-attachment-4660\" class=\"wp-caption-text\"><em>Figure 15.6.4 The common bile duct carries bile from the liver and gallbladder to the duodenum.<\/em><\/figcaption><\/figure>\n<p>Besides its roles in digestion, the liver has many other vital functions:<\/p>\n<ul>\n<li>The liver synthesizes glycogen from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_317\">glucose<\/a> and stores the glycogen as required to help regulate blood sugar levels. It also breaks down the stored glycogen to glucose and releases it back into the blood as needed.<\/li>\n<li>The liver stores many substances in addition to glycogen, including vitamins A, D, B12, and K. It also stores the\u00a0minerals\u00a0iron and copper.<\/li>\n<li>The liver synthesizes numerous <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_297\">proteins<\/a>\u00a0and many of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_305\">amino acids<\/a>\u00a0needed to make them. These proteins have a wide range of functions. They include fibrinogen, which is needed for blood clotting; insulin-like growth factor (IGF-1), which is important for childhood growth; and albumen, which is the most abundant protein in blood serum and functions to transport fatty acids and steroid hormones in the blood.<\/li>\n<li>The liver synthesizes many important\u00a0lipids, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4661\">cholesterol<\/a>,\u00a0triglycerides, and lipoproteins.<\/li>\n<li>The liver is responsible for the breakdown of many waste products and toxic substances. The wastes are excreted in bile or travel to the\u00a0kidneys, which excrete them in urine.<\/li>\n<\/ul>\n<p>The liver is clearly a vital organ that supports almost every other organ in the body. Because of its strategic\u00a0location\u00a0and diversity of functions, the liver is also prone to many diseases, some of which cause loss of liver function. There is currently no way to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. An artificial liver has not yet been developed, so liver transplantation may be the only option for people with liver failure.<\/p>\n<div>\n<h1>Gallbladder<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4586\">gallbladder<\/a><\/strong> is a small, hollow, pouch-like organ that lies just under the right side of the liver (see Figure 15.6.5). It is about 8 cm (about 3 in) long and shaped like a tapered sac, with the open end continuous with the cystic duct. The gallbladder stores and concentrates bile from the liver until it is needed in the duodenum to help digest lipids. After the bile leaves the liver, it reaches the gallbladder through the cystic duct. At any given time, the gallbladder may store between 30 to 60 mL (1 to 2 oz) of bile. A hormone stimulated by the presence of fat in the duodenum signals the gallbladder to contract and force its contents back through the cystic duct and into the common bile duct to drain into the duodenum.<\/p>\n<figure id=\"attachment_4662\" aria-describedby=\"caption-attachment-4662\" style=\"width: 563px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4662\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gallbladder_organ-1-1.png\" alt=\"15.6.5 Gallbladder\" width=\"563\" height=\"563\"><figcaption id=\"caption-attachment-4662\" class=\"wp-caption-text\"><em>Figure 15.6.5 The gallbladder is connected to the common duct by the cystic duct. It stores bile secreted by the liver.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Pancreas<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2913\">digestive system<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2909\">endocrine system<\/a>. As shown in Figure 15.6.6, it is located in the abdomen behind the stomach, with the head of the pancreas surrounded by the duodenum of the small intestine. The pancreas is about 15 cm (almost 6 in) long, and it has two major ducts: the main pancreatic duct and the accessory pancreatic duct. Both of these ducts drain into the duodenum.<\/p>\n<figure id=\"attachment_4665\" aria-describedby=\"caption-attachment-4665\" style=\"width: 519px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4665\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0698_PancreasAnatomy-1.png\" alt=\"15.6.6\" width=\"519\" height=\"519\"><figcaption id=\"caption-attachment-4665\" class=\"wp-caption-text\"><em>Figure 15.6.6 Pancreatic digestive enzymes and bicarbonate travel to the duodenum through the pancreatic ducts. The main pancreatic duct joins with the common bile duct before the latter enters the duodenum.<\/em><\/figcaption><\/figure>\n<p>As an endocrine gland, the pancreas secretes several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_377\">hormones<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2590\">insulin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3405\">glucagon<\/a>, which circulate in the blood. The\u00a0endocrine hormones\u00a0are secreted by clusters of\u00a0cells\u00a0called pancreatic islets (or islets of Langerhans). As a digestive organ, the pancreas secretes many digestive\u00a0enzymes\u00a0and also bicarbonate, which helps neutralize acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4582\">chyme<\/a> after it enters the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4597\">Trypsin<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4598\">chymotrypsin<\/a><\/strong>, which help digest proteins.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_4659\">hepatocytes<\/a>. The liver receives oxygen in blood from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3197\">pancreas<\/a> is a glandular organ that secretes both\u00a0endocrine hormones\u00a0and digestive\u00a0enzymes. As an endocrine gland, the pancreas secretes insulin and glucagon to regulate blood sugar. As a digestive organ, the pancreas secretes digestive enzymes into the duodenum through ducts. Pancreatic digestive enzymes include amylase (starches) trypsin and chymotrypsin (proteins), lipase (lipids), and ribonucleases and deoxyribonucleases (RNA\u00a0and DNA).<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Name three accessory organs of digestion. How do these organs differ from digestive organs that are part of the GI tract?<\/li>\n<li>\n<div id=\"h5p-187\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-187\" class=\"h5p-iframe\" data-content-id=\"187\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Describe the liver and its blood supply.<\/li>\n<li>Explain the main digestive function of the liver and describe the components of bile and it's importance in the digestive process.<\/li>\n<li>What type of secretions does the pancreas release as part of each body system?<\/li>\n<li>List pancreatic enzymes that work in the duodenum, along with the substances they help digest.<\/li>\n<li>What are two substances produced by accessory organs of digestion that help neutralize chyme in the small intestine? Where are they produced?<\/li>\n<li>People who have their gallbladder removed sometimes have digestive problems after eating high-fat meals. Why do you think this happens?<\/li>\n<li>Which accessory organ of digestion synthesizes cholesterol?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/8dgoeYPoE-0<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed. 2015.<\/p>\n<p>https:\/\/youtu.be\/wbh3SjzydnQ<\/p>\n<p style=\"text-align: center\">What does the liver do? - Emma Bryce, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/a0d1yvGcfzQ<\/p>\n<p style=\"text-align: center\">Scar wars: Repairing the liver, nature video, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Scleral_Icterus.jpg\" rel=\"cc:attributionURL\">Scleral_Icterus<\/a> by <a class=\"new\" title=\"User:Sedooka (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Sedooka&amp;action=edit&amp;redlink=1\">Sheila J. Toro<\/a> on Wikimedia Commons is used under a \u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\" rel=\"license\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0428_Gallbladder-Liver-Pancreas_Location.png\" rel=\"cc:attributionURL\">Blausen_0428_Gallbladder-Liver-Pancreas_Location<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 15.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg\" rel=\"cc:attributionURL\">Diagram_showing_the_two_lobes_of_the_liver_and_its_blood_supply_CRUK_376.svg<\/a> by <a class=\"external text\" href=\"http:\/\/www.cancerresearchuk.org\/\" rel=\"nofollow\">Cancer Research UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> \u00a0(https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 15.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/D3rQHN\" rel=\"cc:attributionURL\">Gallbladder<\/a> by <a class=\"owner-name truncate\" title=\"Go to NIH Image Gallery's photostream\" href=\"https:\/\/www.flickr.com\/photos\/nihgov\/\" data-track=\"attributionNameClick\">NIH Image Gallery<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 15.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Gallbladder_(organ).png\" rel=\"cc:attributionURL\">Gallbladder_(organ) (1)<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license. (See a\u00a0<a class=\"external text\" href=\"http:\/\/blausen.com\/?Topic=1252\" rel=\"nofollow\">full animation<\/a> of this medical topic at blausen.com.)<\/p>\n<p><strong>Figure 15.6.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0698_PancreasAnatomy.png\" rel=\"cc:attributionURL\">Blausen_0698_PancreasAnatomy<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">nature video. (2018, December 19). Scar wars: Repairing the liver. YouTube. https:\/\/www.youtube.com\/watch?v=a0d1yvGcfzQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, November 25). What does the liver do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=wbh3SjzydnQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 19). What does the pancreas do? - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;feature=youtu.be<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_5883\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5883\"><div tabindex=\"-1\"><p>A roughly almond-shaped mass of gray matter inside each cerebral hemisphere, involved with the experiencing of emotions. Responsible for the perception of emotions such as anger, fear, and sadness, as well as the controlling of aggression. The amygdala helps to store memories of events and emotions so that an individual may be able to recognize similar events in the future.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3011\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_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_4805_3004\">voluntary<\/a> process controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_4717\">urine<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_2533\">autonomic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4732\">urethra<\/a><\/strong> is a tube that connects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3014\">somatic nervous system<\/a>, so it is under conscious, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4725\">Ureters<\/a>\u00a0are tube-like structures that connect the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>\u00a0with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. Each ureter arises at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2982\">smooth muscle<\/a> that can contract to push <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> through the ureter by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4627\">sphincter<\/a> for urination to be under <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_6027\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_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_4805_3124\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3124\"><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_4805_3125\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3125\"><div tabindex=\"-1\"><p>Image shows a diagram of the bladder. There is smooth muscle in the bladder walls which are under involuntary control.  There is a sphincter between the bladder and the urethra which can inhibit urination.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3126\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3126\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-413\">\n<div class=\"h5p-content\" data-content-id=\"413\"><\/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_4805_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_4805_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_4722\" aria-describedby=\"caption-attachment-4722\" style=\"width: 560px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4722\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Urinary_System_Male-1.png\" alt=\"16.3.2 Urinary System\" width=\"560\" height=\"560\"><figcaption id=\"caption-attachment-4722\" 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_4805_4717\">Urine<\/a> is formed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>, which filter many substances out of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4723\" aria-describedby=\"caption-attachment-4723\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-4723\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2610_The_Kidney-1.jpg\" alt=\"16.3.3 The Kidney\" width=\"1024\" height=\"585\"><figcaption id=\"caption-attachment-4723\" 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_4805_2702\">Blood<\/a> is filtered and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4708\">urea<\/a> \u2014 a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3721\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3629\">catabolism<\/a> \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4709\">uric\u00a0acid<\/a>, a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_3893\">endocrine<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3569\">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_4805_3441\"><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_4805_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_4805_3789\">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_4729\" aria-describedby=\"caption-attachment-4729\" style=\"width: 588px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4729 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-e1592620428819-1.jpg\" alt=\"16.3.4 Adrenal Glands\" width=\"588\" height=\"540\"><figcaption id=\"caption-attachment-4729\" 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_4730\" aria-describedby=\"caption-attachment-4730\" style=\"width: 428px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4730\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary_Sphincter-1.png\" alt=\"16.3.5 Urinary sphincter\" width=\"428\" height=\"428\"><figcaption id=\"caption-attachment-4730\" 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_4805_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_4805_3807\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_3681\">metabolism<\/a> from the body by forming and excreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4725\">ureters<\/a> via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. The bladder stores the urine until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4708\">urea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3669\">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_4805_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_4805_3801\">antidiuretic hormone<\/a> from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3467\">parathyroid hormone<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3402\">parathyroid glands<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3789\">aldosterone<\/a> from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3777\">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_4805_3807\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4627\">sphincter<\/a> at the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-414\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-414\" class=\"h5p-iframe\" data-content-id=\"414\" 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_4805_3127\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3127\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-193\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-193\" class=\"h5p-iframe\" data-content-id=\"193\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"11.2 Quiz\"><\/iframe><\/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_4805_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_4805_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_4722\" aria-describedby=\"caption-attachment-4722\" style=\"width: 560px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4722\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Urinary_System_Male-1.png\" alt=\"16.3.2 Urinary System\" width=\"560\" height=\"560\"><figcaption id=\"caption-attachment-4722\" 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_4805_4717\">Urine<\/a> is formed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>, which filter many substances out of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4723\" aria-describedby=\"caption-attachment-4723\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-4723\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2610_The_Kidney-1.jpg\" alt=\"16.3.3 The Kidney\" width=\"1024\" height=\"585\"><figcaption id=\"caption-attachment-4723\" 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_4805_2702\">Blood<\/a> is filtered and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> is formed by tiny filtering units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_4708\">urea<\/a> \u2014 a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_297\">protein<\/a>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_178\">catabolism<\/a> \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4709\">uric\u00a0acid<\/a>, a by-product of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_2909\">endocrine<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_377\">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_4805_4728\"><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_4805_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_4805_3406\">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_4729\" aria-describedby=\"caption-attachment-4729\" style=\"width: 588px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4729 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-e1592620428819-1.jpg\" alt=\"16.3.4 Adrenal Glands\" width=\"588\" height=\"540\"><figcaption id=\"caption-attachment-4729\" 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_4730\" aria-describedby=\"caption-attachment-4730\" style=\"width: 428px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4730\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary_Sphincter-1.png\" alt=\"16.3.5 Urinary sphincter\" width=\"428\" height=\"428\"><figcaption id=\"caption-attachment-4730\" 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_4805_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_4805_2940\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_176\">metabolism<\/a> from the body by forming and excreting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4725\">ureters<\/a> via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. The bladder stores the urine until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4708\">urea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_173\">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_4805_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_4805_3094\">antidiuretic hormone<\/a> from the\u00a0posterior\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3467\">parathyroid hormone<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3402\">parathyroid glands<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3406\">aldosterone<\/a> from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2959\">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_4805_2940\">autonomic<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4627\">sphincter<\/a> at the distal end of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-194\">\n<div class=\"h5p-content\" data-content-id=\"194\"><\/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_4805_3128\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3128\"><div tabindex=\"-1\"><p>Image shows a freshly baked Steak and Kidney Pie.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3129\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3129\"><div tabindex=\"-1\"><p>Image shows a labelled diagram of the posterior (from the back) view of the kidneys.  The aorta and renal arteries are clearly visible bringing blood to each kidney.  The left kidney sits a bit higher than the right kidney.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3164\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3164\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4803\" aria-describedby=\"caption-attachment-4803\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4803\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Lymph-nodes-1.png\" alt=\"17.1.1 Checking Lymph Nodes\" width=\"400\" height=\"380\"><figcaption id=\"caption-attachment-4803\" class=\"wp-caption-text\"><em>Figure 17.1.1 Health practitioners will often check your lymph nodes for unusual lumps.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study: Defending Your Defenses<\/h1>\n<\/div>\n<figure id=\"attachment_4807\" aria-describedby=\"caption-attachment-4807\" style=\"width: 291px\" class=\"wp-caption alignright\"><img class=\" wp-image-4807\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/mitchell-luo-ymo_yC_N_2o-unsplash-scaled-2.jpg\" alt=\"17.1.2 Hakeem\" width=\"291\" height=\"437\"><figcaption id=\"caption-attachment-4807\" class=\"wp-caption-text\"><em>Figure 17.1.2 Hakeem is concerned about his health - he has been unusually tired, has been losing weight and most recently, found an unexpected lump on the side of his neck.<\/em><\/figcaption><\/figure>\n<p>Twenty-six-year-old Hakeem wasn\u2019t feeling well. He was more tired than usual, dragging through his workdays despite going to bed earlier, and napping on the weekends. He didn\u2019t have much of an appetite, and had started losing weight. When he pressed on the side of his neck, like the doctor is doing in Figure 17.1.1, he noticed an unusual lump.<\/p>\n<p>Hakeem went to his doctor, who performed a physical exam and determined that the lump was a swollen lymph node. Lymph nodes are part of the immune system, and they will often become enlarged when the body is fighting off an infection. Dr. Hayes thinks that the swollen lymph node and fatigue could be signs of a viral or bacterial infection, although he is concerned about Hakeem\u2019s lack of appetite and weight loss. All of those symptoms combined can indicate a type of cancer called lymphoma. An infection, however, is a more likely cause, particularly in a young person like Hakeem. Dr. Hayes prescribes an antibiotic in case Hakeem has a bacterial infection, and advises him to return in a few weeks if his lymph node does not shrink, or if he is not feeling better.<\/p>\n<p>Hakeem returns a few weeks later. He is not feeling better and his lymph node is still enlarged. Dr. Hayes is concerned, and orders a biopsy of the enlarged lymph node. A lymph node biopsy for suspected lymphoma often involves the surgical removal of all or part of a lymph node. This helps to determine whether the tissue contains cancerous cells.<\/p>\n<figure id=\"attachment_4808\" aria-describedby=\"caption-attachment-4808\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4808\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Lymph-node-biopsy-by-US-Army-in-Africa-on-Flickr-1.jpg\" alt=\"17.1.3 Lymph Node Biopsy\" width=\"400\" height=\"314\"><figcaption id=\"caption-attachment-4808\" class=\"wp-caption-text\"><em>Figure 17.1.3 Surgeons performing a lymph node biopsy.<\/em><\/figcaption><\/figure>\n<p>The initial results of the biopsy indicate that Hakeem does have lymphoma. Although lymphoma is more common in older people, young adults and even children can get this disease. There are many types of lymphoma, with the two main types being <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/hodgkins-lymphoma\/symptoms-causes\/syc-20352646\">Hodgkin's lymphoma<\/a> and <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/non-hodgkins-lymphoma\/symptoms-causes\/syc-20375680\">non-Hodgkin's lymphoma<\/a>. Non-Hodgkin lymphoma (NHL), in turn, has many subtypes. The subtype depends on several factors, including which cell types are affected. Some subtypes of NHL, for example, affect immune system cells called B cells, while others affect different immune system cells called T cells.<\/p>\n<p>Dr. Hayes explains to Hakeem that it is important to determine which type of lymphoma he has, in order to choose the best course of treatment. Hakeem\u2019s biopsied tissue will be further examined and tested to see which cell types are affected, as well as which specific cell-surface proteins \u2014 called antigens \u2014 are present. This should help identify his specific type of lymphoma.<\/p>\n<p>As you read this chapter, you will learn about the functions of the immune system, and the specific roles that its cells and organs \u2014 such as B and T cells and lymph nodes \u2014 play in defending the body. At the end of this chapter, you will learn what type of lymphoma Hakeem has and what some of his treatment options are, including treatments that make use of the biochemistry of the immune system to fight cancer with the immune system itself.<\/p>\n<div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter Overview: Immune System<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you will learn about the immune system \u2014 the system that defends the body against infections and other causes of disease, such as cancerous cells. Specifically, you will learn about:<\/p>\n<ul>\n<li>How the immune system identifies normal cells of the body as \u201cself\u201d and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_271\">pathogens<\/a> and damaged cells as \u201cnon-self.\u201d<\/li>\n<li>The two major subsystems of the general immune system: the innate immune system \u2014 which provides a quick, but non-specific response \u2014 and the adaptive immune system, which is slower, but provides a specific response that often results in long-lasting immunity.<\/li>\n<li>The specialized immune system that protects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2986\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3010\">spinal cord<\/a>, called the neuroimmune system.<\/li>\n<li>The organs, cells, and responses of the innate immune system, which includes physical barriers (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3521\">skin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4571\">mucus<\/a>), chemical and biological barriers, inflammation, activation of the complement system of molecules, and non-specific cellular responses (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1680\">phagocytosis<\/a>).<\/li>\n<li>The lymphatic system \u2014 which includes white blood cells called lymphocytes, lymphatic vessels (which transport a fluid called lymph), and organs (such as the spleen, tonsils, and lymph nodes) \u2014 and its important role in the adaptive immune system.<\/li>\n<li>Specific cells of the immune system and their functions, including B cells, T cells, plasma cells, and natural killer cells.<\/li>\n<li>How the adaptive immune system can generate specific and often long-lasting immunity against pathogens through the production of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_390\">antibodies<\/a>.<\/li>\n<li>How vaccines work to generate immunity.<\/li>\n<li>How cells in the immune system detect and kill cancerous cells.<\/li>\n<li>Some strategies that pathogens employ to evade the immune system.<\/li>\n<li>Disorders of the immune system, including allergies, autoimmune diseases (such as diabetes and multiple sclerosis), and immunodeficiency resulting from conditions such as HIV infection.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<p>As you read the chapter, think about the following questions:<\/p>\n<ol>\n<li>What are the functions of lymph nodes?<\/li>\n<li>What are B and T cells? How do they relate to lymph nodes?<\/li>\n<li>What are cell-surface antigens? How do they relate to the immune system and to cancer?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.1.1<\/strong><\/p>\n<p><a href=\"https:\/\/vimeo.com\/271958333\" rel=\"cc:attributionURL\">Lymph nodes\/Is it a Cold or the Flu\u00a0<\/a> by <a href=\"https:\/\/vimeo.com\/leehealth\">Lee Health<\/a> on Vimeo is used under <a href=\"https:\/\/vimeo.com\/terms#licenses\">Vimeo's Terms of Service<\/a> (https:\/\/vimeo.com\/terms#licenses).<\/p>\n<p><strong>Figure 17.1.2<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/ymo_yC_N_2o\" rel=\"cc:attributionURL\">mitchell-luo-ymo_yC_N_2o-unsplash<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@mitchel3uo\">Mitchell Luo<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the <a href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p><strong>Figure 17.1.3<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/qMacvT\" rel=\"cc:attributionURL\">Lymph node biopsy<\/a> by <a class=\"owner-name truncate\" title=\"Go to US Army Africa's photostream\" href=\"https:\/\/www.flickr.com\/photos\/usarmyafrica\/\" data-track=\"attributionNameClick\">US Army Africa<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a\u00a0 <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<h2>References<\/h2>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Hodgkin's lymphoma [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/hodgkins-lymphoma\/symptoms-causes\/syc-20352646<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Non-Hodgkin's lymphoma [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/non-hodgkins-lymphoma\/symptoms-causes\/syc-20375680<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3144\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3144\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4767\" aria-describedby=\"caption-attachment-4767\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4767\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Cliche-1.jpg\" alt=\"16.5.1 Dog peeing on fire hydrant\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-4767\" 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_4805_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_4805_3004\">voluntary<\/a> process controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3823\">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_4805_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_4769\" aria-describedby=\"caption-attachment-4769\" style=\"width: 446px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4769\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary-System-Male-1.jpg\" alt=\"16.5.2 Urinary System - Ureters\" width=\"446\" height=\"449\"><figcaption id=\"caption-attachment-4769\" 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_4770\" aria-describedby=\"caption-attachment-4770\" style=\"width: 388px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4770\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-1-1.jpg\" alt=\"16.5.3 Renal Pelvis and Ureter\" width=\"388\" height=\"357\"><figcaption id=\"caption-attachment-4770\" 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_4805_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_4805_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_4805_4717\">urine<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4771\" aria-describedby=\"caption-attachment-4771\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4771\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2605_The_Bladder-1.jpg\" alt=\"16.5.4 Urinary Bladder\" width=\"1024\" height=\"627\"><figcaption id=\"caption-attachment-4771\" 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_4805_3807\">autonomic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4732\">urethra<\/a><\/strong> is a tube that connects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4772\" aria-describedby=\"caption-attachment-4772\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4772\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Male_and_female_urethral_openings.svg_-1.png\" alt=\"16.5.5\" width=\"512\" height=\"355\"><figcaption id=\"caption-attachment-4772\" 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_4805_3014\">somatic nervous system<\/a>, so it is under conscious, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4725\">Ureters<\/a>\u00a0are tube-like structures that connect the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>\u00a0with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. Each ureter arises at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2982\">smooth muscle<\/a> that can contract to push <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> through the ureter by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4627\">sphincter<\/a> for urination to be under <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-416\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-416\" class=\"h5p-iframe\" data-content-id=\"416\" 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_4805_3145\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3145\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4767\" aria-describedby=\"caption-attachment-4767\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4767\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Cliche-1.jpg\" alt=\"16.5.1 Dog peeing on fire hydrant\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-4767\" 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_4805_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_4805_3004\">voluntary<\/a> process controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2986\">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_4805_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_4769\" aria-describedby=\"caption-attachment-4769\" style=\"width: 446px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4769\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Urinary-System-Male-1.jpg\" alt=\"16.5.2 Urinary System - Ureters\" width=\"446\" height=\"449\"><figcaption id=\"caption-attachment-4769\" 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_4770\" aria-describedby=\"caption-attachment-4770\" style=\"width: 388px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4770\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Adrenal-glands-on-Kidney-by-NCI-Public-Domain-1-1.jpg\" alt=\"16.5.3 Renal Pelvis and Ureter\" width=\"388\" height=\"357\"><figcaption id=\"caption-attachment-4770\" 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_4805_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_4805_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_4805_4717\">urine<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4771\" aria-describedby=\"caption-attachment-4771\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4771\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2605_The_Bladder-1.jpg\" alt=\"16.5.4 Urinary Bladder\" width=\"1024\" height=\"627\"><figcaption id=\"caption-attachment-4771\" 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_4805_2940\">autonomic<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4732\">urethra<\/a><\/strong> is a tube that connects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4772\" aria-describedby=\"caption-attachment-4772\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4772\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Male_and_female_urethral_openings.svg_-1.png\" alt=\"16.5.5\" width=\"512\" height=\"355\"><figcaption id=\"caption-attachment-4772\" 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_4805_3014\">somatic nervous system<\/a>, so it is under conscious, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4725\">Ureters<\/a>\u00a0are tube-like structures that connect the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>\u00a0with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>. Each ureter arises at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2982\">smooth muscle<\/a> that can contract to push <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a> through the ureter by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_4627\">sphincter<\/a> for urination to be under <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-196\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-196\" class=\"h5p-iframe\" data-content-id=\"196\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Energy Needs of Living Things\"><\/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_4805_3165\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3165\"><div tabindex=\"-1\"><p>Image shows a Scanning electron micrograph of a parasite.  It looks quite scary, with a creepy sucker-type thing on its neck<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3151\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3151\"><div tabindex=\"-1\"><p>Image shows a diagram of the kidney with several kidney stones, which have accumulated in the renal pelvis and are blocking the exit to the ureter.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3155\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3155\"><div tabindex=\"-1\"><p>Image shows  a photograph of several wine bottles on a shelf.  The image has been deliberately blurred to simulate the effects of drunkeness.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3157\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3157\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4799\" aria-describedby=\"caption-attachment-4799\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4799\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/alcohol-64164_1920-1.jpg\" alt=\"16.7.1\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-4799\" class=\"wp-caption-text\"><em>Figure 16.7.1 Alcoholic affects.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study Conclusion: Drink and Flush<\/h1>\n<\/div>\n<p>You are probably aware that,\u00a0because of its effects on the brain,\u00a0drinking alcohol can cause visual disturbances, slurred speech, drowsiness, impaired judgment, and loss of coordination. Although it may be less obvious, alcohol also can have serious effects on the functioning of the excretory system.<\/p>\n<p>As you learned from the conversation between Talia and Shae \u2014 who were in line for the restroom at the beginning of this chapter \u2014 alcohol consumption inhibits a hormone that causes our bodies to retain water. As a result, more water is released in urine, increasing the frequency of restroom trips, as well as the risk of dehydration.<\/p>\n<p>Which hormone discussed in this chapter does this? If you answered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3094\">antidiuretic hormone<\/a> (ADH; also called vasopressin) \u2014 you are correct! ADH is secreted by the\u00a0posterior <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2938\">pituitary gland<\/a>\u00a0and acts on the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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\">. As you have learned, the kidneys filter the blood, reabsorb needed substances, and produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a>. ADH helps the body conserve water by influencing this process. ADH makes the collecting ducts in the kidneys permeable to water, allowing water molecules to be reabsorbed from the urine back into the blood through osmosis into capillaries.<\/span><\/p>\n<p>Alcohol is thought to produce more dilute urine by inhibiting the release of ADH. This causes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4759\">collecting 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\">\u00a0to be more impermeable to water, so less water can be reabsorbed, and more is excreted in urine. Because the volume of urine is increased, the bladder fills up more quickly, and the urge to urinate occurs more frequently. This is part of the reason why you often see a long line for the restroom in situations where many people are drinking alcohol. In addition to producing more dilute urine, simply consuming many beverages can also increase urine output.<\/span><\/p>\n<p>In most cases, moderate drinking causes only a minor and temporary effect on kidney function. However, when people consume a large quantity of alcohol in a short period of time, or abuse alcohol over long time periods, there can be serious effects on the kidney.\u00a0Binge drinking (consuming\u00a0roughly\u00a0four to five drinks in two hours) can cause a condition called \u201cacute kidney injury,\u201d a serious and sudden impairment of kidney function that requires immediate medical attention. As with the other cases of kidney failure that you learned about in this chapter, the treatment is to artificially filter the blood using <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4783\">hemodialysis<\/a>. While normal kidney function may eventually return, acute kidney injury can sometimes cause long-term damage to the kidneys.<\/p>\n<p>In cases where people abuse alcohol, particularly for an extended period of time, there can be many serious effects on the kidneys and other parts of the excretory system. The dehydrating effect of alcohol on the body can impair the function of many organs, including the kidneys themselves. Additionally, because of alcohol\u2019s effect on kidney function, water balance, and ion balance, chronic alcohol consumption can cause abnormalities in blood ion concentration and acid-base balance, which can be very dangerous.<\/p>\n<p>Drinking more than two alcoholic beverages a day can increase your risk for high blood pressure, too. As you have learned, high blood pressure is a risk factor for some kidney disorders, as well as a common cause of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4782\">kidney failure<\/a>.\u00a0Drinking too much alcohol can damage the kidneys by raising blood pressure.<\/p>\n<p>Finally, chronic excessive consumption of alcohol can cause liver disease. The liver is an important organ of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2915\">excretory system<\/a> that breaks down toxic substances in the blood. The liver and kidneys work together to remove wastes from the bloodstream. You may remember, for example, the liver transforms <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4707\">ammonia<\/a> into <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4708\">urea<\/a>, which is then filtered and excreted by the kidneys. When the liver is not functioning normally, it puts added strain on the kidneys, which can result in kidney dysfunction. This association between alcohol, liver disease, and kidney dysfunction is so strong that most of the patients in Canada with both liver disease and related kidney dysfunction are alcoholics.<\/p>\n<p>As you have learned, the excretory system is essential\u00a0in\u00a0removing toxic wastes from the body and regulating homeostasis. Having an occasional drink can temporarily alter these functions, but excessive alcohol exposure can seriously and permanently damage this system in many ways. Limiting alcohol consumption can help preserve the normal functioning of the excretory system, so that it can protect your health.<\/p>\n<div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 16 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter you learned about the excretory system. Specifically, you learned that:<\/p>\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4705\">Excretion<\/a> is the process of removing wastes and excess water from the body. It is an essential process in all living things, and a major way in which the human body maintains <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_173\">homeostasis<\/a>.<\/li>\n<li>Organs of the excretory system include the skin, liver, large intestine, lungs, and kidneys.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3521\">skin<\/a> plays a role in excretion through the production of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4711\">sweat<\/a> by sweat glands. Sweating eliminates excess water and salts, as well as a small amount of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4708\">urea<\/a>, a byproduct of protein <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_178\">catabolism<\/a>.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2989\">liver<\/a> is a very important organ of excretion. The liver breaks down many substances \u2014 including toxins \u2014 in the blood. The liver also excretes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4715\">bilirubin<\/a> (a waste product of hemoglobin catabolism) in bile. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4599\">Bile<\/a> then travels to the small intestine and is eventually excreted in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4636\">feces<\/a> by the large intestine.<\/li>\n<li>The main excretory function of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4560\">large intestine<\/a> is to eliminate solid waste that remains after food is digested and water is extracted from the indigestible matter. The large intestine also collects and excretes wastes from throughout the body.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2990\">lungs<\/a> are responsible for the excretion of gaseous wastes \u2014 primarily carbon dioxide \u2014 from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1172\">cellular respiration<\/a> in cells throughout the body. Exhaled air also contains water vapor and trace levels of some other waste gases.<\/li>\n<\/ul>\n<\/li>\n<li>The paired <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2988\">kidneys<\/a>\u00a0are often considered the main organs of excretion. Their primary function is the elimination of excess water and wastes from the bloodstream by the production of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4717\">urine<\/a>. The kidneys filter many substances out of blood, allow the blood to reabsorb needed materials, and use the remaining materials to form urine.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The two bean-shaped kidneys are located high in the back of the abdominal cavity on either side of the spine. A renal artery connects each kidney with the aorta, and transports unfiltered blood to the kidney. A renal vein connects each kidney with the inferior vena cava and transports filtered blood back to the circulation.<\/li>\n<li>The kidney has two main layers involved in the filtration of blood and formation of urine: the outer cortex and inner medulla. At least a million <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4718\">nephrons<\/a>\u00a0\u2014 which are the tiny functional units of the kidney \u2014 span the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4741\">cortex<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4742\">medulla<\/a>. The entire kidney is surrounded by a fibrous capsule and protective fat layers.<\/li>\n<li>As blood flows through a nephron, many materials are filtered out of the blood, needed materials are returned to the blood, and the remaining materials are used to form urine.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>In each nephron, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4747\">glomerulus<\/a> and the surrounding <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4748\">glomerular capsule<\/a> form the unit that filters blood. From the glomerular capsule, the material filtered from blood (called filtrate) passes through the long <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4749\">renal tubule<\/a>. As it does, some substances are reabsorbed into the blood, and other substances are secreted from the blood into the filtrate, finally forming urine. The urine empties into collecting ducts, where more water may be reabsorbed.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>The kidneys are part of the urinary system, which also includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4725\">ureters<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4731\">urinary bladder<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4732\">urethra<\/a>. The main function of the urinary system is to eliminate the waste products of metabolism from the body by forming and excreting urine. After urine forms in the kidneys, it is transported through the ureters to the bladder. The bladder stores the urine until urination, when urine is transported by the urethra to be excreted outside the body.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Besides the elimination of waste products such as urea, uric acid, excess water, and mineral ions, the urinary system has other vital functions. These include maintaining <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_173\">homeostasis<\/a> of mineral ions in extracellular fluid, regulating acid-base balance in the blood, regulating the volume of extracellular fluids, and controlling blood pressure.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The formation of urine must be closely regulated to maintain body-wide homeostasis. Several endocrine hormones help control this function of the urinary system, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3094\">antidiuretic hormone<\/a> secreted from the posterior pituitary gland, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3467\">parathyroid hormone<\/a> from the parathyroid glands, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3406\">aldosterone<\/a> from the adrenal glands.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>For example, the kidneys are part of the renin-angiotensin-aldosterone system that regulates the concentration of sodium in the blood to control blood pressure. In this system, the enzyme renin secreted by the kidneys works with hormones from the liver and adrenal gland to stimulate nephrons to reabsorb more sodium and water from urine.<\/li>\n<\/ul>\n<\/li>\n<li>The kidneys also secrete endocrine hormones, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4763\">calcitriol<\/a> \u2014 which helps control the level of calcium in the blood \u2014 and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4764\">erythropoietin<\/a>, which stimulates bone marrow to produce red blood cells.<\/li>\n<\/ul>\n<\/li>\n<li>The process of urination is controlled by both the autonomic and the somatic nervous systems. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2940\">autonomic system<\/a> causes the detrusor muscle in the bladder wall to relax as the bladder fills with urine, but conscious contraction of the detrusor muscle expels urine from the bladder during urination.<\/li>\n<li>Ureters are tube-like structures that connect the kidneys with the urinary bladder. Each ureter arises at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2982\">smooth muscle<\/a> that can contract to push urine through the ureter by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2890\">peristalsis<\/a>. The walls are lined with transitional epithelium that can expand and stretch.<\/li>\n<li>The urinary bladder 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 autonomic nervous system to stimulate the detrusor muscle in the bladder wall to contract. This forces urine out of the bladder and into the urethra.<\/li>\n<li>The urethra is a tube that connects the urinary bladder to the external urethral orifice. Somatic nerves control the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4627\">sphincter<\/a> at the distal end of the urethra. This allows the opening of the sphincter for urination to be under voluntary control.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4778\">Diabetic nephropathy<\/a> is a progressive kidney disease caused by damage to the capillaries in the glomeruli of the kidneys due to long-standing diabetes mellitus. Years of capillary damage may occur before symptoms first appear.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4780\">Polycystic kidney disease<\/a> (PKD) is a genetic disorder (autosomal dominant or recessive) in which multiple abnormal cysts grow in the kidneys.<\/li>\n<li>Diabetic nephropathy, PKD, or chronic hypertension may lead to kidney failure, in which the kidneys are no longer able to adequately filter metabolic wastes from the blood. Kidneys may fail to such a degree that kidney transplantation or repeated, frequent <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4783\">hemodialysis<\/a> is needed to support life. In hemodialysis, the patient\u2019s blood is filtered artificially through a machine and then returned to the patient\u2019s circulation.<\/li>\n<li>A kidney stone is a solid crystal that forms in a kidney from minerals in urine. A small stone may pass undetected through the ureters and the rest of the urinary tract. A larger stone may cause pain when it passes or be too large to pass, causing blockage of a ureter. Large kidney stones may be shattered with high-intensity ultrasound into pieces small enough to pass through the urinary tract, or they may be removed surgically.<\/li>\n<li>A bladder infection is generally caused by bacteria that reach the bladder from the GI tract and multiply. Bladder infections are much more common in females than males because the female urethra is much shorter and closer to the anus. Treatment generally includes antibiotic drugs.<\/li>\n<li>Urinary incontinence is a chronic problem of uncontrolled leakage of urine. It is very common, especially at older ages and in women. In men, urinary incontinence is usually caused by an enlarged prostate gland. In women, it is usually caused by stretching of pelvic floor muscles during childbirth (stress incontinence) or by an \u201coveractive bladder\u201d that empties without warning (urge incontinence).<\/li>\n<\/ul>\n<p>You have learned that,\u00a0through the removal of toxic wastes and the maintenance of homeostasis,\u00a0the excretory system protects your body. But how does your body protect itself against pathogens and other threats? Read the next chapter on the immune system to find out.<\/p>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 16 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>&nbsp;<\/p>\n<ol>\n<li>\n<div id=\"h5p-198\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-198\" class=\"h5p-iframe\" data-content-id=\"198\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"11.3 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>In what ways can the alveoli of the lungs be considered analogous to the nephrons of the kidney?<\/li>\n<li>What is urea?\u00a0Where is urea produced, and what is it produced from?\u00a0How is urea excreted from the body?<\/li>\n<li>If a person has a large kidney stone preventing\u00a0urine that has left the kidney from reaching the bladder, where do you think this kidney stone is located? Explain your answer.<\/li>\n<li>As it relates to urine production, explain what is meant by \u201cExcretion = Filtration \u2013 Reabsorption + Secretion.\"<\/li>\n<li>Which disease discussed in the chapter specifically affects the glomerular capillaries of the kidneys?\u00a0Where are the glomerular capillaries located within the kidneys, and what is their function?<\/li>\n<li>Describe one way in which the excretory system helps maintain homeostasis in the body.<\/li>\n<li>High blood pressure can both contribute to the development of kidney disorders and be a symptom of kidney disorders.\u00a0What is a kidney disorder that can be caused by high blood pressure?\u00a0What is a kidney disorder that has high blood pressure as a symptom?\u00a0How does blood pressure generally relate to the function of the kidney?<\/li>\n<li>If the body is dehydrated, what do the kidneys do? What does this do to the appearance of the urine produced?<\/li>\n<li>Identify three risk factors for the development of kidney stones.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<h2>Attribution<\/h2>\n<p><strong>Figure 16.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/pixabay.com\/photos\/alcohol-drink-alkolismus-bottles-64164\/\" rel=\"cc:attributionURL\">Tags: Alcohol Drink Alkolismus Bottles Glass Container<\/a> by Gerd Altmann [<a class=\"hover_opacity\" href=\"https:\/\/pixabay.com\/users\/geralt-9301\/\">geralt]<\/a> 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\/).<\/p>\n<\/div>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3158\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3158\"><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_4805_3169\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3169\"><div tabindex=\"-1\"><p>Image shows a pictomicrograph of the giardia lamblia protozoa.  It is roughly cone-shaped and has four trailing flagella.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3171\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3171\"><div tabindex=\"-1\"><p>Image shows a labelled diagram of the components of the lymphatic system.  These include organs such as the spleen, thymus, bone marrow, adenoids, tonsils as well as lymphatic vessels, lymphatic capillaries and lymph nodes.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3172\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3172\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4810\" aria-describedby=\"caption-attachment-4810\" style=\"width: 405px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4810\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/nci-vol-1762-300-1.jpg\" alt=\"17.2.1 Schistosome Parasite\" width=\"405\" height=\"500\"><figcaption id=\"caption-attachment-4810\" 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_4805_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_4805_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_4805_2989\">liver<\/a> damage, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4782\">kidney failure<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4813\">infertility<\/a>, or bladder <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3513\">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_4805_3707\">pathogen<\/a>.<\/strong>\u00a0Most pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3683\">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_4805_2588\">bacteria<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-4815 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/EscherichiaColi_NIAID-1-e1592703123663-1.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-4816\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Herpes_simplex_virus_TEM_B82-0474_lores-1.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-4817\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Red_death_cap_mushroom-1.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-4819 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/256px-Giardia_lamblia_SEM_8698_lores-e1592706174288-1.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_4805_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_4805_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_4821\" aria-describedby=\"caption-attachment-4821\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4821\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Phagocytosis-1.jpg\" alt=\"17.2.2 Phagocytosis\" width=\"400\" height=\"274\"><figcaption id=\"caption-attachment-4821\" 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_4805_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_4805_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_4805_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_4805_3371\">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_4805_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_4805_3567\">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_4805_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_4805_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_4805_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_4805_3835\">cardiovascular system<\/a> and plays a major role in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3877\">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_4828\" aria-describedby=\"caption-attachment-4828\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4828\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2201_Anatomy_of_the_Lymphatic_System-1.jpg\" alt=\"17.2.3 The Lymphatic System\" width=\"1024\" height=\"1085\"><figcaption id=\"caption-attachment-4828\" 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_4805_4552\">Lymph<\/a><\/strong>\u00a0is essentially blood plasma that has leaked from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3831\">capillaries<\/a> into tissue spaces. It includes many leukocytes, especially <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4829\">thymus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4497\">spleen<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4830\">tonsils<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_3823\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3707\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3683\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_3567\">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-419\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-419\" class=\"h5p-iframe\" data-content-id=\"419\" 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_4805_3173\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3173\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4810\" aria-describedby=\"caption-attachment-4810\" style=\"width: 405px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4810\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/nci-vol-1762-300-1.jpg\" alt=\"17.2.1 Schistosome Parasite\" width=\"405\" height=\"500\"><figcaption id=\"caption-attachment-4810\" 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_4805_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_4805_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_4805_2989\">liver<\/a> damage, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4782\">kidney failure<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4813\">infertility<\/a>, or bladder <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_1600\">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_4805_271\">pathogen<\/a>.<\/strong>\u00a0Most pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_270\">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_4805_2588\">bacteria<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-4815 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/EscherichiaColi_NIAID-1-e1592703123663-1.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-4816\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Herpes_simplex_virus_TEM_B82-0474_lores-1.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-4817\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Red_death_cap_mushroom-1.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-4819 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/256px-Giardia_lamblia_SEM_8698_lores-e1592706174288-1.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_4805_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_4805_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_4821\" aria-describedby=\"caption-attachment-4821\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4821\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Phagocytosis-1.jpg\" alt=\"17.2.2 Phagocytosis\" width=\"400\" height=\"274\"><figcaption id=\"caption-attachment-4821\" 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_4805_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_4805_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_4805_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_4805_4826\">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_4805_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_4805_390\">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_4805_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_4805_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_4805_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_4805_2910\">cardiovascular system<\/a> and plays a major role in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2913\">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_4828\" aria-describedby=\"caption-attachment-4828\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4828\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2201_Anatomy_of_the_Lymphatic_System-1.jpg\" alt=\"17.2.3 The Lymphatic System\" width=\"1024\" height=\"1085\"><figcaption id=\"caption-attachment-4828\" 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_4805_4552\">Lymph<\/a><\/strong>\u00a0is essentially blood plasma that has leaked from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_3501\">capillaries<\/a> into tissue spaces. It includes many leukocytes, especially <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4829\">thymus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_4497\">spleen<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4830\">tonsils<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_2986\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_271\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_270\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_390\">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-199\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-199\" class=\"h5p-iframe\" data-content-id=\"199\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"11.4 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_4805_3174\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3174\"><div tabindex=\"-1\"><p>Image shows a photograph of the back of a person's throat.  The tonsils are abnormally swollen and red and have white patches on them.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3175\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3175\"><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_4805_3176\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3176\"><div tabindex=\"-1\"><p>Image shows a diagram of a blood capillary, body cells, and a lymphatic capillary.  There is blood in the blood vessel, lymph in the lymphatic capillary, and interstitial fluid surrounding the body 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_4805_3178\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3178\"><div tabindex=\"-1\"><p>Image shows a diagram of three parts.  The first shows the general location of the thymus, sitting just above the heart.  The next shows a pictomicrograph o f the thymus, labelling the outer cortex and the inner medulla.  The third part shows a labelled illustration of some of the cells within the thymus including thymocytes, macrophages, epithelial cells and dendritic 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_4805_3179\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3179\"><div tabindex=\"-1\"><p>Image shows a side view diagram of the head and neck.  The adenoid tonsils are in the back of the nasal cavity.  The palatine tonsils are at the back of the throat.  The lingual tonsil is at the very back of the tongue.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_4805_3184\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_3184\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4840\" aria-describedby=\"caption-attachment-4840\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4840\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/512px-Tonsillitis-1.jpg\" alt=\"17.3.1 Tonsilitis\" width=\"400\" height=\"305\"><figcaption id=\"caption-attachment-4840\" 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_4805_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_4805_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_4841\" aria-describedby=\"caption-attachment-4841\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4841\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0623_LymphaticSystem_Female-1.png\" alt=\"17.3.2 Lymphatic System\" width=\"1024\" height=\"945\"><figcaption id=\"caption-attachment-4841\" 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_4805_3577\">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_4805_2910\">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_4805_3501\">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_4842\" aria-describedby=\"caption-attachment-4842\" style=\"width: 482px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4842 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2201_Anatomy_of_the_Lymphatic_System-1-e1592718747447-1.jpg\" alt=\"17.3.3 Interstitial Fluid\" width=\"482\" height=\"292\"><figcaption id=\"caption-attachment-4842\" 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_4843\" aria-describedby=\"caption-attachment-4843\" style=\"width: 253px\" class=\"wp-caption alignright\"><img class=\" wp-image-4843\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Intestinal_villus_simplified.svg_-1.png\" alt=\"17.3.4 Lacteals\" width=\"253\" height=\"322\"><figcaption id=\"caption-attachment-4843\" 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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4805_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_4846\" aria-describedby=\"caption-attachment-4846\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-4846\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2206_The_Location_Structure_and_Histology_of_the_Thymus-1.jpg\" alt=\"17.3.5 The Thymus\" width=\"1024\" height=\"718\"><figcaption id=\"caption-attachment-4846\" 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_4805_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_4805_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4849\" aria-describedby=\"caption-attachment-4849\" style=\"width: 488px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4849\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0861_TonsilsThroat_Anatomy2-1.png\" alt=\"17.3.6 Tonsils\" width=\"488\" height=\"488\"><figcaption id=\"caption-attachment-4849\" 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_4805_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_4805_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_4805_4552\">lymph<\/a>, the spleen also filters <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4850\" aria-describedby=\"caption-attachment-4850\" style=\"width: 544px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4850\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Figure_42_02_14-1.jpg\" alt=\"17.3.7 The Spleen\" width=\"544\" height=\"581\"><figcaption id=\"caption-attachment-4850\" 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_4805_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_4851\" aria-describedby=\"caption-attachment-4851\" style=\"width: 465px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4851\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Illu_lymph_node_structure-1.png\" alt=\"17.3.8 Lymph Node\" width=\"465\" height=\"265\"><figcaption id=\"caption-attachment-4851\" 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_4852\" aria-describedby=\"caption-attachment-4852\" style=\"width: 464px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4852\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Lymph_node_regions.svg_-1.png\" alt=\"17.3.9 Lymph Node Regions\" width=\"464\" height=\"663\"><figcaption id=\"caption-attachment-4852\" 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_4805_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_4805_4397\">leukocytes<\/a>\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_2910\">cardiovascular system<\/a>. Lymph is similar in composition to blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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_4805_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_4805_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_4805_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_4805_4829\">thymus<\/a>. Both the bone marrow and thymus are considered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4845\">primary lymphatic organs<\/a>.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4847\">Secondary lymphatic organs<\/a>\u00a0include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4830\">tonsils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_4805_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-200\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-200\" class=\"h5p-iframe\" data-content-id=\"200\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cellular Respiration\"><\/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_4805_5553\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_4805_5553\"><div tabindex=\"-1\"><p>A state of reliance upon a drug such that when the drug is withdrawn, several physiologic reactions occur.<\/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":9,"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-4805","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\/4805","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\/4805\/revisions"}],"predecessor-version":[{"id":6442,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/4805\/revisions\/6442"}],"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\/4805\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/media?parent=4805"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapter-type?post=4805"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/contributor?post=4805"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/license?post=4805"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}