{"id":5023,"date":"2019-06-24T16:48:55","date_gmt":"2019-06-24T16:48:55","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/14-7-case-study-conclusion-needing-to-relax-3\/"},"modified":"2023-11-30T23:06:43","modified_gmt":"2023-11-30T23:06:43","slug":"14-7-case-study-conclusion-needing-to-relax-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/chapter\/14-7-case-study-conclusion-needing-to-relax-3\/","title":{"raw":"12.7\u00a0Case Study Conclusion: Needing to Relax","rendered":"12.7\u00a0Case Study Conclusion: Needing to Relax"},"content":{"raw":"&nbsp;\r\n\r\n[caption id=\"attachment_4269\" align=\"aligncenter\" width=\"640\"]<img class=\"wp-image-4269 size-full\" title=\"Botox, he whispered by Michael Reuter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Botox-joke-2.jpg\" alt=\"12.7 Botox Joke\" width=\"640\" height=\"225\" \/> <em>Figure 12.7.1 The botox effect.\u00a0<\/em>[\/caption]\r\n\r\n<div>\r\n<h1>Case Study Conclusion: Needing to Relax<\/h1>\r\n<\/div>\r\nAs you learned in the beginning of this chapter, botulinum toxin \u2014 one form of which is sold under the brand name [pb_glossary id=\"4150\"]Botox[\/pb_glossary] \u2014 does much more than smooth out wrinkles. It can be used to treat a number of disorders involving excessive muscle contraction, including cervical dystonia. You also\u00a0learned that cervical dystonia, which Edward suffers from, causes abnormal, involuntary muscle contractions of the neck. This results in jerky movements of the head and neck, and\/or a sustained abnormal tilt to the head. It is often painful and can significantly interfere with a person\u2019s life.\r\n\r\n[caption id=\"attachment_4271\" align=\"alignleft\" width=\"432\"]<img class=\"wp-image-4271\" title=\"botulism by Jason Wilson\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Botulism-by-Jason-Wilson-on-flickr-2.jpg\" alt=\"12.7 Botulism joke\" width=\"432\" height=\"325\" \/> <em>Figure 12.7.2 These pickles are jokingly labeled \"botulism,\" but <\/em>actual <em>botulism is really no joke.<\/em>[\/caption]\r\n\r\nHow could a toxin actually\u00a0<em>help<\/em>\u00a0treat a muscular disorder? The botulinum toxin is produced by the soil bacterium,\u00a0<em>Clostridium botulinum<\/em>, and it is the cause of the potentially deadly disease called botulism. Botulism is often a foodborne illness, commonly caused by foods that are improperly canned. Other forms of botulism are caused by wound infections, or occur when infants consume spores of the bacteria from soil or honey.\r\n<div><\/div>\r\nBotulism can be life-threatening, because it paralyzes muscles throughout the body, including those involved in breathing. When a very small amount of botulinum toxin is injected carefully into specific muscles by a trained medical professional, however, it can be useful in inhibiting unwanted muscle contractions.\r\n\r\nFor cosmetic purposes, botulinum toxin injected into the facial muscles relaxes them to reduce the appearance of wrinkles. When used to treat cervical dystonia, it is injected into the muscles of the neck to inhibit excessive muscle contractions. For many patients, this helps relieve the abnormal positioning, movements, and pain associated with the disorder. The effect is temporary, so the injections must be repeated every three to four months to keep the symptoms under control.\r\n\r\nHow does botulinum toxin inhibit muscle contraction? First, recall how skeletal muscle contraction works. A motor neuron instructs skeletal muscle fibres to contract at a synapse between them called the neuromuscular junction. A nerve impulse called an action potential travels down to the axon terminal of the motor neuron, where it causes the release of the neurotransmitter acetylcholine (ACh) from synaptic vesicles. The ACh travels across the synaptic cleft and binds to ACh receptors on the muscle fibre, signaling the muscle fibre to contract. According to the sliding filament theory, the contraction of the muscle fibre occurs due to the sliding of myosin and actin filaments across each other. This causes the Z discs of the sacromeres to move closer together, shortening the sacromeres and causing the muscle fibre to contract.\r\n\r\nIf you wanted to inhibit muscle contraction, at what points could you theoretically interfere with this process? Inhibiting the action potential in the motor neuron, the release of ACh, the activity of ACh receptors, or the sliding filament process in the muscle fibre would all theoretically impair this process and inhibit muscle contraction. For example, in the disease myasthenia gravis, the function of the ACh receptors is impaired, causing a lack of sufficient muscle contraction. As you have learned, this results in muscle weakness that can eventually become life-threatening. Botulinum toxin works by inhibiting the release of ACh from the motor neurons, thereby removing the signal instructing the muscles to contract.\r\n\r\nFortunately, Edward\u2019s excessive muscle contractions and associated pain improved significantly thanks to botulinum toxin injections. Although cervical dystonia cannot currently be cured, botulinum toxin injections have improved the quality of life for many patients with this and other disorders involving excessive involuntary muscle contractions.\r\n\r\nAs you have learned in this chapter, our muscular system allows us to do things like make voluntary movements, digest our food, and pump blood through our bodies. Whether they are in your arm, heart, stomach, or blood vessels, muscle tissue works by contracting. But as you have seen here, too much contraction can be a very bad thing. Fortunately, scientists and physicians have found a way to put a potentially deadly toxin \u2014 and wrinkle-reducing treatment \u2014 to excellent use as a medical treatment for some muscular system disorders.\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">Chapter 12 Summary<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nIn this chapter, you learned about the muscular system. Specifically, you learned that:\r\n<ul>\r\n \t<li>The [pb_glossary id=\"2907\"]muscular system[\/pb_glossary] consists of all the muscles of the body. There are three types of muscle: [pb_glossary id=\"2981\"]skeletal muscle[\/pb_glossary] (which is attached to bones by tendons and enables voluntary body movements), [pb_glossary id=\"5925\"]cardiac muscle[\/pb_glossary] (which makes up the walls of the heart and makes it beat) and [pb_glossary id=\"2982\"]smooth muscle[\/pb_glossary] (which is found in the walls of internal organs and other internal structures and controls their movements).<\/li>\r\n \t<li>Muscles are organs composed mainly of muscle cells, which may also be called [pb_glossary id=\"4156\"]muscle fibres[\/pb_glossary] or [pb_glossary id=\"4157\"]myocytes[\/pb_glossary]. Muscle cells are specialized for the function of contracting, which occurs when protein filaments inside the cells slide over one another using energy from [pb_glossary id=\"5549\"]ATP[\/pb_glossary]. Muscle tissue is the only type of tissue that has cells with the ability to contract.<\/li>\r\n \t<li>Muscles can grow larger, or [pb_glossary id=\"4159\"]hypertrophy[\/pb_glossary]. This generally occurs through increased use, although hormonal or other influences can also play a role. Muscles can also grow smaller, or [pb_glossary id=\"4160\"]atrophy[\/pb_glossary]. This may occur through lack of use, starvation, certain diseases, or aging. In both hypertrophy and atrophy, the size \u2014 but not the number \u2014 of muscle fibres changes. The size of muscles is the main determinant of muscle strength.<\/li>\r\n \t<li>Skeletal muscles need the stimulus of [pb_glossary id=\"3031\"]motor neurons[\/pb_glossary]\u00a0to contract, and to move the body, they need the [pb_glossary id=\"2906\"]skeletal system[\/pb_glossary] to act upon.<\/li>\r\n \t<li>Skeletal muscle\u00a0is the most common type of muscle tissue in the human body.\u00a0To move bones in opposite directions, skeletal muscles often consist of pairs of muscles that work in opposition to one another to move bones in different directions at [pb_glossary id=\"3949\"]joints[\/pb_glossary].<\/li>\r\n \t<li>Skeletal muscle fibres are bundled together in units called muscle fascicles, which are bundled together to form individual skeletal muscles. Skeletal muscles also have connective tissue supporting and protecting the muscle tissue.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>Each skeletal muscle fibre consists of a bundle of [pb_glossary id=\"4180\"]myofibrils[\/pb_glossary], which are bundles of protein filaments. The filaments are arranged in repeating units called [pb_glossary id=\"4179\"]sarcomeres[\/pb_glossary], which are the basic functional units of skeletal muscles. Skeletal muscle tissue is striated, because of the pattern of sarcomeres in its fibres.<\/li>\r\n \t<li>Skeletal muscle fibres can be divided into two types, called [pb_glossary id=\"4184\"]slow-twitch[\/pb_glossary] and [pb_glossary id=\"4185\"]fast-twitch[\/pb_glossary] fibres. Slow-twitch fibres are used mainly in [pb_glossary id=\"1796\"]aerobic[\/pb_glossary] endurance activities (such as long-distance running). Fast-twitch fibres are used mainly for non-aerobic, strenuous activities (such as sprinting). Proportions of the two types of fibres vary from muscle to muscle and person to person.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Smooth muscle tissue is found in the walls of internal organs and vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. The pattern of smooth muscle contraction to move substances through body tubes is called [pb_glossary id=\"2890\"]peristalsis[\/pb_glossary].\u00a0 Contractions of smooth muscles are [pb_glossary id=\"3005\"]involuntary[\/pb_glossary] and controlled by the [pb_glossary id=\"5899\"]autonomic nervous system[\/pb_glossary], [pb_glossary id=\"5661\"]hormones[\/pb_glossary], and other substances.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>Cells of smooth muscle tissue are not striated because they lack sarcomeres, but the cells contract in the same basic way as striated muscle cells. Unlike striated muscle, smooth muscle can sustain very long-term contractions and maintain its contractile function, even when stretched.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Cardiac muscle tissue is found only in the wall of the [pb_glossary id=\"2987\"]heart[\/pb_glossary]. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac cells.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres.\u00a0The exact arrangement, however, differs, making cardiac and skeletal muscle tissues look different from one another.<\/li>\r\n \t<li>The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Its cells contain a great many [pb_glossary id=\"5783\"]mitochondria[\/pb_glossary] to produce ATP for energy and to help the heart resist fatigue.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>A muscle contraction is an increase in the tension or a decrease in the length of a muscle. A muscle contraction is [pb_glossary id=\"4207\"]isometric[\/pb_glossary] if muscle tension changes, but muscle length remains the same. It is [pb_glossary id=\"4208\"]isotonic[\/pb_glossary] if muscle length changes, but muscle tension remains the same.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>A skeletal muscle contraction begins with electrochemical stimulation of a muscle fibre by a motor neuron. This occurs at a chemical synapse called a neuromuscular junction. The neurotransmitter acetylcholine diffuses across the synaptic cleft and binds to receptors on the muscle fibre. This initiates a muscle contraction.<\/li>\r\n \t<li>Once stimulated, the protein filaments within the skeletal muscle fibre slide past each other to produce a contraction. The [pb_glossary id=\"4212\"]sliding filament theory[\/pb_glossary] is the most widely accepted explanation for how this occurs. According to this theory, thick [pb_glossary id=\"4182\"]myosin[\/pb_glossary] filaments repeatedly attach to and pull on thin [pb_glossary id=\"4181\"]actin[\/pb_glossary] filaments, thus shortening sarcomeres.<\/li>\r\n \t<li>[pb_glossary id=\"4214\"]Crossbridge cycling[\/pb_glossary] is a cycle of molecular events that underlies the sliding filament theory. Using energy in ATP, myosin heads repeatedly bind with and pull on actin filaments. This moves the actin filaments toward the center of a sarcomere, shortening the sarcomere and causing a muscle contraction.<\/li>\r\n \t<li>The ATP needed for a muscle contraction comes first from ATP already available in the cell, and more is generated from [pb_glossary id=\"4217\"]creatine phosphate[\/pb_glossary]. These sources are quickly used up. [pb_glossary id=\"5451\"]Glucose[\/pb_glossary] and [pb_glossary id=\"327\"]glycogen[\/pb_glossary] can be broken down to form ATP and pyruvate. Pyruvate can then be used to produce ATP in [pb_glossary id=\"5877\"]aerobic respiration[\/pb_glossary] if oxygen is available, or it can be used in [pb_glossary id=\"5617\"]anaerobic respiration[\/pb_glossary] if oxygen is not available.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Physical exercise is defined as any bodily activity that enhances or maintains physical fitness and overall health. Activities such as household chores may even count as physical exercise! Current recommendations for adults are 30 minutes of moderate exercise a day.<\/li>\r\n \t<li>[pb_glossary id=\"4225\"]Aerobic exercise[\/pb_glossary] 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 slow-twitch muscle fibres that consume large amounts of oxygen. Aerobic exercises increase cardiovascular endurance, and include cycling and brisk walking.<\/li>\r\n \t<li>[pb_glossary id=\"4226\"]Anaerobic exercise[\/pb_glossary] 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 fast-twitch muscle fibres that consume small amounts of oxygen. Anaerobic exercises increase muscle and bone mass and strength, and they include push-ups and sprinting.<\/li>\r\n \t<li>[pb_glossary id=\"4228\"]Flexibility exercise[\/pb_glossary] 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>\r\n \t<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>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>Many of the benefits of exercise may come about because contracting muscles release hormones called [pb_glossary id=\"4230\"]myokines[\/pb_glossary], which promote tissue repair and growth and have anti-inflammatory effects.<\/li>\r\n \t<li>Physical exercise can reduce risk factors for cardiovascular disease, including [pb_glossary id=\"4231\"]hypertension[\/pb_glossary] and [pb_glossary id=\"4243\"]excess body weight[\/pb_glossary]. Physical exercise can also increase factors associated with cardiovascular health, such as mechanical efficiency of the heart.<\/li>\r\n \t<li>Physical exercise has been shown to offer protection from [pb_glossary id=\"4233\"]dementia[\/pb_glossary] and other cognitive problems, perhaps because it increases blood flow or neurotransmitters in the brain, among other potential effects.<\/li>\r\n \t<li>Numerous studies suggest that regular aerobic exercise works as well as pharmaceutical antidepressants in treating mild-to-moderate [pb_glossary id=\"4237\"]depression[\/pb_glossary], possibly because it increases synthesis of natural [pb_glossary id=\"4239\"]euphoriants[\/pb_glossary]\u00a0in the brain.<\/li>\r\n \t<li>Research shows 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 diabetes and obesity.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>There is great variation in individual responses to exercise, partly due to genetic differences in proportions of slow-twitch and fast-twitch 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>\r\n \t<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>\r\n \t<li>[pb_glossary id=\"4253\"]Musculoskeletal disorders[\/pb_glossary]\u00a0are injuries that occur in muscles or associated tissues (such as tendons) because of biomechanical stresses. The disorders may be caused by sudden exertion, over-exertion, repetitive motions, and similar stresses.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>A [pb_glossary id=\"4255\"]muscle strain[\/pb_glossary] is an injury in which muscle fibres tear as a result of overstretching. First aid for a muscle strain includes the five steps represented by the acronym PRICE (protection, rest, ice, compression, and elevation). Medications for inflammation and pain (such as NSAIDs) may also be used.<\/li>\r\n \t<li>[pb_glossary id=\"4257\"]Tendinitis[\/pb_glossary] is inflammation of a tendon that occurs when it is over-extended or worked too hard without rest. Tendinitis may also be treated with PRICE and NSAIDs.<\/li>\r\n \t<li>[pb_glossary id=\"4258\"]Carpal tunnel syndrome[\/pb_glossary] is a biomechanical problem that occurs in the wrist when the median nerve becomes compressed between carpal bones. It may occur with repetitive use, a tumor, or trauma to the wrist. It may cause pain, numbness, and eventually \u2014 if untreated \u2014 muscle wasting in the thumb and first two fingers of the hand.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>[pb_glossary id=\"4254\"]Neuromuscular disorders[\/pb_glossary]\u00a0are systemic disorders that occur because of problems with the nervous control of muscle contractions, or with the muscle cells themselves.<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none;\">\r\n<ul>\r\n \t<li>[pb_glossary id=\"4260\"]Muscular dystrophy[\/pb_glossary] is a genetic disorder caused by defective proteins in muscle cells. It is characterized by progressive skeletal muscle weakness and death of muscle tissues.<\/li>\r\n \t<li>[pb_glossary id=\"4262\"]Myasthenia gravis[\/pb_glossary] is a genetic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. More muscles are affected, and muscles become increasingly weakened as the disorder progresses. Myasthenia gravis most often occurs because immune system antibodies block acetylcholine receptors on muscle cells, and because of the actual loss of acetylcholine receptors.<\/li>\r\n \t<li>[pb_glossary id=\"4264\"]Parkinson\u2019s disease[\/pb_glossary] is a degenerative disorder of the central nervous system that mainly affects the muscular system and movement. It occurs because of the death of neurons in the midbrain. Characteristic signs of the disorder are muscle tremor, muscle rigidity, slowness of movement, and postural instability. Dementia and depression also often characterize advanced stages of the disease.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\nAs you saw in this chapter, muscles need oxygen to provide enough ATP for most of their activities. In fact, all of the body\u2019s systems require oxygen, and also need to remove waste products, such as carbon dioxide. In the next chapter, you will learn about how the respiratory system obtains and distributes oxygen throughout the body, as well as\u00a0how it removes\u00a0wastes, such as carbon dioxide.\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 12 Review<\/span><\/h1>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>[h5p id=\"606\"]<\/li>\r\n \t<li>What are tendons? Name a muscular system disorder involving tendons<\/li>\r\n \t<li>Describe the relationship between muscles, muscle fibres, and fascicles.\r\n<img class=\"alignnone wp-image-4274\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Biceps_PSF-2.jpg\" alt=\"\" width=\"178\" height=\"223\" \/><\/li>\r\n \t<li>The biceps and triceps muscles are shown above. Answer the following questions about these arm muscles.\r\n<ol type=\"a\">\r\n \t<li>When the biceps contract and become shorter (as in the picture above), what kind of motion does this produce in the arm?<\/li>\r\n \t<li>Is the situation described in part (a) more likely to be an isometric or isotonic contraction? Explain your answer.<\/li>\r\n \t<li>If the triceps were to then contract, which way would the arm move?<\/li>\r\n<\/ol>\r\n<\/li>\r\n \t<li>What are Z discs? What happens to them during muscle contraction?<\/li>\r\n \t<li>What is the function of mitochondria in muscle cells? Which type of muscle fibre has more mitochondria \u00ad\u2014 slow-twitch or fast-twitch?<\/li>\r\n \t<li>What is the difference between primary and secondary Parkinson\u2019s disease?<\/li>\r\n \t<li>Why can carpal tunnel syndrome cause muscle weakness in the hands?<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n<h2>Attributions<\/h2>\r\n<strong>Figure 12.7.1<\/strong>\r\n\r\n<a href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/5409410945\">Botox, he whispered<\/a> by <a class=\"owner-name truncate\" title=\"Go to Michael Reuter's photostream\" href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/\" data-track=\"attributionNameClick\">Michael Reuter<\/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.\r\n\r\n<strong>Figure 12.7.2<\/strong>\r\n\r\n<a style=\"font-size: 1em;\" href=\"https:\/\/www.flickr.com\/photos\/hive\/2962297451\">botulism<\/a><span style=\"font-size: 1em;\">\u00a0<\/span>by <a class=\"owner-name truncate no-outline\" title=\"Go to jason wilson's photostream\" href=\"https:\/\/www.flickr.com\/photos\/hive\/\" data-track=\"attributionNameClick\">jason wilson<\/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.\r\n<h2>Reference<\/h2>\r\n<p class=\"hanging-indent\">Pearson Scott Foresman. (2020, April 14). File:Biceps (PSF).jpg [digital image]. <i>Wikimedia Commons.<\/i>\u00a0https:\/\/commons.wikimedia.org\/w\/index.php?title=File:Biceps_(PSF).jpg&amp;oldid=411251538. [Public Domain (https:\/\/en.wikipedia.org\/wiki\/Public_domain)]<\/p>\r\n&nbsp;","rendered":"<p>&nbsp;<\/p>\n<figure id=\"attachment_4269\" aria-describedby=\"caption-attachment-4269\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-4269 size-full\" title=\"Botox, he whispered by Michael Reuter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Botox-joke-2.jpg\" alt=\"12.7 Botox Joke\" width=\"640\" height=\"225\" \/><figcaption id=\"caption-attachment-4269\" class=\"wp-caption-text\"><em>Figure 12.7.1 The botox effect.\u00a0<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study Conclusion: Needing to Relax<\/h1>\n<\/div>\n<p>As you learned in the beginning of this chapter, botulinum toxin \u2014 one form of which is sold under the brand name <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4150\">Botox<\/a> \u2014 does much more than smooth out wrinkles. It can be used to treat a number of disorders involving excessive muscle contraction, including cervical dystonia. You also\u00a0learned that cervical dystonia, which Edward suffers from, causes abnormal, involuntary muscle contractions of the neck. This results in jerky movements of the head and neck, and\/or a sustained abnormal tilt to the head. It is often painful and can significantly interfere with a person\u2019s life.<\/p>\n<figure id=\"attachment_4271\" aria-describedby=\"caption-attachment-4271\" style=\"width: 432px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-4271\" title=\"botulism by Jason Wilson\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Botulism-by-Jason-Wilson-on-flickr-2.jpg\" alt=\"12.7 Botulism joke\" width=\"432\" height=\"325\" \/><figcaption id=\"caption-attachment-4271\" class=\"wp-caption-text\"><em>Figure 12.7.2 These pickles are jokingly labeled &#8220;botulism,&#8221; but <\/em>actual <em>botulism is really no joke.<\/em><\/figcaption><\/figure>\n<p>How could a toxin actually\u00a0<em>help<\/em>\u00a0treat a muscular disorder? The botulinum toxin is produced by the soil bacterium,\u00a0<em>Clostridium botulinum<\/em>, and it is the cause of the potentially deadly disease called botulism. Botulism is often a foodborne illness, commonly caused by foods that are improperly canned. Other forms of botulism are caused by wound infections, or occur when infants consume spores of the bacteria from soil or honey.<\/p>\n<div><\/div>\n<p>Botulism can be life-threatening, because it paralyzes muscles throughout the body, including those involved in breathing. When a very small amount of botulinum toxin is injected carefully into specific muscles by a trained medical professional, however, it can be useful in inhibiting unwanted muscle contractions.<\/p>\n<p>For cosmetic purposes, botulinum toxin injected into the facial muscles relaxes them to reduce the appearance of wrinkles. When used to treat cervical dystonia, it is injected into the muscles of the neck to inhibit excessive muscle contractions. For many patients, this helps relieve the abnormal positioning, movements, and pain associated with the disorder. The effect is temporary, so the injections must be repeated every three to four months to keep the symptoms under control.<\/p>\n<p>How does botulinum toxin inhibit muscle contraction? First, recall how skeletal muscle contraction works. A motor neuron instructs skeletal muscle fibres to contract at a synapse between them called the neuromuscular junction. A nerve impulse called an action potential travels down to the axon terminal of the motor neuron, where it causes the release of the neurotransmitter acetylcholine (ACh) from synaptic vesicles. The ACh travels across the synaptic cleft and binds to ACh receptors on the muscle fibre, signaling the muscle fibre to contract. According to the sliding filament theory, the contraction of the muscle fibre occurs due to the sliding of myosin and actin filaments across each other. This causes the Z discs of the sacromeres to move closer together, shortening the sacromeres and causing the muscle fibre to contract.<\/p>\n<p>If you wanted to inhibit muscle contraction, at what points could you theoretically interfere with this process? Inhibiting the action potential in the motor neuron, the release of ACh, the activity of ACh receptors, or the sliding filament process in the muscle fibre would all theoretically impair this process and inhibit muscle contraction. For example, in the disease myasthenia gravis, the function of the ACh receptors is impaired, causing a lack of sufficient muscle contraction. As you have learned, this results in muscle weakness that can eventually become life-threatening. Botulinum toxin works by inhibiting the release of ACh from the motor neurons, thereby removing the signal instructing the muscles to contract.<\/p>\n<p>Fortunately, Edward\u2019s excessive muscle contractions and associated pain improved significantly thanks to botulinum toxin injections. Although cervical dystonia cannot currently be cured, botulinum toxin injections have improved the quality of life for many patients with this and other disorders involving excessive involuntary muscle contractions.<\/p>\n<p>As you have learned in this chapter, our muscular system allows us to do things like make voluntary movements, digest our food, and pump blood through our bodies. Whether they are in your arm, heart, stomach, or blood vessels, muscle tissue works by contracting. But as you have seen here, too much contraction can be a very bad thing. Fortunately, scientists and physicians have found a way to put a potentially deadly toxin \u2014 and wrinkle-reducing treatment \u2014 to excellent use as a medical treatment for some muscular system disorders.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">Chapter 12 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you learned about the muscular system. Specifically, you learned that:<\/p>\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2907\">muscular system<\/a> consists of all the muscles of the body. There are three types of muscle: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">skeletal muscle<\/a> (which is attached to bones by tendons and enables voluntary body movements), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5925\">cardiac muscle<\/a> (which makes up the walls of the heart and makes it beat) and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscle<\/a> (which is found in the walls of internal organs and other internal structures and controls their movements).<\/li>\n<li>Muscles are organs composed mainly of muscle cells, which may also be called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4156\">muscle fibres<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4157\">myocytes<\/a>. Muscle cells are specialized for the function of contracting, which occurs when protein filaments inside the cells slide over one another using energy from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5549\">ATP<\/a>. Muscle tissue is the only type of tissue that has cells with the ability to contract.<\/li>\n<li>Muscles can grow larger, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4159\">hypertrophy<\/a>. This generally occurs through increased use, although hormonal or other influences can also play a role. Muscles can also grow smaller, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4160\">atrophy<\/a>. This may occur through lack of use, starvation, certain diseases, or aging. In both hypertrophy and atrophy, the size \u2014 but not the number \u2014 of muscle fibres changes. The size of muscles is the main determinant of muscle strength.<\/li>\n<li>Skeletal muscles need the stimulus of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3031\">motor neurons<\/a>\u00a0to contract, and to move the body, they need the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2906\">skeletal system<\/a> to act upon.<\/li>\n<li>Skeletal muscle\u00a0is the most common type of muscle tissue in the human body.\u00a0To move bones in opposite directions, skeletal muscles often consist of pairs of muscles that work in opposition to one another to move bones in different directions at <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3949\">joints<\/a>.<\/li>\n<li>Skeletal muscle fibres are bundled together in units called muscle fascicles, which are bundled together to form individual skeletal muscles. Skeletal muscles also have connective tissue supporting and protecting the muscle tissue.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Each skeletal muscle fibre consists of a bundle of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a>, which are bundles of protein filaments. The filaments are arranged in repeating units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a>, which are the basic functional units of skeletal muscles. Skeletal muscle tissue is striated, because of the pattern of sarcomeres in its fibres.<\/li>\n<li>Skeletal muscle fibres can be divided into two types, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4184\">slow-twitch<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4185\">fast-twitch<\/a> fibres. Slow-twitch fibres are used mainly in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1796\">aerobic<\/a> endurance activities (such as long-distance running). Fast-twitch fibres are used mainly for non-aerobic, strenuous activities (such as sprinting). Proportions of the two types of fibres vary from muscle to muscle and person to person.<\/li>\n<\/ul>\n<\/li>\n<li>Smooth muscle tissue is found in the walls of internal organs and vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. The pattern of smooth muscle contraction to move substances through body tubes is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>.\u00a0 Contractions of smooth muscles are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3005\">involuntary<\/a> and controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5899\">autonomic nervous system<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5661\">hormones<\/a>, and other substances.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Cells of smooth muscle tissue are not striated because they lack sarcomeres, but the cells contract in the same basic way as striated muscle cells. Unlike striated muscle, smooth muscle can sustain very long-term contractions and maintain its contractile function, even when stretched.<\/li>\n<\/ul>\n<\/li>\n<li>Cardiac muscle tissue is found only in the wall of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2987\">heart<\/a>. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac cells.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres.\u00a0The exact arrangement, however, differs, making cardiac and skeletal muscle tissues look different from one another.<\/li>\n<li>The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Its cells contain a great many <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5783\">mitochondria<\/a> to produce ATP for energy and to help the heart resist fatigue.<\/li>\n<\/ul>\n<\/li>\n<li>A muscle contraction is an increase in the tension or a decrease in the length of a muscle. A muscle contraction is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4207\">isometric<\/a> if muscle tension changes, but muscle length remains the same. It is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4208\">isotonic<\/a> if muscle length changes, but muscle tension remains the same.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>A skeletal muscle contraction begins with electrochemical stimulation of a muscle fibre by a motor neuron. This occurs at a chemical synapse called a neuromuscular junction. The neurotransmitter acetylcholine diffuses across the synaptic cleft and binds to receptors on the muscle fibre. This initiates a muscle contraction.<\/li>\n<li>Once stimulated, the protein filaments within the skeletal muscle fibre slide past each other to produce a contraction. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4212\">sliding filament theory<\/a> is the most widely accepted explanation for how this occurs. According to this theory, thick <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4182\">myosin<\/a> filaments repeatedly attach to and pull on thin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4181\">actin<\/a> filaments, thus shortening sarcomeres.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4214\">Crossbridge cycling<\/a> is a cycle of molecular events that underlies the sliding filament theory. Using energy in ATP, myosin heads repeatedly bind with and pull on actin filaments. This moves the actin filaments toward the center of a sarcomere, shortening the sarcomere and causing a muscle contraction.<\/li>\n<li>The ATP needed for a muscle contraction comes first from ATP already available in the cell, and more is generated from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4217\">creatine phosphate<\/a>. These sources are quickly used up. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5451\">Glucose<\/a> and glycogen can be broken down to form ATP and pyruvate. Pyruvate can then be used to produce ATP in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5877\">aerobic respiration<\/a> if oxygen is available, or it can be used in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5617\">anaerobic respiration<\/a> if oxygen is not available.<\/li>\n<\/ul>\n<\/li>\n<li>Physical exercise is defined as any bodily activity that enhances or maintains physical fitness and overall health. Activities such as household chores may even count as physical exercise! Current recommendations for adults are 30 minutes of moderate exercise a day.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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 slow-twitch muscle fibres 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_5023_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 fast-twitch muscle fibres 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_5023_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<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\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_5023_4230\">myokines<\/a>, which promote tissue repair and growth and have anti-inflammatory effects.<\/li>\n<li>Physical exercise can reduce risk factors for cardiovascular disease, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4231\">hypertension<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4243\">excess body weight<\/a>. Physical exercise can also increase factors associated with cardiovascular health, such as mechanical efficiency of 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_5023_4233\">dementia<\/a> and other cognitive problems, perhaps because it increases blood flow or neurotransmitters in the brain, 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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4237\">depression<\/a>, possibly because it increases synthesis of natural <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4239\">euphoriants<\/a>\u00a0in the brain.<\/li>\n<li>Research shows 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 diabetes and obesity.<\/li>\n<\/ul>\n<\/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 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<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4253\">Musculoskeletal disorders<\/a>\u00a0are injuries that occur in muscles or associated tissues (such as tendons) because of biomechanical stresses. The disorders may be caused by sudden exertion, over-exertion, repetitive motions, and similar stresses.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4255\">muscle strain<\/a> is an injury in which muscle fibres tear as a result of overstretching. First aid for a muscle strain includes the five steps represented by the acronym PRICE (protection, rest, ice, compression, and elevation). Medications for inflammation and pain (such as NSAIDs) may also be used.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4257\">Tendinitis<\/a> is inflammation of a tendon that occurs when it is over-extended or worked too hard without rest. Tendinitis may also be treated with PRICE and NSAIDs.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4258\">Carpal tunnel syndrome<\/a> is a biomechanical problem that occurs in the wrist when the median nerve becomes compressed between carpal bones. It may occur with repetitive use, a tumor, or trauma to the wrist. It may cause pain, numbness, and eventually \u2014 if untreated \u2014 muscle wasting in the thumb and first two fingers of the hand.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4254\">Neuromuscular disorders<\/a>\u00a0are systemic disorders that occur because of problems with the nervous control of muscle contractions, or with the muscle cells themselves.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4260\">Muscular dystrophy<\/a> is a genetic disorder caused by defective proteins in muscle cells. It is characterized by progressive skeletal muscle weakness and death of muscle tissues.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4262\">Myasthenia gravis<\/a> is a genetic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. More muscles are affected, and muscles become increasingly weakened as the disorder progresses. Myasthenia gravis most often occurs because immune system antibodies block acetylcholine receptors on muscle cells, and because of the actual loss of acetylcholine receptors.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4264\">Parkinson\u2019s disease<\/a> is a degenerative disorder of the central nervous system that mainly affects the muscular system and movement. It occurs because of the death of neurons in the midbrain. Characteristic signs of the disorder are muscle tremor, muscle rigidity, slowness of movement, and postural instability. Dementia and depression also often characterize advanced stages of the disease.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>As you saw in this chapter, muscles need oxygen to provide enough ATP for most of their activities. In fact, all of the body\u2019s systems require oxygen, and also need to remove waste products, such as carbon dioxide. In the next chapter, you will learn about how the respiratory system obtains and distributes oxygen throughout the body, as well as\u00a0how it removes\u00a0wastes, such as carbon dioxide.<\/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 12 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-606\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-606\" class=\"h5p-iframe\" data-content-id=\"606\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 12 Review Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What are tendons? Name a muscular system disorder involving tendons<\/li>\n<li>Describe the relationship between muscles, muscle fibres, and fascicles.<br \/>\n<img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4274\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Biceps_PSF-2.jpg\" alt=\"\" width=\"178\" height=\"223\" \/><\/li>\n<li>The biceps and triceps muscles are shown above. Answer the following questions about these arm muscles.\n<ol type=\"a\">\n<li>When the biceps contract and become shorter (as in the picture above), what kind of motion does this produce in the arm?<\/li>\n<li>Is the situation described in part (a) more likely to be an isometric or isotonic contraction? Explain your answer.<\/li>\n<li>If the triceps were to then contract, which way would the arm move?<\/li>\n<\/ol>\n<\/li>\n<li>What are Z discs? What happens to them during muscle contraction?<\/li>\n<li>What is the function of mitochondria in muscle cells? Which type of muscle fibre has more mitochondria \u00ad\u2014 slow-twitch or fast-twitch?<\/li>\n<li>What is the difference between primary and secondary Parkinson\u2019s disease?<\/li>\n<li>Why can carpal tunnel syndrome cause muscle weakness in the hands?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/5409410945\">Botox, he whispered<\/a> by <a class=\"owner-name truncate\" title=\"Go to Michael Reuter's photostream\" href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/\" data-track=\"attributionNameClick\">Michael Reuter<\/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 12.7.2<\/strong><\/p>\n<p><a style=\"font-size: 1em;\" href=\"https:\/\/www.flickr.com\/photos\/hive\/2962297451\">botulism<\/a><span style=\"font-size: 1em;\">\u00a0<\/span>by <a class=\"owner-name truncate no-outline\" title=\"Go to jason wilson's photostream\" href=\"https:\/\/www.flickr.com\/photos\/hive\/\" data-track=\"attributionNameClick\">jason wilson<\/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>Reference<\/h2>\n<p class=\"hanging-indent\">Pearson Scott Foresman. (2020, April 14). File:Biceps (PSF).jpg [digital image]. <i>Wikimedia Commons.<\/i>\u00a0https:\/\/commons.wikimedia.org\/w\/index.php?title=File:Biceps_(PSF).jpg&amp;oldid=411251538. [Public Domain (https:\/\/en.wikipedia.org\/wiki\/Public_domain)]<\/p>\n<p>&nbsp;<\/p>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_5023_4150\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4150\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_2608\" aria-describedby=\"caption-attachment-2608\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-2608\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Rebeccas-Pedigree-Cancer-1.png\" alt=\"Pedigree showing Cancer in the family\" width=\"500\" height=\"375\"><figcaption id=\"caption-attachment-2608\" class=\"wp-caption-text\"><em>Figure 5.18.1 Pedigree for Rebecca's family, as described in the beginning of this chapter, showing individuals with cancer (red) and those that do not have cancer (blue). Circles represent women, squares represent men.<\/em><\/figcaption><\/figure>\n<div>\n<p><strong style=\"font-size: 1.424em\">Case Study Conclusion: Cancer in the Family<\/strong><\/p>\n<\/div>\n<p>Rebecca\u2019s family tree, as illustrated in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2519\">pedigree<\/a> above (Figure 5.18.1), shows a high incidence of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a> among close relatives. But are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3429\">genes<\/a> the cause of cancer in this family? Only genetic testing, which is the sequencing of specific genes in an individual, can reveal whether a cancer-causing gene is being inherited in this family.<\/p>\n<p>Fortunately for Rebecca, the results of her genetic testing show that she does not have the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2381\">mutations<\/a> in the BRCA1 and BRCA2 genes that most commonly increase a person\u2019s risk of getting cancer.\u00a0This doesn't mean, however,\u00a0that she doesn\u2019t have\u00a0<em>other<\/em> mutations in these genes that could increase her risk of getting cancer. There are many other mutations in BRCA genes whose effect on cancer risk is still not known \u2014 and there may be many more yet to be discovered. Figure 5.18.2 from the National Cancer Institute illustrates many of the different types of known mutations in the BRCA1 gene. It is important to continue to study the variations in genes such as BRCA in different people to better assess their possible contribution to the development of disease. As you now know from this chapter, many mutations are harmless, while others can cause significant health effects, depending on the specific mutation and the gene involved.<\/p>\n<figure id=\"attachment_2609\" aria-describedby=\"caption-attachment-2609\" style=\"width: 570px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-2609\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Mutations_on_BRCA1-1.jpg\" alt=\"Mutations in Cancer Susceptibility Genes: BRCA1\" width=\"570\" height=\"428\"><figcaption id=\"caption-attachment-2609\" class=\"wp-caption-text\"><em>Figure 5.18.2 Use the knowledge you gained from this chapter to define nonsense, frameshift, and missense mutations. Do these tend to be neutral or harmful mutations?<\/em><\/figcaption><\/figure>\n<p>Mutations in BRCA genes are particularly likely to cause cancer because these genes encode for tumor-suppressor proteins that normally repair damaged DNA and control cell division. If these genes are mutated in a way that causes the proteins to not function properly, other mutations can accumulate and cell division can run out of control, which can cause cancer.<\/p>\n<p>BRCA1 and BRCA2 are on chromosomes 17 and 13, respectively, which are autosomes. As Rebecca\u2019s genetic counselor mentioned, mutations in these genes have a dominant inheritance pattern. Now that you know the pattern of inheritance of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2112\">autosomal<\/a> dominant genes, if Rebecca\u2019s grandmother\u00a0<em>did<\/em> have one copy of a mutated BRCA gene, what are the chances that Rebecca\u2019s mother also has this mutation? Because it is dominant, only one copy of the gene is needed to increase the risk of cancer, and because it is on autosomes instead of sex chromosomes, the sex of the parent or offspring does not matter in the inheritance pattern. In this situation, Rebecca\u2019s grandmother\u2019s eggs would have had a 50 per cent chance of having a BRCA gene mutation (Mendel\u2019s law of segregation). Therefore, Rebecca\u2019s mother would have had a 50 per cent chance of inheriting this gene. Even though Rebecca does not have the most common BRCA mutations that increase the risk of cancer, it does not mean that her mother does not, because there would also only be a 50 per cent chance that she would pass it on to Rebecca. Rebecca\u2019s mother, therefore, should consider getting tested for mutations in the BRCA genes, as well. Ideally, the individuals with cancer in a family should be tested first when a genetic cause is suspected, so that if there is a specific mutation being inherited, it can be identified, and the other family members can be tested for that same mutation.<\/p>\n<p>Mutations in both BRCA1 and BRCA2 are often found in Ashkenazi Jewish families. However, these genes are not linked in the chromosomal sense, because they are on different chromosomes and are therefore inherited independently, in accordance with Mendel\u2019s law of independent assortment. Why would certain gene mutations be prevalent in particular ethnic groups? If people within an ethnic group tend to produce offspring with each other, their genes will remain prevalent within the group. These may be genes for harmless variations such as skin, hair, or eye colour, or harmful variations such as the mutations in the BRCA genes. Other genetically based diseases and disorders are sometimes more commonly found in particular ethnic groups, such as cystic fibrosis in people of European descent, and sickle cell anemia in people of African descent. You will learn more about the prevalence of certain genes and traits in particular ethnic groups and populations in the chapter on <em>Human Variation.<\/em><\/p>\n<p>As you learned in this chapter, genetics is not the sole determinant of phenotype. The environment can also influence many traits, including adult height and skin colour. The environment plays a major role in the development of cancer, too. Ninety to 95 per cent of all cancers do not have an identified genetic cause, and are often caused by mutagens in the environment, such as UV radiation from the sun or toxic chemicals in cigarette smoke. But for families like Rebecca\u2019s, knowing their family health history and genetic makeup may help them better prevent or treat diseases that are caused by their genetic inheritance. If a person knows they have a gene that can increase their risk of cancer, they can make lifestyle changes and have early and more frequent cancer screenings. They may even choose to have preventative surgeries that can help reduce their risk of getting cancer and increase their odds of long-term survival if cancer does occur. The next time you go to the doctor and they ask whether any members of your family have had cancer, you will have a deeper understanding why this information is so important to your health.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter you learned about genetics \u2014 the science of heredity. Specifically you learned that:<\/p>\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3527\">Chromosomes<\/a> are structures made of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3721\">proteins<\/a>\u00a0that are encoded with genetic instructions for making <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_519\">RNA<\/a> and proteins. The instructions are organized into units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3429\">genes<\/a>, which are segments of DNA that code for particular pieces of RNA. The RNA molecules can then act as a blueprint for proteins, or directly help regulate various cellular processes.<\/li>\n<\/ul>\n<ul>\n<li>Humans normally have 23 pairs of chromosomes. Of these, 22 pairs are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2112\">autosomes<\/a>, which contain genes for characteristics unrelated to sex. The other pair consists of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2125\">sex chromosomes<\/a> (XX in females, XY in males). Only the Y chromosome contains genes that determine sex.<\/li>\n<li>Humans have an estimated 20 thousand to 22 thousand genes. The majority of human genes have two or more possible versions, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3357\">alleles<\/a>.<\/li>\n<li>Genes that are located on the same chromosome are called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2120\">linked genes<\/a>. Linkage explains why certain characteristics are frequently inherited together.<\/li>\n<li>Determining that DNA is the genetic material was an important milestone in biology.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>In the 1920s, Griffith showed that something in virulent bacteria could be transferred to nonvirulent bacteria, making them virulent, as well.<\/li>\n<li>In the 1940s, Avery and colleagues showed that the \"something\" Griffith found was DNA and not protein. This result was confirmed by Hershey and Chase, who demonstrated that viruses insert DNA into bacterial cells.<\/li>\n<li>In the 1950s, Chargaff showed that in DNA, the concentration of adenine is always the same as the concentration of thymine, and the concentration of guanine is always the same as the concentration of cytosine. These observations came to be known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2136\">Chargaff's rules<\/a>.<\/li>\n<li>In the 1950s, James Watson and Francis Crick, building on the prior X-ray research of Rosalind Franklin and others, discovered the double helix structure of the DNA molecule.<\/li>\n<\/ul>\n<\/li>\n<li>Knowledge of DNA's structure helped scientists understand how DNA replicates, which must occur before <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3541\">cell division<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3467\">DNA replication<\/a> is semi-conservative because each daughter molecule contains one strand from the parent molecule and one new strand that is complementary to it.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2209\">central dogma of molecular biology<\/a> can be summed up as:\u00a0DNA \u2192 RNA \u2192 Protein. This means that the genetic instructions encoded in DNA are transcribed to RNA. From RNA, they are translated into a protein.<\/li>\n<li>RNA is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3383\">nucleic acid<\/a>. Unlike DNA, RNA consists of just one polynucleotide chain instead of two, contains the base uracil instead of thymine, and contains the sugar ribose instead of deoxyribose.<\/li>\n<li>The main function of RNA is to help make proteins. There are three main types of RNA: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2211\">messenger RNA<\/a> (mRNA), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2213\">ribosomal RNA<\/a> (rRNA), and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2215\">transfer RNA<\/a> (tRNA).<\/li>\n<li>According to the RNA world hypothesis, RNA was the first type of biochemical molecule to evolve, predating both DNA and proteins.<\/li>\n<li>The genetic code was cracked in the 1960s by Marshall Nirenberg. It consists of the sequence of nitrogen bases in a polynucleotide chain of DNA or RNA. The four bases make up the \"letters\" of the code. The letters are combined in groups of three to form code \"words,\" or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3853\">codons<\/a>, each of which encodes for one <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3615\">amino acid<\/a> or a start or stop signal.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>AUG is the start codon, and it establishes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3463\">reading frame <\/a>of the code. After the start codon, the next three bases are read as the second codon, and so on until a stop codon is reached.<\/li>\n<li>The genetic code is universal, unambiguous, and redundant.<\/li>\n<\/ul>\n<\/li>\n<li>Protein synthesis is the process in which cells make proteins. It occurs in two stages: transcription and translation.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2241\">Transcription<\/a> is the transfer of genetic instructions in DNA to mRNA in the nucleus. It includes the steps of initiation, elongation, and termination. After the mRNA is processed, it carries the instructions to a ribosome in the cytoplasm.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2242\">Translation<\/a> occurs at the ribosome, which consists of rRNA and proteins. In translation, the instructions in mRNA are read, and tRNA brings the correct sequence of amino acids to the ribosome. Then rRNA helps bonds form between the amino acids, producing a polypeptide chain.<\/li>\n<li>After a polypeptide chain is synthesized, it may undergo additional processing to form the finished protein.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2381\">Mutations <\/a>are random changes in the sequence of bases in DNA or RNA. They are the ultimate source of all new genetic variation in any species.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Mutations may happen spontaneously during DNA replication or transcription. Other mutations are caused by environmental factors called mutagens.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3483\">Germline mutations<\/a>\u00a0occur in gametes and may be passed on to offspring. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3547\">Somatic mutations<\/a>\u00a0occur in cells other than gametes and cannot be passed on to offspring.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2388\">Chromosomal alterations<\/a> are mutations that change chromosome structure and usually affect the organism in multiple ways.\u00a0Charcot-Marie-Tooth disease type 1\u00a0is an example of a chromosomal alteration.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2389\">Point mutations<\/a> are changes in a single nucleotide. The effects of point mutations depend on how they change the genetic code, and may range from no effects to very serious effects.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2392\">Frameshift mutations<\/a> change the reading frame of the genetic code and are likely to have a drastic effect on the encoded protein.<\/li>\n<li>Many mutations are neutral and have no effects on the organism in which they occur. Some mutations are beneficial and improve fitness, while others are harmful and decrease fitness.<\/li>\n<\/ul>\n<\/li>\n<li>Using a gene to make a protein is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3939\">gene expression<\/a>. Gene expression is regulated to ensure that the correct proteins are made when and where they are needed. Regulation may occur at any stage of protein synthesis or processing.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The regulation of transcription is controlled by regulatory proteins that bind to regions of DNA called regulatory elements, which are usually located near <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2404\">promoters<\/a>. Most regulatory proteins are either activators that promote transcription or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2406\">repressors<\/a> that impede transcription.<\/li>\n<li>A regulatory element common to almost all eukaryotic genes is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2410\">TATA box<\/a>. A number of regulatory proteins must bind to the TATA box in the promoter before transcription can proceed.<\/li>\n<li>The regulation of gene expression is extremely important during the early development of an organism. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2411\">Homeobox genes<\/a>, which encode for chains of amino acids called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2413\">homeodomains<\/a>, are important genes that regulate development.<\/li>\n<li>Some types of cancer occur because of mutations in genes that control the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3551\">cell cycle<\/a>. Cancer-causing mutations most often occur in two types of regulatory genes, called tumor-suppressor genes and proto-oncogenes.<\/li>\n<\/ul>\n<\/li>\n<li>Mendel experimented with the inheritance of traits in pea plants, which have two different forms of several visible characteristics. Mendel crossed pea plants with different forms of traits.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>In Mendel's first set of experiments, he crossed plants that only differed in one characteristic. The results led to Mendel's first law of inheritance, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2445\">law of segregation<\/a>. This law states that there are two factors controlling a given characteristic, one of which dominates the other, and these factors separate and go to different gametes when a parent reproduces.<\/li>\n<li>In Mendel's second set of experiments, he experimented with two characteristics at a time. The results led to Mendel's second law of inheritance, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2447\">law of independent assortment<\/a>. This law states that the factors controlling different characteristics are inherited independently of each other.<\/li>\n<\/ul>\n<\/li>\n<li>Mendel's laws of inheritance, now expressed in terms of genes, form the basis of genetics, the science of heredity. Mendel is often called the father of genetics.<\/li>\n<li>The position of a gene on a chromosome is its <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2465\">locus<\/a>. A given gene may have different versions called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3357\">alleles<\/a>.\u00a0Paired chromosomes of the same type are called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3517\">homologous chromosomes<\/a> and they have the same genes at the same loci.<\/li>\n<li>The alleles an individual inherits for a given gene make up the individual's <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3947\">genotype<\/a>. An organism with two of the same alleles is called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2473\">homozygote<\/a>, and an individual with two different alleles is called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2474\">heterozygote<\/a>.<\/li>\n<li>The expression of an organism's genotype is referred to as its <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2477\">phenotype<\/a>. A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3881\">dominant<\/a> allele is always expressed in the phenotype, even when just one dominant allele has been inherited. A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2479\">recessive<\/a> allele is expressed in the phenotype only when two recessive alleles have been inherited.<\/li>\n<li>In <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2468\">sexual reproduction<\/a>, two parents produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3931\">gametes<\/a> that unite in the process of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">fertilization<\/a> to form a single-celled <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2471\">zygote<\/a>. Gametes are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2484\">haploid<\/a> cells with only one of each pair of homologous chromosomes, and the zygote is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2103\">diploid<\/a> cell with two of each pair of chromosomes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3933\">gametogenesis<\/a>, the process in which the haploid daughter cells change into mature gametes. Males produce gametes called sperm through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">spermatogenesis<\/a>, and females produce gametes called eggs through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2509\">oogenesis<\/a>.<\/li>\n<li>Sexual reproduction produces offspring that are genetically unique. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2500\">Crossing-over<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2502\">independent alignment<\/a>, and the random union of gametes result in a high degree of genetic variation.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2515\">Mendelian inheritance<\/a> refers to the inheritance of traits controlled by a single gene with two alleles, one of which may be completely dominant to the other. The pattern of inheritance of Mendelian traits depends on whether the traits are controlled by genes on <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2112\">autosomes<\/a> or by genes on <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2125\">sex chromosomes<\/a>.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Examples of human autosomal Mendelian traits include albinism and Huntington's disease. Examples of human X-linked traits include red-green colour blindness and hemophilia.<\/li>\n<\/ul>\n<\/li>\n<li>Two tools for studying inheritance are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2519\">pedigrees<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2520\">Punnett squares<\/a>. A pedigree is a chart that shows how a trait is passed from generation to generation. A Punnett square is a chart that shows the expected ratios of possible genotypes in the offspring of two parents.<\/li>\n<li>Non-Mendelian inheritance refers to the inheritance of traits that have a more complex genetic basis than one gene with two alleles and complete dominance.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2540\">Multiple allele traits<\/a> are controlled by a single gene with more than two alleles. An example of a human multiple allele trait is ABO blood type.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2544\">Codominance<\/a> occurs when two alleles for a gene are expressed equally in the phenotype of heterozygotes. A human example of codominance occurs in the AB blood type, in which the A and B alleles are codominant.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2545\">Incomplete dominance<\/a> is the case in which the dominant allele for a gene is not completely dominant to a recessive allele, so an intermediate phenotype occurs in heterozygotes who inherit both alleles. A human example of incomplete dominance is Tay Sachs disease, in which heterozygotes produce half as much functional enzyme as normal homozygotes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2548\">Polygenic traits<\/a> are controlled by more than one gene, each of which has a minor additive effect on the phenotype. This results in a continuum of phenotypes. Examples of human polygenic traits include skin colour and adult height. Many of these types of traits, as well as others, are affected by the environment, as well as by genes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2552\">Pleiotropy<\/a> refers to the situation in which a gene affects more than one phenotypic trait. A human example of pleiotropy occurs with sickle cell anemia, which has multiple effects on the body.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3901\">Epistasis<\/a> is when one gene affects the expression of other genes. An example of epistasis is albinism, in which the albinism mutation negates the expression of skin colour genes.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2562\">Genetic disorders<\/a> are diseases, syndromes, or other abnormal conditions that are caused by mutations in one or more genes or by chromosomal alterations.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Examples of genetic disorders caused by single-gene mutations include Marfan syndrome (autosomal dominant), sickle cell anemia (autosomal recessive), vitamin D-resistant rickets (X-linked dominant), and hemophilia A (X-linked recessive). Very few genetic disorders are caused by dominant mutations because these alleles are less likely to be passed on to successive generations.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2565\">Nondisjunction<\/a> is the failure of replicated chromosomes to separate properly during meiosis. This may result in genetic disorders caused by abnormal numbers of chromosomes. An example is Down syndrome, in which the individual inherits an extra copy of chromosome 21. Most chromosomal disorders involve the X chromosome. An example is Klinefelter's syndrome (XXY, XXXY).<\/li>\n<li>Prenatal genetic testing (by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2570\">amniocentesis<\/a>, for example) can detect chromosomal alterations\u00a0<em>in utero<\/em>. The symptoms of some genetic disorders can be treated or prevented. For example, symptoms of phenylketonuria (PKU) can be prevented by following a low-phenylalanine diet throughout life.<\/li>\n<li>Cures for genetic disorders are still in the early stages of development. One potential cure is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2573\">gene therapy<\/a>, in which normal genes are introduced into cells by a vector such as a virus to compensate for mutated genes.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2585\">Genetic engineering<\/a>\u00a0is the use of technology to change the genetic makeup of living things for human purposes.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Genetic engineering\u00a0methods include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2586\">gene cloning<\/a> and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2597\">polymerase chain reaction<\/a>.\u00a0Gene cloning is the process of isolating and making copies of a DNA segment, such as a gene. The polymerase chain reaction makes many copies of a gene or other DNA segment.<\/li>\n<li>Genetic engineering\u00a0can be used to transform bacteria so they are able to make human proteins, such as insulin. It can also be used to create <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2591\">transgenic crops<\/a>, such as crops that yield more food or resist insect pests.<\/li>\n<li>Genetic engineering\u00a0has raised a number of ethical, legal, and social issues including health, environmental, and privacy concerns.<\/li>\n<\/ul>\n<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2602\">human genome<\/a> refers to all of the DNA of the human species. It consists of more than 3.3 billion base pairs divided into 20,500 genes on 23 pairs of chromosomes.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2604\">Human Genome Project<\/a> (HGP) was a multi-billion dollar international research project that began in 1990. By 2003, it had sequenced and mapped the location of all of the DNA base pairs in the human genome. It published the results as a human reference genome that is available to anyone on the Internet.<\/li>\n<li>Sequencing of the human genome is helping researchers better understand <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a> and genetic diseases. It is also helping them tailor medications to individual patients, which is the focus of the new field of pharmacogenomics. In addition, it is helping researchers better understand human evolution.<\/li>\n<\/ul>\n<\/div>\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 5 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-254\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-254\" class=\"h5p-iframe\" data-content-id=\"254\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 5 Review\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What are the differences between a sequence of DNA and the sequence of mature mRNA that it produces?<\/li>\n<li>Scientists sometimes sequence DNA that they \u201creverse transcribe\u201d from the mRNA in an organism\u2019s cells, which is called complementary DNA (cDNA). Why do you think this technique might be particularly useful for understanding an organism\u2019s proteins versus sequencing the whole genome (i.e. nuclear DNA) of the organism?<\/li>\n<li>A person has a hypothetical\u00a0<em>A a\u00a0<\/em>genotype. Answer the following questions about this genotype:\n<ol type=\"a\">\n<li>What do\u00a0<em>A\u00a0<\/em>and\u00a0<em>a<\/em>\u00a0represent?<\/li>\n<li>If the person expresses only the phenotype associated with\u00a0<em>A<\/em>, is this an example of complete dominance, codominance, or incomplete dominance? Explain your answer. Also, describe what the observed phenotypes would be if it were either of the two incorrect answers.<\/li>\n<\/ol>\n<\/li>\n<li>Explain how a mutation that occurs in a parent can result in a genetic disorder in their child. Be sure to include which type of cell or cells in the parent must be affected in order for this to happen.<\/li>\n<li>What is the term for an allele that is not expressed in a heterozygote?<\/li>\n<li>What might happen if codons encoded for more than one amino acid?<\/li>\n<li>Explain why a human gene can be inserted into bacteria and can still produce the correct human protein, despite being in a very different organism.<\/li>\n<li>What is gene therapy?\u00a0Why is gene therapy considered a type of biotechnology?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<h1>Chapter 5 Attributions and References<\/h1>\n<h2>Unit 5.18 Image Attributions<\/h2>\n<ul>\n<li><strong>Figure 5.18.1 <\/strong><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/5.17\/\" rel=\"cc:attributionURL\">Rebeccas Pedigree Cancer<\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0by <\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/5.17\/\">CK-12 Foundation<\/a><span style=\"text-align: initial;font-size: 1em\"> is used under a\u00a0 <\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/\" rel=\"license\">CC BY 3.0<\/a><span style=\"text-align: initial;font-size: 1em\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0\/) license. <\/span><img style=\"text-align: initial;font-size: 1em\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/logo_ck12.png\" alt=\"\"> <span style=\"font-size: 1em\">\u00a9<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/\">CK-12 Foundation<\/a> <span style=\"font-size: 1em\">Licensed under\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\"><img class=\"alignnone size-full wp-image-8217\" title=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/icon_licence.png\" alt=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\"><\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/terms-of-use\/\">Terms of Use<\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/attribution\/\">Attribution<\/a><\/li>\n<\/ul>\n<ul>\n<li><strong>Figure 5.18.2 <\/strong><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Mutations_on_BRCA1.jpg\" rel=\"cc:attributionURL\">Mutations_on_BRCA1<\/a><span style=\"text-align: initial;font-size: 1em\"> by <\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/www.cancer.gov\/\">National Cancer Institute (NCI)<\/a><span style=\"text-align: initial;font-size: 1em\"> on Wikimedia Commons is in the <\/span><a class=\"extiw\" style=\"text-align: initial;font-size: 1em\" title=\"w:en:Public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/en:Public_domain\">public domain<\/a><span style=\"text-align: initial;font-size: 1em\"> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/span><\/li>\n<\/ul>\n<h2>Reference<\/h2>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2016). Figure 1 Pedigree for Rebecca's family, as described in the beginning of this chapter, [digital image]. In <em>CK-12 College Human Biology<\/em> (Section 5.17) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/5.17\/<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_2907\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2907\"><div tabindex=\"-1\"><p>Created by:\u00a0CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 373px\" class=\"wp-caption alignnone\"><img class=\"wp-image-237\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Animal_Cell_Unannotated.svg_.png\" alt=\"\" width=\"373\" height=\"216\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.1 Simple cut-away model of an animal cell.\u00a0<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 368px\" class=\"wp-caption alignnone\"><img class=\"wp-image-238\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/jello-mold.jpg\" alt=\"\" width=\"368\" height=\"245\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.2 Jello molds containing fruit. <\/em><\/figcaption><\/figure>\n<div>\n<h1>A Bag Full of Jell-O<\/h1>\n<\/div>\n<p>The simple cut-away model of an animal <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2223\">cell<\/a> (Figure 4.4.1) shows that a cell resembles a plastic bag full of Jell-O. Its basic structure is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a> filled with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1963\">cytoplasm<\/a>. Like Jell-O containing mixed fruit (Figure 4.4.2), the cytoplasm of the cell also contains various structures, including a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2402\">nucleus<\/a> and other <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2083\">organelles<\/a>. Your body is composed of trillions of cells, but all of them perform the same basic life functions. They all obtain and use <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2340\">energy<\/a>, respond to the environment, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2414\">reproduce<\/a>. How do your cells carry out these basic functions and keep themselves \u2014 and you \u2014 alive? To answer these questions, you need to know more about the structures that make up cells, starting with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a>.<\/p>\n<div>\n<h1><strong>What is<\/strong> the<strong> Plasma Membrane?<\/strong><\/h1>\n<\/div>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a> is a structure that forms a barrier between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1963\">cytoplasm<\/a> inside the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2223\">cell<\/a> and\u00a0the environment\u00a0outside the cell. Without the plasma membrane, there would be no cell.\u00a0Although it is very thin and flexible, the plasma membrane protects and supports the cell by controlling everything that enters and leaves it.\u00a0It allows only certain substances to pass through, while keeping others in or out. To understand how the plasma membrane controls what passes into or out of the cell, you need to know its basic structure.<\/p>\n<div>\n<h2>Phospholipid Bilayer<\/h2>\n<\/div>\n<p>The plasma membrane is composed mainly of\u00a0phospholipids, which consist of fatty acids and alcohol. The phospholipids in the plasma membrane are arranged in two layers, called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2137\">phospholipid bilayer<\/a><\/strong>. As shown in the simplified diagram in Figure 4.4.3, each individual\u00a0 phospholipid molecule has a phosphate group head (in red) and two fatty acid tails (in yellow). The head \u201cloves\u201d water (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2240\">hydrophilic<\/a>) and the tails \u201chate\u201d water (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2237\">hydrophobic<\/a>). The water-hating tails are on the interior of the membrane, whereas the water-loving heads point outward, toward either the cytoplasm (intracellular) or the fluid that surrounds the cell (extracellular).<\/p>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2237\">Hydrophobic<\/a> molecules can easily pass through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a> if they are small enough, because they are water-hating like the interior of the membrane. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2240\">Hydrophilic<\/a> molecules, on the other hand, <em>cannot<\/em> pass through the plasma membrane \u2014 at least not without help \u2014 because they are water-loving like the exterior of the membrane.<\/p>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 457px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1592\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Phospholipid_Bilayer-1.jpg\" alt=\"Image shows a diagram of a phospholipid bilayer. The bilayer is made up of two sheets of phospholipids, with the fatty acid tails facing towards the center, and the phosphate heads on the two external surfaces.\" width=\"457\" height=\"308\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.3 The phospholipid bilayer is made up of two sheets of phospholipids, with the fatty acid tails facing the centre.<\/em><\/figcaption><\/figure>\n<div>\n<h2>Other Molecules in the Plasma Membrane<\/h2>\n<\/div>\n<p>The plasma membrane also contains other molecules, primarily other <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2205\">lipids<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2422\">proteins<\/a>. The yellow molecules in the diagram here, for example, are the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2205\">lipid<\/a> cholesterol. Molecules of the steroid lipid cholesterol help the plasma membrane keep its shape. Proteins in the plasma membrane (shown blue in Figure 4.4.4) include: transport <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2422\">proteins<\/a> that assist other substances in crossing the cell membrane, receptors that allow the cell to respond to chemical signals in its environment, and cell-identity markers that indicate what type of cell it is and whether it belongs in the body.<\/p>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 610px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-240\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Lipid-bilayer.jpg\" alt=\"Image shows a diagram of a plasma membrane. The lipid bilayer contains embedded molecules including proteins, glycoproteins, glycolipids, and cholesterol.\" width=\"610\" height=\"279\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.4 The plasma membrane contains many molecules embedded in the lipid bilayer.<\/em><\/figcaption><\/figure>\n<div>\n<h2>Additional Functions of the Plasma Membrane<\/h2>\n<\/div>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a> may have extensions, such as whip-like <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2151\">flagella<\/a> (singular flagellum) or brush-like <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1597\">cilia<\/a> (singular cilium), shown below (Figure 4.4.5), that give it other functions. In single-celled organisms, these membrane extensions may help the organisms move. In multicellular organisms, the extensions have different functions. For example, the cilia on human lung cells sweep foreign particles and mucus toward the mouth and nose, while the flagellum on a human sperm cell allows it to swim.<\/p>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 379px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-241\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Spermatozoa-human-3140x.jpg\" alt=\"Image shows a scanning electron microscope image of three human sperm on a porous surface.\" width=\"379\" height=\"265\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.5 Human sperm with their long, whip-like flagella.<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 369px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-242\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Cilia.jpg\" alt=\"Image shows a scanning electron microscope image of the interior surface of bronchi. The cells lining the interior of this tube have clumps of cilia.\" width=\"369\" height=\"378\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.6 Brush-like cilia on lung epithelial cells.<\/em><\/figcaption><\/figure>\n<div>\n<p><strong>Feature: My\u00a0<\/strong><strong>Human Body<\/strong><\/p>\n<\/div>\n<p>If you smoke or use e-cigarettes (vaping) and need another reason to quit, here's a good one.\u00a0We usually think of lung\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2148\">cancer<\/a>\u00a0as the major disease caused by smoking. But smoking and vaping can have devastating effects on the body's ability to protect itself from repeated, serious respiratory infections, such as bronchitis and pneumonia.<\/p>\n<figure id=\"attachment_243\" aria-describedby=\"caption-attachment-243\" style=\"width: 672px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-243\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Adverse_effects_of_vaping_raster.png\" alt=\"4.4.7 Adverse Affects of Vaping\" width=\"672\" height=\"910\"><figcaption id=\"caption-attachment-243\" class=\"wp-caption-text\"><em>Figure 4.4.7 Airways of \u201chealthy\u201d vapors are abnormal - results of vaping.<\/em><\/figcaption><\/figure>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1597\">Cilia<\/a> are microscopic, hair-like projects on\u00a0cells\u00a0that line the respiratory, reproductive, and digestive systems. Cilia in the\u00a0respiratory system\u00a0line most of your airways, where they have the job of trapping and removing dust, germs, and other foreign particles before they can make you sick. Cilia secrete mucus that traps particles, and they move in a continuous wave-like motion that sweeps the mucus and particles upward toward the throat, where they can be expelled from the body. When you are sick and cough up phlegm, that's what you are doing.<\/p>\n<p>Smoking prevents cilia from performing these important functions. Chemicals in tobacco smoke paralyze the cilia so they can't sweep mucus out of the airways. Those chemicals also inhibit the cilia from producing mucus. Fortunately, these effects start to wear off soon after the\u00a0most recent\u00a0exposure to tobacco smoke. If you stop smoking, your cilia will return to normal. Even if prolonged smoking has destroyed cilia, they will regrow and resume functioning in a matter of months after you stop smoking.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">4.4 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_5023_1996\">plasma membrane<\/a> is a structure that forms a barrier between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1963\">cytoplasm<\/a> inside the cell and\u00a0the environment\u00a0outside the cell. It allows only certain substances to pass in or out of the cell.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1996\">plasma membrane<\/a> is composed mainly of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2137\">bilayer of phospholipid<\/a> molecules. It also contains other molecules, such as the steroid cholesterol, which helps the membrane keep its shape, and transport proteins, which help substances pass through the membrane.<\/li>\n<li>The\u00a0plasma\u00a0membranes of some cells have extensions that have other functions, like flagella to help\u00a0sperm\u00a0move, or cilia to help keep our airways clear.<\/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\">4.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What are the general functions of the plasma membrane?<\/li>\n<li>Describe the phospholipid bilayer of the plasma membrane.<\/li>\n<li>Identify other molecules in the plasma membrane. State their functions.<\/li>\n<li>Why do some cells have plasma membrane extensions, like flagella and cilia?<\/li>\n<li>Explain why hydrophilic molecules cannot easily pass through the cell membrane. What type of molecule in the cell membrane might help hydrophilic molecules pass through it?<\/li>\n<li>Which part of a phospholipid molecule in the plasma membrane is made of fatty\u00a0acid\u00a0chains? Is this part hydrophobic or hydrophilic?<\/li>\n<li>The two layers of\u00a0phospholipids\u00a0in the plasma membrane are called a phospholipid ____________.<\/li>\n<li>\n<div id=\"h5p-38\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-38\" class=\"h5p-iframe\" data-content-id=\"38\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Plasma Membrane\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Steroid hormones can pass directly through cell membranes. Why do you think this is the case?<\/li>\n<li>Some antibiotics work by making holes in the plasma membrane of bacterial cells. How do you think this kills the cells?<\/li>\n<li>What is the name of the long, whip-like extensions of the plasma membrane that helps some single-celled organisms move?<\/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\">4.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=yAXnYcUjn5k&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Insights into cell membranes via dish detergent - Ethan Perlstein, TED-Ed, 2013.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=qBCVVszQQNs<\/p>\n<p style=\"text-align: center\">Inside the cell membrane, by The Amoeba Sisters, 2018.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 4.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Animal_Cell_Unannotated.svg\">Animal Cell Unannotated,<\/a> by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Kelvin13\">Kelvin Song<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\">CC0 1.0<\/a> (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en) public domain dedication license.<\/p>\n<p><strong>Figure 4.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/aimeeknight\/5184668689\/\">Jello mold at the mexican bakery<\/a> photo by <a href=\"https:\/\/www.flickr.com\/photos\/aimeeknight\/\">Aim\u00e9e Knight<\/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 4.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:0302_Phospholipid_Bilayer.jpg\" rel=\"cc:attributionURL\">Phospholipid_Bilayer<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-1-the-cell-membrane\">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 4.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:0303_Lipid_Bilayer_With_Various_Components.jpg\" rel=\"cc:attributionURL\">Lipid bilayer<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-1-the-cell-membrane\">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 4.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Spermatozoa-human-3140x.jpg\" rel=\"cc:attributionURL\">Spermatozoa-human-3140x<\/a> by No specific author on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:WP:PD\" href=\"https:\/\/en.wikipedia.org\/wiki\/WP:PD\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 4.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bronchiolar_epithelium_3_-_SEM.jpg\">Cilia\/ Bronchiolar epithelium 3 - SEM<\/a> by Charles Daghlian on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:WP:PD\" href=\"https:\/\/en.wikipedia.org\/wiki\/WP:PD\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 4.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Adverse_effects_of_vaping_(raster).png\">Adverse effects of vaping (raster)<\/a> by <a title=\"User:Mikael H\u00e4ggstr\u00f6m\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Mikael_H%C3%A4ggstr%C3%B6m\">Mikael H\u00e4ggstr\u00f6m<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:WP:PD\" href=\"https:\/\/en.wikipedia.org\/wiki\/WP:PD\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Amoeba Sisters. (2018, February 27). Inside the cell membrane. YouTube. https:\/\/www.youtube.com\/watch?v=qBCVVszQQNs&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Betts, J.G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E.. Womble, M., DeSaix. P. (2013, April 25). Figure 3.3 Phospolipid Bilayer [digital image]. In <em>Anatomy and Physiology. OpenStax. <\/em>https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-1-the-cell-membrane<\/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, April 25). Figure\u00a0<\/span><span class=\"os-number\">3.4<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"5458\" class=\"os-title\" data-type=\"title\">Cell Membrane<\/span><span class=\"os-divider\"> [digital image]. In <em>Anatomy and Physiology. OpenStax. <\/em>https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-1-the-cell-membrane<\/span><\/p>\n<p class=\"hanging-indent\">Ghosh, A., Coakley, R. C., Mascenik, T., Rowell, T. R., Davis, E. S., Rogers, K., Webster, M. J., Dang, H., Herring, L. E., Sassano, M. F., Livraghi-Butrico, A., Van Buren, S. K., Graves, L. M., Herman, M. A., Randell, S. H., Alexis, N. E., &amp; Tarran, R. (n.d.). Chronic E-Cigarette Exposure Alters the Human Bronchial Epithelial Proteome.\u00a0<i>American Journal of Respiratory and Critical \/Care Medicine<\/i>,\u00a0<i>198<\/i>(1), 67\u201376. https:\/\/doi-org.ezproxy.tru.ca\/10.1164\/rccm.201710-2033OC<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, February 26). Insights into cell membranes via dish detergent - Ethan Perlstein. YouTube. https:\/\/www.youtube.com\/watch?v=yAXnYcUjn5k&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_5023_2981\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2981\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1059\" aria-describedby=\"caption-attachment-1059\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1053\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Natalia_Zabolotnaya_2012b.jpg\" alt=\"12.2 Natalia Zabolotnaya\" width=\"400\" height=\"460\"><figcaption id=\"caption-attachment-1059\" class=\"wp-caption-text\"><em>Figure 12.2.1 Natalia Zabolotnaya, 2012 Olympics.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Marvelous Muscles<\/h1>\n<\/div>\n<p>Does the word\u00a0<em>muscle<\/em> make you think of the well-developed muscles of a weightlifter, like the woman in Figure 12.2.1? Her name is <a href=\"https:\/\/en.wikipedia.org\/wiki\/Natalya_Zabolotnaya\">Natalia Zabolotnaya<\/a>, and she\u2019s a Russian Olympian. The muscles that are used to lift weights are easy to feel and see, but they aren\u2019t the only muscles in the human body. Many muscles are deep within the body, where they form the walls of internal organs and other structures. You can flex your biceps at will, but you can\u2019t control internal muscles\u00a0like\u00a0these. It\u2019s a good thing that these internal muscles work without any conscious effort on your part, because movement of these muscles is essential for survival. Muscles are the organs of the muscular system.<\/p>\n<div>\n<h1>What Is the Muscular System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2907\">muscular system<\/a><\/strong> consists of all the muscles of the body. The largest percentage of muscles in the muscular system consists of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">skeletal muscles<\/a>, which are attached to bones and enable voluntary body movements (shown in Figure 12.2.2). There are almost 650 skeletal muscles in the human body, many of them shown in Figure 12.2.2. Besides skeletal muscles, the muscular system also includes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2568\">cardiac muscle<\/a>, which makes up the walls of the heart, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscles<\/a>, which control movement in other internal organs and structures.<\/p>\n<figure id=\"attachment_1059\" aria-describedby=\"caption-attachment-1059\" style=\"width: 304px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1055\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Bougle_whole2_retouched.png\" alt=\"11.2.2 Muscular System\" width=\"304\" height=\"900\"><figcaption id=\"caption-attachment-1059\" class=\"wp-caption-text\"><em>Figure 12.2.2 Many of the skeletal muscles in the human muscular system are shown in this drawing of the human body.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Muscle Structure and Function<\/span><\/p>\n<\/div>\n<p>Muscles are organs composed mainly of muscle cells, which are also called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4156\">muscle fibres<\/a> <\/strong>(mainly in skeletal and cardiac muscle) or\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4157\">myocytes<\/a><\/strong>\u00a0(mainly in smooth muscle). Muscle cells are long, thin cells that are specialized for the function of contracting. They contain protein filaments that slide over one another using energy in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2072\">ATP<\/a>. The sliding filaments increase the tension in \u2014 or shorten the length of \u2014 muscle cells, causing a contraction. Muscle contractions are responsible for virtually\u00a0<em>all<\/em>\u00a0the movements of the body, both inside and out.<\/p>\n<p>Skeletal muscles are attached to bones of the skeleton. When these muscles contract, they move the body. They allow us to use our limbs in a variety of ways, from walking to turning cartwheels. Skeletal muscles also maintain posture and help us to keep balance.<\/p>\n<p>Smooth muscles in the walls of blood vessels contract to cause <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3942\">vasoconstriction<\/a>, which may help conserve body heat. Relaxation of these muscles causes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2756\">vasodilation<\/a>, which may help the body lose heat. In the organs of the digestive system, smooth muscles squeeze food through the gastrointestinal tract by contracting in sequence to form a wave of muscle contractions called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>.<\/strong>\u00a0Think of squirting toothpaste through a tube by applying pressure in sequence from the bottom of the tube to the top, and you have a good idea of how food is moved by muscles through the digestive system. Peristalsis of smooth muscles also moves urine through the urinary tract.<\/p>\n<p>Cardiac muscle tissue is found only in the walls of the heart. When cardiac muscle contracts, it makes the heart beat. The pumping action of the beating heart keeps blood flowing through the cardiovascular system.<\/p>\n<div>\n<h1>Muscle Hypertrophy and Atrophy<\/h1>\n<\/div>\n<p>Muscles can grow larger, or\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4159\">hypertrophy<\/a>.<\/strong>\u00a0This generally occurs through increased use, although hormonal or other influences can also play a role.\u00a0The increase in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a> that occurs in males during puberty, for example, causes a significant increase in muscle size. Physical exercise that involves weight bearing or resistance training can increase the size of skeletal muscles in virtually everyone. Exercises (such as running) that increase the heart rate may also increase the size and strength of cardiac muscle. The size of muscle, in turn, is the main determinant of muscle strength, which may be measured by the amount of force a muscle can exert.<\/p>\n<p>Muscles can also grow smaller, or\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4160\">atrophy<\/a><\/strong>, which can occur through lack of physical activity or from starvation. People who are immobilized for any length of time \u2014 for example, because of a broken bone or surgery \u2014 lose muscle mass relatively quickly. People in concentration or famine camps may be so malnourished that they lose much of their muscle mass, becoming almost literally just \u201cskin and bones.\u201d Astronauts on the International Space Station may also lose significant muscle mass because of weightlessness in space (see Figure 12.2.3).<\/p>\n<figure id=\"attachment_1059\" aria-describedby=\"caption-attachment-1059\" style=\"width: 479px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-1059\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Daniel_Tani_iss016e027910.jpg\" alt=\"12.1\" width=\"479\" height=\"467\"><figcaption id=\"caption-attachment-1059\" class=\"wp-caption-text\"><em>Figure 12.2.3 It is important for astronauts to exercise on board the International Space Station to help counter the loss of muscle mass that occurs because they are weightless without Earth\u2019s gravity.<\/em><\/figcaption><\/figure>\n<p>Many diseases, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2148\">cancer<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2159\">AIDS<\/a>, are often associated with muscle atrophy. Atrophy of muscles also\u00a0happens\u00a0with age. As people grow older, there is a gradual decrease in the ability to maintain skeletal muscle mass, known as\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4163\">sarcopenia<\/a>.<\/strong>\u00a0The exact cause of sarcopenia is not known, but one possible cause is a decrease in sensitivity to growth factors that are needed to maintain muscle mass. Because muscle size determines strength, muscle atrophy causes a corresponding decline in muscle strength.<\/p>\n<p>In both hypertrophy and atrophy, the number of muscle fibres does not change. What changes is the size of the muscle fibres. When muscles hypertrophy, the individual fibres become wider. When muscles atrophy, the fibres become narrower.<\/p>\n<div>\n<h1>Interactions with Other Body Systems<\/h1>\n<\/div>\n<p>Muscles cannot contract on their own. Skeletal muscles need stimulation from motor neurons in order to contract. The point where a motor neuron attaches to a muscle is called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4164\">neuromuscular junction<\/a><\/strong>. Let\u2019s say you decide to raise your hand in class. Your brain sends electrical messages through motor neurons to your arm and shoulder. The motor neurons, in turn, stimulate muscle fibres in your arm and shoulder to contract, causing your arm to rise.<\/p>\n<p>Involuntary contractions of smooth and cardiac muscles are also controlled by electrical impulses, but in the case of these muscles, the impulses come from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2533\">autonomic nervous system<\/a> (smooth muscle) or specialized cells in the heart (cardiac muscle). <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2218\">Hormones<\/a> and some other factors also influence involuntary contractions of cardiac and smooth muscles. For example, the fight-or-flight hormone adrenaline increases the rate at which cardiac muscle contracts, thereby speeding up the heartbeat.<\/p>\n<p>Muscles cannot move the body on their own. They need the skeletal system to act upon. The two systems together are often referred to as the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4165\">musculoskeletal system<\/a><\/strong>. Skeletal muscles are attached to the skeleton by tough connective tissues called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4166\">tendons<\/a><\/strong>. Many skeletal muscles are attached to the ends of bones that meet at a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3949\">joint<\/a>. The muscles span the joint and connect the bones. When the muscles contract, they pull on the bones, causing them to move. The skeletal system provides a system of levers that allow body movement. The muscular system provides the force that moves the levers.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.2 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_5023_2907\">muscular system<\/a> consists of all the muscles of the body. There are three types of muscle: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">skeletal muscle<\/a> (which is attached to bones and enables <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3004\">voluntary<\/a> body movements), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2568\">cardiac muscle<\/a> (which makes up the walls of the heart and makes it beat), and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscle<\/a> (which is found in the walls of internal organs and other internal structures and controls their movements).<\/li>\n<li>Muscles are organs composed mainly of muscle cells, which may also be called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4156\">muscle fibres<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4157\">myocytes<\/a>. Muscle cells are specialized for the function of contracting, which occurs when protein filaments inside the cells slide over one another using energy in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2072\">ATP<\/a>.<\/li>\n<li>Muscles can grow larger, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4159\">hypertrophy<\/a>. This generally occurs through increased use (physical exercise), although hormonal or other influences can also play a role. Muscles can also grow smaller, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4160\">atrophy<\/a>. This may occur through lack of use, starvation, certain diseases, or aging. In both hypertrophy and atrophy, the size \u2014 but not the number \u2014 of muscle fibres changes. The size of muscles is the main determinant of muscle strength.<\/li>\n<li>Skeletal muscles need the stimulus of motor neurons to contract, and to move the body, they need the skeletal system to act upon. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3005\">Involuntary<\/a> contractions of cardiac and smooth muscles are controlled by special cells in the heart, nerves of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2533\">autonomic nervous system<\/a>, hormones, or other factors.<\/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\">12.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the muscular system?<\/li>\n<li>Describe muscle cells and their function.<\/li>\n<li>Identify three types of muscle\u00a0tissue\u00a0and where each type is found.<\/li>\n<li>Define muscle hypertrophy and muscle atrophy.<\/li>\n<li>What are some possible causes of muscle hypertrophy?<\/li>\n<li>Give three reasons that muscle atrophy may occur.<\/li>\n<li>How do muscles change when they increase or decrease in size?<\/li>\n<li>How do changes in muscle size affect strength?<\/li>\n<li>Explain why astronauts can easily lose muscle mass in space.<\/li>\n<li>Describe how the terms\u00a0<em>muscle cells<\/em>,\u00a0<em>muscle fibres<\/em>, and\u00a0<em>myocytes<\/em>\u00a0relate to each other.<\/li>\n<li>\n<div id=\"h5p-216\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-216\" class=\"h5p-iframe\" data-content-id=\"216\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"12.2 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Name two systems in the body that work together with the muscular system to carry out movements.<\/li>\n<li>Describe one way in which the muscular system is involved in regulating body temperature.<\/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\">12.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=VVL-8zr2hk4<\/p>\n<p style=\"text-align: center\">How your muscular system works - Emma Bryce, TED-Ed, 2017.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=Ujr0UAbyPS4&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">3D Medical Animation - Peristalsis in Large Intestine\/Bowel || ABP \u00a9, AnimatedBiomedical, 2013.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=LkXwfTsqQgQ&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Muscle matters: Dr Brendan Egan at TEDxUCD, TEDx Talks, 2014.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.2.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Natalia_Zabolotnaya_2012b.jpg\" rel=\"cc:attributionURL\">Natalia_Zabolotnaya_2012b<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/10287726@N02\" rel=\"nofollow\">Simon Q<\/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\/deed.en) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 12.2.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bougle_whole2_retouched.png\" rel=\"cc:attributionURL\">Bougle_whole2_retouched<\/a> by <a href=\"https:\/\/locatorplus.gov\/cgi-bin\/Pwebrecon.cgi?SC=Author&amp;SA=Bougle%CC%81%2C%20Julien%2E&amp;PID=gqesdtV7B_MJOCmbavf7c_g&amp;BROWSE=1&amp;HC=4&amp;SID=2\">Bougl\u00e9, Julien<\/a> from the <a href=\"https:\/\/www.nlm.nih.gov\/exhibition\/historicalanatomies\/bougle_home.html\">National LIbrary of Medicine (NLM)<\/a> on Wikimedia Commons is in the <a class=\"mw-redirect\" title=\"Public domain\" href=\"https:\/\/commons.wikimedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 12.2.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Daniel_Tani_iss016e027910.jpg\" rel=\"cc:attributionURL\">Daniel_Tani_iss016e027910<\/a> by <a href=\"https:\/\/spaceflight.nasa.gov\/gallery\/images\/station\/crew-16\/html\/iss016e027910.html\">NASA\/ International Space Station Imagery<\/a> on Wikimedia Commons\u00a0is in the <a class=\"mw-redirect\" title=\"Public domain\" href=\"https:\/\/commons.wikimedia.org\/wiki\/Public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">AnimatedBiomedical. (2013, January 30). 3D Medical animation - Peristalsis in large intestine\/bowel || ABP \u00a9. YouTube. https:\/\/www.youtube.com\/watch?v=Ujr0UAbyPS4&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Bougle\u0301, J. (1899). Le corps humain en grandeur naturelle : planches colorie\u0301es et superpose\u0301es, avec texte explicatif. J. B. Baillie\u0300re et fils. In <em>Historical Anatomies on the Web<\/em>. http:\/\/www.nlm.nih.gov\/exhibition\/historicalanatomies\/bougle_home.html<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, October 26). How your muscular system works - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=VVL-8zr2hk4&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2014, June 27). Muscle matters: Dr Brendan Egan at TEDxUCD. YouTube. https:\/\/www.youtube.com\/watch?v=LkXwfTsqQgQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 15). Natalya Zabolotnaya. In\u00a0<i>Wikipedia.<\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=Natalya_Zabolotnaya&amp;oldid=962630409<\/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_5023_5925\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5925\"><div tabindex=\"-1\"><p>Involuntary, striated muscle found only in the walls of the heart; also called myocardium.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_2982\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2982\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 333px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4169\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Look-by-ali-yahya-155huuQwGvA-unsplash-scaled-1.jpg\" alt=\"12.3.1 Eyes\" width=\"333\" height=\"500\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.1 \"Eye\" can see you.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Work Those Eye Muscles!<\/h1>\n<\/div>\n<p>Imagine the man in Figure 12.3.1 turns his eyes in your direction. This is a very small movement, considering the conspicuously large and strong external eye muscles that control eyeball movements. These muscles have been called the strongest muscles in the human body relative to the work they do. However, the external eye muscles actually do a surprising amount of work. Eye movements occur almost constantly during waking hours, especially when we are scanning faces or reading. Eye muscles are also exercised nightly during the phase of sleep called rapid eye movement sleep. External eye muscles can move the eyes because they are made mainly of muscle tissue.<\/p>\n<div>\n<h1>What is Muscle Tissue?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2817\">Muscle tissue<\/a><\/strong>\u00a0is a soft tissue that makes up most of the tissues in the muscles of the human muscular system. Other tissues in muscles\u00a0are\u00a0connective tissues, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4166\">tendons<\/a>\u00a0that attach\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">skeletal muscles<\/a>\u00a0to\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2552\">bones<\/a>\u00a0and sheaths of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2815\">connective tissues<\/a>\u00a0that cover or line muscle tissues. Only muscle tissue <em>per se<\/em>, has cells with the ability to contract.<\/p>\n<p>There are three major types of muscle tissues in the human body: skeletal, smooth, and cardiac muscle tissues. Figure 12.3.2 shows how the three types of muscle tissues appear under magnification. When you read about each type below, you will learn why the three types appear as they do.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 535px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-511\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Skeletal_Smooth_Cardiac.jpg\" alt=\"12.3 Muscle types\" width=\"535\" height=\"900\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.2 These magnified images show (a) skeletal muscle tissue, (b) smooth muscle tissue, and (c) cardiac muscle tissue.<\/em><\/figcaption><\/figure>\n<div>\n<h2>Skeletal Muscle Tissue<\/h2>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">Skeletal muscle<\/a><\/strong>\u00a0is muscle tissue that is attached to\u00a0bones\u00a0by\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4166\">tendons<\/a>, <\/strong>which are bundles of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3970\">collagen<\/a> fibres. Whether you are moving your eyes or running a marathon, you are using skeletal muscles. Contractions of skeletal muscles are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3004\">voluntary<\/a>, or under conscious control of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2579\">central nervous system<\/a> via the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3014\">somatic nervous system<\/a>. Skeletal muscle tissue is the most common type of muscle tissue in the human body. By weight, an average adult male is about 42% skeletal muscles, and the average adult female is about 36% skeletal muscles. Some of the major skeletal muscles in the human body are labeled in Figure 12.3.3 below.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 387px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/wp-content\/uploads\/sites\/6\/2019\/06\/Anterior_and_Posterior_Views_of_Muscles-scaled.jpg\"><img class=\"wp-image-4171\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Anterior_and_Posterior_Views_of_Muscles-scaled-1.jpg\" alt=\"12.4.3 Major Skeletal muscles\" width=\"387\" height=\"900\"><\/a><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.3 Major skeletal muscles of the body. View this image full size here: <a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/wp-content\/uploads\/sites\/6\/2019\/06\/Anterior_and_Posterior_Views_of_Muscles-scaled.jpg\" aria-label=\"Image of Major Skeletal muscles\">http:\/\/humanbiology.pressbooks.tru.ca\/wp-content\/uploads\/sites\/6\/2019\/06\/Anterior_and_Posterior_Views_of_Muscles-scaled.jpg<\/a> <br \/><\/em><\/figcaption><\/figure>\n<h2>Skeletal Muscle Pairs<\/h2>\n<p>To move bones in opposite directions, skeletal muscles often consist of muscle pairs that work in opposition to one another, also called antagonistic muscle pairs.\u00a0 For example, when the biceps muscle (on the front of the upper arm) contracts, it can cause the elbow joint to flex or bend the arm, as shown in Figure 12.3.4. When the triceps muscle (on the back of the upper arm) contracts, it can cause the elbow to extend or straighten the arm. The biceps and triceps muscles, also shown in Figure 12.3.4, are an example of a muscle pair where the muscles work in opposition to each other.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1072\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Antagonistic-Muscle-Pair-by-CK-12-Foundation.jpg\" alt=\"12.3 Antagonistic Muscle Pair\" width=\"500\" height=\"427\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\">Figure 12.3.4 Triceps and biceps muscles in the upper arm are opposing muscles that move the arm at the elbow in opposite directions.<\/figcaption><\/figure>\n<h2>Skeletal Muscle Structure<\/h2>\n<p>Each skeletal muscle consists of hundreds \u2014 or even\u00a0<em>thousands<\/em> \u2014 of skeletal muscle fibres, which are long, string-like cells. As shown in Figure 12.3.5 below, skeletal muscle fibres are individually wrapped in connective tissue called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4173\">endomysium<\/a><\/strong>. The skeletal muscle fibres are bundled together in units called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4174\">muscle fascicles<\/a><\/strong>, which\u00a0are surrounded by sheaths of connective tissue\u00a0called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4175\">perimysium<\/a><\/strong>. Each fascicle contains between ten and 100 (or even more!) skeletal muscle fibres. Fascicles, in turn, are bundled together to form individual skeletal muscles, which are wrapped in connective tissue called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4176\">epimysium<\/a><\/strong>. The connective tissues in skeletal muscles have a variety of functions. They support and protect muscle fibres, allowing them to withstand the forces of contraction by distributing the forces applied to the muscle. They also provide pathways for nerves and blood vessels to reach the muscles. In addition, the epimysium anchors the muscles to tendons.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 675px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1074 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Muscle_Fibes_large.jpg\" alt=\"11.3.5 Muscle Fibers Structure\" width=\"675\" height=\"741\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.5 Each skeletal muscle has a structure of bundles within bundles. Bundles of muscle fibres make up a muscle fascicle, and bundles of fascicles make up a skeletal muscle. At each level of bundling, a connective tissue membrane surrounds the bundle.<\/em><\/figcaption><\/figure>\n<p>The same bundles-within-bundles structure is replicated within each muscle fibre. As shown in Figure 12.3.6, a muscle fibre consists of a bundle of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a>, which are themselves bundles of protein filaments. These protein filaments consist of thin filaments of the protein <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4181\"><strong>actin<\/strong><\/a>, which are anchored to structures called Z discs, and thick filaments of the protein <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4182\"><strong>myosin<\/strong><\/a>. The filaments are arranged together within a myofibril in repeating units called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a>,<\/strong> which run from one Z disc to the next. The sarcomere is the basic functional unit of skeletal and cardiac muscles. It contracts as actin and myosin filaments slide over one another. Skeletal muscle tissue is said to be striated, because it appears striped. It has this appearance because of the regular, alternating A (dark) and I (light) bands of filaments arranged in sarcomeres inside the muscle fibres. Other components of a skeletal muscle fibre include multiple nuclei and mitochondria.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 801px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-1075\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Muscle_Fibers_small.jpg\" alt=\"11.3 Sarcomere\" width=\"801\" height=\"642\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.6 Bundles of protein filaments form a myofibril, and bundles of myofibrils make up a single muscle fibre. I and A bands refer to the positioning of myosin and actin fibres in a myofibril. Sarcoplasmic reticulum is a specialized type of endoplasmic reticulum that forms a network around each myofibril. It serves as a reservoir for calcium ions, which are needed for muscle contractions. H zones and Z discs are also involved in muscle contractions, which you can read about in the concept Muscle Contraction.<\/em><\/figcaption><\/figure>\n<h2>Slow- and Fast-Twitch Skeletal Muscle Fibres<\/h2>\n<p>Skeletal muscle fibres can be divided into two types, called slow-twitch (or type I) muscle fibres and fast-twitch (or type II) muscle fibres.<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4184\">Slow-twitch muscle fibres<\/a><\/strong> are dense with capillaries and rich in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a> and myoglobin, which is a protein that stores oxygen until needed for muscle activity. Relative to fast-twitch fibres, slow-twitch fibres can carry more oxygen and sustain aerobic (oxygen-using) activity. Slow-twitch fibres can contract for long periods of time, but not with very much force. They are relied upon primarily in endurance events, such as distance running or cycling.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4185\">Fast-twitch muscle fibres<\/a><\/strong> contain fewer capillaries and mitochondria and less myoglobin. This type of muscle fibre can contract rapidly and powerfully, but it fatigues very quickly. Fast-twitch fibres can sustain only short, anaerobic (non-oxygen-using) bursts of activity. Relative to slow-twitch fibres, fast-twitch fibres contribute more to muscle strength and have a greater potential for increasing in mass. They are relied upon primarily in short, strenuous events, such as sprinting or weightlifting.<\/li>\n<\/ul>\n<p>Proportions of fibre types vary considerably from muscle to muscle and from person to person. Individuals may be genetically predisposed to have a larger percentage of one type of muscle fibre than the other. Generally, an individual who has more slow-twitch fibres is better suited for activities requiring endurance, whereas an individual who has more fast-twitch fibres is better suited for activities requiring short bursts of power.<\/p>\n<div>\n<h1>Smooth Muscle<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">Smooth muscle<\/a><\/strong>\u00a0is muscle tissue in the walls of internal organs and other internal structures such as\u00a0blood vessels. When smooth muscles contract, they help the organs and vessels carry out their functions.\u00a0When smooth muscles in the stomach wall contract, for example, they squeeze the food inside the stomach, helping to mix and churn the food and break it into smaller pieces. This is an important part of digestion. Contractions of smooth muscles are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3005\">involuntary<\/a>, so they are not under conscious control. Instead, they are controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2935\">autonomic\u00a0nervous system<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2218\">hormones<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3056\">neurotransmitters<\/a>, and other physiological factors.<\/p>\n<h2>Structure of Smooth Muscle<\/h2>\n<p>The\u00a0cells\u00a0that make up smooth muscle are generally called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4157\">myocytes<\/a>. <\/strong>Unlike the muscle fibres of striated muscle tissue, the myocytes of smooth muscle tissue do not have their filaments arranged in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a>. Therefore, smooth tissue is not striated. However, the myocytes of smooth muscle do contain <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a>, which in turn contain bundles of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4182\">myosin<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4181\">actin<\/a> filaments. The filaments cause contractions when they slide over each other, as shown in Figure 12.3.7.<\/p>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1076 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Smooth_Muscle_Contraction.jpg\" alt=\"11.3.7 Smooth Muscle Contraction\" width=\"1024\" height=\"212\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.7 The basic mechanism of muscle contraction in smooth muscle is the same as that in other types of muscle tissue.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Functions of Smooth Muscle<\/span><\/p>\n<\/div>\n<p>Unlike striated muscle, smooth muscle can sustain very long-term contractions. Smooth muscle can also stretch and still maintain its contractile function, which striated muscle cannot. The elasticity of smooth muscle is enhanced by an extracellular matrix secreted by myocytes. The matrix consists of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4187\">elastin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3970\">collagen<\/a>, and other stretchy fibres. The ability to stretch and still contract is an important attribute of smooth muscle in organs such as the stomach and uterus (see Figures 12.3.8 and 12.3.9), both of which must stretch considerably as they perform their normal functions.<\/p>\n<table class=\"no-lines aligncenter\" style=\"border-collapse: collapse;width: 51.6508%;height: 383px\" border=\"0\">\n<tbody>\n<tr style=\"height: 473px\">\n<td style=\"width: 675.063px;text-align: center;height: 473px\">\n<figure id=\"attachment_1079\" aria-describedby=\"caption-attachment-1079\" style=\"width: 358px\" class=\"wp-caption alignleft\"><img class=\"wp-image-1079\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0747_Pregnancy.png\" alt=\"11.3.8 Uterus Smooth Muscle\" width=\"358\" height=\"358\"><figcaption id=\"caption-attachment-1079\" class=\"wp-caption-text\"><em>Figure 12.3.8 The muscular uterine wall stretches to a great extent to accommodate a growing fetus, yet it can still contract with great force during the labour that precedes childbirth. At that time, it can exert up to 100 pounds of force.<\/em><\/figcaption><\/figure>\n<\/td>\n<td style=\"width: 676.063px;height: 473px\">\n<figure id=\"attachment_1080\" aria-describedby=\"caption-attachment-1080\" style=\"width: 320px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1080\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Size_of_Uterus_Throughout_Pregnancy-02.jpg\" alt=\"12.3.9 Growing uterus.\" width=\"320\" height=\"427\"><figcaption id=\"caption-attachment-1080\" class=\"wp-caption-text\"><em>Figure 12.3.9 The uterus will continue to expand further into the abdominal cavity as pregnancy progresses.<\/em><\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"text-align: left\">The following list indicates where many smooth muscles are found, along with some of their specific functions.<\/p>\n<ul>\n<li>Walls of organs of the gastrointestinal tract (such as the esophagus, stomach, and intestines), moving food through the tract by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a><\/li>\n<li>Walls of air passages of the respiratory tract (such as the bronchi), controlling the diameter of the passages and the volume of air that can pass through them<\/li>\n<li>Walls of organs of the male and female reproductive tracts; in the uterus, for example, pushing a baby out of the uterus and into the birth canal<\/li>\n<li>Walls of structures of the\u00a0urinary system, including the urinary bladder, allowing the bladder to expand so it can hold more urine, and then contract as urine is released<\/li>\n<li>Walls of\u00a0blood vessels, controlling the diameter of the vessels and thereby affecting\u00a0blood\u00a0flow and\u00a0blood pressure<\/li>\n<li>Walls of lymphatic vessels, squeezing the fluid called lymph through the vessels<\/li>\n<li>Iris of the\u00a0eyes, controlling the size of the pupils and thereby the amount of light entering the eyes<\/li>\n<li>Arrector pili in the skin, raising hairs in\u00a0hair\u00a0follicles in the\u00a0dermis<\/li>\n<\/ul>\n<div>\n<h1>Cardiac Muscle<\/h1>\n<\/div>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 441px\" class=\"wp-caption alignright\"><img class=\" wp-image-1082\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0470_HeartWall.png\" alt=\"11.3 Cardiac Muscle\" width=\"441\" height=\"441\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.10 The thick wall of the heart consists mainly of cardiac muscle tissue called myocardium.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2568\">Cardiac muscle<\/a><\/strong> is found only in the wall of the heart. It is also called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4191\">myocardium<\/a>. As shown in Figure 12.3.10, myocardium is enclosed within connective tissues, including the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4193\">endocardium<\/a> on the inside of the heart and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4194\">pericardium<\/a> on the outside of the heart. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac muscle cells in an area of the heart muscle called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4195\">sinoatrial node<\/a>.<\/p>\n<p>Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a> inside the muscle fibres. However, in cardiac muscle, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a> are branched at irregular angles rather than arranged in parallel rows (as they are in skeletal muscle). This explains why cardiac and skeletal muscle tissues look different from one another.<\/p>\n<p>The cells of cardiac muscle tissue are arranged in interconnected networks. This arrangement allows rapid transmission of electrical impulses, which stimulate virtually simultaneous contractions of the cells. This enables the cells to coordinate contractions of the heart muscle.<\/p>\n<p>The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Although the power output of the heart is much less than the maximum power output of some other muscles in the human body, the heart does its work continuously over an entire lifetime without rest. Cardiac muscle contains a great many <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a>, which produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2072\">ATP<\/a> for\u00a0energy\u00a0and help the heart resist fatigue.<\/p>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<figure id=\"attachment_1085\" aria-describedby=\"caption-attachment-1085\" style=\"width: 330px\" class=\"wp-caption alignleft\"><img class=\" wp-image-1085\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Tipet_e_kardiomiopative.png\" alt=\"12.3 Types of Cardiomyopathy\" width=\"330\" height=\"456\"><figcaption id=\"caption-attachment-1085\" class=\"wp-caption-text\"><em>Figure 12.3.11 Cardiomyopathy results in decreased ability of the heart to circulate blood properly through the body. There are several types of cardiomyopathy.<\/em><\/figcaption><\/figure>\n<p>Cardiomyopathy is a disease in which the muscles of the heart are no longer able to effectively pump blood to the body \u2014 extreme forms of this disease can lead to heart failure.\u00a0 There are four main types of cardiomyopathy (also illustrated in Figure 12.3.11):<\/p>\n<ul>\n<li>Dilated (congestive) cardiomyopathy: the left ventricle (the chamber itself) of the heart becomes enlarged and can't pump blood our to the body.\u00a0 This is normally related to coronary artery disease and\/or heart attack<\/li>\n<li>Hypertrophic cardiomyopathy: abnormal thickening of the muscular walls of the left ventricle make the chamber less able to work properly.\u00a0 This condition is more common in patients with a family history of the disease.<\/li>\n<li>Restrictive cardiomyopathy: the myocardium becomes abnormally rigid and inelastic and is unable to expand in between heartbeats to refill with blood.\u00a0 Restrictive cardiomyopathy typically affects older people.<\/li>\n<li>Arrhythmogenic right ventricular cardiomyopathy: the right ventricular muscle is replaced by adipose or scar tissue, reducing elasticity and interfering with normal heartbeat and rhythm.\u00a0 This disease is often caused by genetic mutations.<\/li>\n<\/ul>\n<p>Cardiomyopathy is typically diagnosed with a physical exam supplemented by medical and family history, an angiogram, blood tests, chest x-rays and electrocardiograms.\u00a0 In some cases your doctor would also requisition a CT scan and\/or genetic testing.<\/p>\n<p>When treating cardiomyopathy, the goal is to reduce symptoms that affect everyday life.\u00a0 Certain medications can help regularize and slow heart rate, decrease chances of blood clots and cause vasodilation in the coronary arteries.\u00a0 If medication is not sufficient to manage symptoms, a pacemaker or even a heart transplant may be the best option.\u00a0 Lifestyle can also help manage the symptoms of cardiomyopathy \u2014 people living with this disease are encouraged to avoid drug and alcohol use, control high blood pressure, eat a healthy diet, get ample rest and exercise, as well as reduce stress levels.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">12.3 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_5023_2817\">Muscle tissue<\/a> is a soft tissue that makes up most of the tissues in the muscles of the human muscular system. It is the only type of tissue that has cells with the ability to contract.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">Skeletal muscle<\/a> tissue is attached to bones by tendons. It allows <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3004\">voluntary<\/a> body movements.<\/li>\n<li>Skeletal muscle\u00a0is the most common type of muscle tissue in the human body. To move <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2552\">bones<\/a>\u00a0in opposite directions, skeletal muscles often consist of pairs of muscles that work in opposition to one another to move bones in different directions at\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3949\">joints<\/a>.<\/li>\n<li>Skeletal muscle fibres are bundled together in units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4174\">muscle fascicles<\/a>, which are bundled together to form individual skeletal muscles. Skeletal muscles also have connective tissue supporting and protecting the muscle tissue.<\/li>\n<li>Each skeletal muscle fibre consists of a bundle of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a>, which are bundles of protein filaments. The filaments are arranged in repeating units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a>, which are the basic functional units of skeletal muscles. Skeletal muscle tissue is striated because of the pattern of sarcomeres in its fibres.<\/li>\n<li>Skeletal muscle fibres can be divided into two types, called<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4184\"> slow-twitch<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4185\">fast-twitch fibres<\/a>. Slow-twitch fibres are used mainly in aerobic endurance activities, such as long-distance running. Fast-twitch fibres are used mainly for non-aerobic, strenuous activities, such as sprinting. Proportions of the two types of fibres vary from muscle to muscle and person to person.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">Smooth muscle<\/a> tissue is found in the walls of internal organs and vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. Contractions of smooth muscles are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3005\">involuntary<\/a> and controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2935\">autonomic\u00a0nervous system<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2218\">hormones<\/a>, and other substances.<\/li>\n<li>Cells of smooth muscle tissue are not striated because they lack sarcomeres, but the cells contract in the same basic way as striated muscle cells. Unlike striated muscle, smooth muscle can sustain very long-term contractions and maintain its contractile function, even when stretched.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2568\">Cardiac muscle<\/a> tissue is found only in the wall of the heart. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac cells.<\/li>\n<li>Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres inside the muscle fibres. However, the myofibrils are branched instead of arranged in parallel rows, making cardiac and skeletal muscle tissues look different from one another.<\/li>\n<li>The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Its cells contain a great many <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a> to produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2072\">ATP<\/a> for\u00a0energy\u00a0and help the heart resist fatigue.<\/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\">12.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is muscle tissue?<\/li>\n<li>\n<div id=\"h5p-220\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-220\" class=\"h5p-iframe\" data-content-id=\"220\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"12.3 Muscular Tissue Flashcards\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-221\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-221\" class=\"h5p-iframe\" data-content-id=\"221\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"12.3 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Where is skeletal muscle found, and what is its general function?<\/li>\n<li>Why do many skeletal muscles work in pairs?<\/li>\n<li>Describe the structure of a skeletal muscle.<\/li>\n<li>Relate muscle fibre structure to the functional units of muscles.<\/li>\n<li>Why is skeletal muscle tissue striated?<\/li>\n<li>Where is smooth muscle found? What controls the contraction of smooth muscle?<\/li>\n<li>Where is cardiac muscle found? What controls its contractions?<\/li>\n<li>The heart muscle is smaller and less powerful than some other muscles in the body. Why is the heart the muscle that performs the greatest amount of physical work in the course of a lifetime? How does the heart resist fatigue?<\/li>\n<li>Give one example of connective tissue that is found in muscles. Describe one of its functions.<\/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\">12.3 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=3_PYnWVoUzM<\/p>\n<p style=\"text-align: center\">What happens during a heart attack? - Krishna Sudhir, TED-Ed, 2017.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=bwOE1MEginA&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Three types of muscle | Circulatory system physiology | NCLEX-RN | KhanAcademyMedicine, 2012.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.3.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/155huuQwGvA\" rel=\"cc:attributionURL\">Look by ali-yahya-155huuQwGvA<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@ayahya09\">Ali Yahya<\/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 12.3.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:414_Skeletal_Smooth_Cardiac.jpg\" rel=\"cc:attributionURL\">Skeletal_Smooth_Cardiac<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-4-muscle-tissue-and-motion\">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 12.3.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1105_Anterior_and_Posterior_Views_of_Muscles.jpg\" rel=\"cc:attributionURL\">Anterior_and_Posterior_Views_of_Muscles<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/11-2-naming-skeletal-muscles\">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 12.3.4<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-biology\/section\/21.3\/\" rel=\"cc:attributionURL\">Antagonistic Muscle Pair<\/a> by <span class=\"ImageAttribution__Details-sc-133gw9p-2 dJAIm\"><span class=\"ImageAttribution__Value-sc-133gw9p-5 gaNGPC\">Laura Guerin at <\/span><\/span><span class=\"ImageAttribution__Details-sc-133gw9p-2 dJAIm\"><span class=\"ImageAttribution__Value-sc-133gw9p-5 gaNGPC\"><a href=\"https:\/\/www.ck12.org\/book\/ck-12-biology\/section\/21.3\/\">CK-12 Foundation<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\">CC BY-NC 3.0<\/a><\/span><\/span><span class=\"ImageAttribution__Details-sc-133gw9p-2 dJAIm\"><span class=\"ImageAttribution__Value-sc-133gw9p-5 gaNGPC\">\u00a0(https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/) license.\u00a0<\/span><\/span><\/p>\n<div><img src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/logo_ck12.png\" alt=\"\"> <span style=\"font-size: 1em\">\u00a9<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/\">CK-12 Foundation<\/a> <span style=\"font-size: 1em\">Licensed under\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\"><img class=\"alignnone size-full wp-image-8217\" title=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/icon_licence.png\" alt=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\"><\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/terms-of-use\/\">Terms of Use<\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/attribution\/\">Attribution<\/a><\/div>\n<p><strong>Figure 12.3.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1007_Muscle_Fibes_(large).jpg\" rel=\"cc:attributionURL\">Muscle_Fibes_(large)<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-2-skeletal-muscle\">OpenStax <\/a>on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong>Figure 12.3.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1022_Muscle_Fibers_(small).jpg\" rel=\"cc:attributionURL\">Muscle_Fibers_(small)<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-2-skeletal-muscle\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong>Figure 12.3.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1028_Smooth_Muscle_Contraction.jpg\" rel=\"cc:attributionURL\">Smooth_Muscle_Contraction<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-8-smooth-muscle\">OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0) license.<\/p>\n<p><strong>Figure 12.3.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0747_Pregnancy.png\" rel=\"cc:attributionURL\">Blausen_0747_Pregnancy<\/a> 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\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 12.3.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2917_Size_of_Uterus_Throughout_Pregnancy-02.jpg\" rel=\"cc:attributionURL\">Size_of_Uterus_Throughout_Pregnancy-02<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/28-4-maternal-changes-during-pregnancy-labor-and-birth\">OpenStax College<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 12.3.10<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0470_HeartWall.png\" rel=\"cc:attributionURL\">1024px-Blausen_0470_HeartWall<\/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\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 12.3.11<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Tipet_e_kardiomiopative.png\" rel=\"cc:attributionURL\">Tipet_e_kardiomiopative<\/a>\u00a0by <a class=\"extiw\" title=\"en:User:Npatchett\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Npatchett\">Npatchett<\/a> at English Wikipedia 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. (Work derived from <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0165_Cardiomyopathy_Dilated.png\">Blausen 0165 Cardiomyopathy Dilated<\/a>\u00a0by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus)<\/a><\/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). <span class=\"os-title-label\">Figure\u00a0<\/span><span class=\"os-number\">4.18<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"26615\" class=\"os-title\" data-type=\"title\">Muscle tissue<\/span> [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 4.4). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-4-muscle-tissue-and-motion<\/p>\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, June 19). Figure 28.18 Size of uterus throughout pregnancy [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 28.4). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/28-4-maternal-changes-during-pregnancy-labor-and-birth<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). <\/span><\/span><\/span>Figure 10.3 The three connective tissue layers <span id=\"94180\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 10.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-2-skeletal-muscle<\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure\u00a0<span class=\"os-number\">10.4<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"30047\" class=\"os-title\" data-type=\"title\">Muscle fiber <\/span><\/span><\/span><\/span><span id=\"94180\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 10.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-2-skeletal-muscle<\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). <\/span><\/span><\/span>Figure 10.24 Muscle contraction <span id=\"94180\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 10.8). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-8-smooth-muscle<\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 18). Figure\u00a0<span class=\"os-number\">11.5<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"94180\" class=\"os-title\" data-type=\"title\">Overview of the muscular system<\/span><\/span><\/span><\/span><span id=\"94180\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1596597506261\" data-highlight-id=\"f552fda7-3392-4a0a-aece-7927947757b3\" data-highlighted=\"true\"><span class=\"search-highlight text\" data-timestamp=\"1596597506359\" data-highlight-id=\"ee4f675e-15b6-447b-bbd6-a729a2b5f3dc\" data-highlighted=\"true\">\u00a0[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 11.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/11-2-naming-skeletal-muscles<\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2012). Figure 5 Triceps and biceps muscles in the upper arm are opposing muscles. [digital image]. In <em>CK-12 Biology<\/em> (Section 21.3) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-biology\/section\/21.3\/ (Last modified August 11, 2017.)<\/p>\n<p class=\"hanging-indent\">khanacademymedicine. (2012, October 19). Three types of muscle | Circulatory system physiology | NCLEX-RN | Khan Academy. YouTube.<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, February 14).\u00a0 What happens during a heart attack? - Krishna Sudhir. YouTube. https:\/\/www.youtube.com\/watch?v=3_PYnWVoUzM&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_5023_4156\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4156\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-267\">\n<div class=\"h5p-content\" data-content-id=\"267\"><\/div>\n<\/div>\n<p><em>Figure 6.7.1 Men from <span class=\"_20NLS _1ByhS\">Maasai Mara, Kenya.<\/span><\/em><\/p>\n<h1>Built for Heat<\/h1>\n<p>These tall, slender men live near the equator in Kenya, East Africa \u2014 one of the hottest regions of the world. These and the other people of his tribal group, called the Maasai, are among the tallest, most linear people on the planet. Their body build is thought to be an adaptation to their climate, which is hot year-round.<\/p>\n<div>\n<h1>Climate Extremes<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2741\">Climate<\/a><\/strong>\u00a0refers to the average weather conditions in a region over a long period of time. One of the main determinants of climate is temperature. Both hot and cold temperatures are serious environmental stresses on the human body.<\/p>\n<p>In the cold, there is risk of\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2742\">hypothermia<\/a>,<\/strong>\u00a0which is a dangerous decrease in core body temperature. The normal temperature of the human body is 37 degrees C (98.6 degrees F). Hypothermia sets in when body temperature drops to 34.4 degrees C (94 degrees F). If body temperature falls below 29.4 degrees C (85 degrees F), it starts to cool very rapidly because the body\u2019s temperature regulation mechanism starts to fail.<\/p>\n<p>The opposite problem occurs in the heat, where the risk is\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2743\">hyperthermia<\/a>,<\/strong>\u00a0which is a dangerous increase in core body temperature. If human body temperature rises above about 40.6 degrees C (105 degrees F), hyperthermia may become life threatening. If a temperature this high persists more than a few days, it generally damages the brain and other internal organs, leading to death.<\/p>\n<div>\n<h2>Human Adaptation to Heat and Cold<\/h2>\n<\/div>\n<p>Humans are the most widespread species on the planet, and they have lived in extreme climates for tens of thousands of years.\u00a0As a result, many human populations have had to cope with extreme temperatures for hundreds of generations, which has\u00a0forced\u00a0them to develop genetic adaptations to these climate extremes.<\/p>\n<p>The size and proportions of the human body may play an important role in how well an individual is able to handle hot or cold temperatures. In general, people with a tall, slender build, like the Maasai man pictured in Figure 6.7.1, are well adapted to heat, whereas people with a short, stocky build (like the Indigenous North American Inuit pictured in Figure 6.7.2) are well adapted to cold. These relationships between body build and climate were first noticed in other animal species in the 1800s by biologists Carl Bergmann and Joel Allen. These scientists formulated what are now known as Bergmann\u2019s and Allen\u2019s rules.<\/p>\n<div id=\"h5p-268\">\n<div class=\"h5p-content\" data-content-id=\"268\"><\/div>\n<\/div>\n<p><em>Figure 6.7.2 Indigenous North American Inuit.<\/em><\/p>\n<h3>Bergmann\u2019s Rule<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2748\">Bergmann's rule<\/a><\/strong>\u00a0states that within a broadly distributed taxonomic group, populations or species of larger size are found in colder environments, whereas populations or species of smaller size are found in warmer environments. Bergmann\u2019s rule has been shown to generally apply to widespread species of mammals and birds, although there are also many exceptions to the rule.<\/p>\n<p>What explains Bergmann\u2019s rule? Larger animals have a lower surface area to volume ratio than smaller animals, which is illustrated in Table 6.7.1 for a simple shape, a cube. From the table, you can see how the surface area to volume ratio of a cube decreases dramatically as the size of the cube increases. Because heat is lost through the surface of the body, an animal with a smaller surface area to volume ratio radiates less body heat per unit of mass. The larger body mass also allows the animal to generate more heat. A larger animal has more cells, so it can produce more body heat as a byproduct of cellular metabolism. Both of these factors allow a larger animal to stay warmer in a cold climate.<\/p>\n<p><strong>Table 6.7.1<\/strong><\/p>\n<p><em>Relationship of Surface Area to Volume in Cubes of Different Sizes<\/em><\/p>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 55.62%;height: 175px\" border=\"0\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 99.9275%;text-align: center\" colspan=\"4\"><strong>Relationship of Surface Area to Volume in Cubes of Different Sizes<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\"><strong>Side of Cube (cm)<\/strong><\/td>\n<td style=\"height: 14px;width: 27.8476%\"><strong>Surface Area of Cube (cm<\/strong><strong>2<\/strong><strong>)<\/strong><\/td>\n<td style=\"height: 14px;width: 22.8146%\"><strong>Volume of Cube (cm<\/strong><strong>3<\/strong><strong>)<\/strong><\/td>\n<td style=\"height: 14px;width: 25.6717%\"><strong>Surface Area:Volume Ratio<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\">2<\/td>\n<td style=\"height: 14px;width: 27.8476%\">24<\/td>\n<td style=\"height: 14px;width: 22.8146%\">8<\/td>\n<td style=\"height: 14px;width: 25.6717%\">3:1<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\">4<\/td>\n<td style=\"height: 14px;width: 27.8476%\">96<\/td>\n<td style=\"height: 14px;width: 22.8146%\">64<\/td>\n<td style=\"height: 14px;width: 25.6717%\">3:2<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\">6<\/td>\n<td style=\"height: 14px;width: 27.8476%\">216<\/td>\n<td style=\"height: 14px;width: 22.8146%\">216<\/td>\n<td style=\"height: 14px;width: 25.6717%\">3:3<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\">12<\/td>\n<td style=\"height: 14px;width: 27.8476%\">864<\/td>\n<td style=\"height: 14px;width: 22.8146%\">1728<\/td>\n<td style=\"height: 14px;width: 25.6717%\">3:6<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"height: 14px;width: 23.5936%\">20<\/td>\n<td style=\"height: 14px;width: 27.8476%\">2400<\/td>\n<td style=\"height: 14px;width: 22.8146%\">8000<\/td>\n<td style=\"height: 14px;width: 25.6717%\">3:10<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Warmer climates impose the opposite problem: body heat generated by metabolism needs to be dissipated quickly rather than stored within the body. Smaller animals have a higher surface area to volume ratio that maximizes heat loss through the surface of the body and helps cool the body. With less mass and fewer cells, smaller animals also generate less heat due to cellular metabolism.<\/p>\n<figure id=\"attachment_2752\" aria-describedby=\"caption-attachment-2752\" style=\"width: 432px\" class=\"wp-caption alignleft\"><img class=\" wp-image-2752\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Bergmanns_rule_-_Canis_lupus-1.jpg\" alt=\"Bergmann's Rule\" width=\"432\" height=\"568\"><figcaption id=\"caption-attachment-2752\" class=\"wp-caption-text\"><em>Figure 6.7.3 According to Bergmann's Rule, species of larger size are found in colder environments and species of smaller size are found in warmer regions.<\/em><\/figcaption><\/figure>\n<p>Anthropologists have found that many human populations tend to follow Bergmann\u2019s rule. For example, a study of 100 human populations in the 1950s found a strong negative correlation between mean body mass and average yearly temperature. In other words, higher body mass was generally found in colder places, and lower body mass was generally found in hotter places.<\/p>\n<p>There are also exceptions to the rule, in part because we use cultural responses to temper environmental stresses so we do not need to change genetically or physiologically in order to cope.\u00a0Humans, for example, use clothing and heated buildings to stay warm in cold climates, which tends to counter the effects of natural selection changing human body shape in cold climates.<\/p>\n<h2>Allen\u2019s Rule<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3533\">Allen\u2019s rule<\/a><\/strong>\u00a0is a corollary of Bergmann\u2019s rule. It states that animals living in hotter climates generally have longer extremities (such as limbs, tails, snouts, and ears) than closely related animals living in colder climates. The explanation for Allen\u2019s rule is similar to the rationale behind Bergmann\u2019s rule. Longer extremities maximize an animal\u2019s surface area, allowing greater heat loss through the surface of the body. Therefore, having long extremities is adaptive in hot climates where the main challenge is dissipating body heat.<\/p>\n<p>Anthropologists have noted that, in populations that have lived in tropical regions for long periods of time, the limbs of people tend to be longer in proportion to overall body height. The Maasai man pictured in Figure 6.7.1 is a clear example. His exceptionally long limbs \u2014 like those of other members of his population \u2014 are optimally proportioned for the hot climate in Kenya. The shorter-limbed body proportions of the Inuit people (Figure 6.7.2) suit them well for their cold climate. Marked differences in limb length have also been observed in related populations that have lived for long periods of time at different altitudes. High altitudes have colder climates than lower altitudes and \u2014 consistent with Allen's rule \u2014people tend to have shorter limbs at higher altitudes.<\/p>\n<div>\n<h1>Other Human Responses to Heat<\/h1>\n<\/div>\n<p>Humans exhibit several other responses to high temperatures that are generally considered either short-term physiological responses or examples of longer-term acclimatization.<\/p>\n<h2>Sweating and Humidity<\/h2>\n<figure id=\"attachment_2753\" aria-describedby=\"caption-attachment-2753\" style=\"width: 346px\" class=\"wp-caption alignright\"><img class=\"wp-image-2753\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Sweating-by-avi-richards-yzLvKZuK4hs-unsplash-scaled-2.jpg\" alt=\"\" width=\"346\" height=\"461\"><figcaption id=\"caption-attachment-2753\" class=\"wp-caption-text\"><em>Figure 6.7.4 Sweating is a normal response to heat stress.<\/em><\/figcaption><\/figure>\n<p>Because humans are basically tropical animals, we generally have an easier time dealing with excessive heat than excessive cold. Evaporation of sweat is the main way we cool the body. The dancer in Figure 6.7.4 is sweating copiously while working out in a hot environment. Why does sweating cool us? When sweat evaporates from the skin, it requires heat. The heat comes from the surface of the body, resulting in evaporative cooling.<\/p>\n<div>\n<p><span style=\"text-align: initial;font-size: 1em\">How well we can deal with high air temperatures depends in large part on the humidity of the air. We have a harder time losing excess body heat when the humidity is high because our sweat does not evaporate as well as it does when the humidity is low. Instead, the sweat stays on the skin, making us feel clammy and warmer than we would feel if the humidity were lower. If the air is dry, on the other hand, sweat evaporates readily, and we feel more comfortable. For this reason, we are able to tolerate higher temperatures when the humidity is low. This is the basis of the common aphorism, \u201cIt\u2019s not the heat, but the humidity.\u201d<\/span><\/p>\n<\/div>\n<p>The\u00a0<strong>heat index (HI)<\/strong> is a number that combines air temperature and relative humidity to indicate how hot the air feels due to the humidity. The heat index is also called \"apparent temperature.\u201d Figure 6.7.5 shows the heat index at different combinations of air temperature and relative humidity. As you can see, when the humidity is very high, even a 90-degree F (32 degrees C) temperature can be very dangerous.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_2754\" aria-describedby=\"caption-attachment-2754\" style=\"width: 638px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-2754\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Heat_Index-1.gif\" alt=\"NOAA's Natonal Weather Service Heat Index - this graph shows the the likelihood of dangerous heat disorders increasing with prolonged exposure or strenuous activity in relation to increased humidity and temperature. \" width=\"638\" height=\"431\"><figcaption id=\"caption-attachment-2754\" class=\"wp-caption-text\"><em>Figure 6.7.5 NOAA's National Weather Service Heat Index <\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Acclimatization to Heat<\/span><\/p>\n<\/div>\n<figure id=\"attachment_2755\" aria-describedby=\"caption-attachment-2755\" style=\"width: 269px\" class=\"wp-caption alignright\"><img class=\"wp-image-2755\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Thirsty-by-dylan-alcock-q5kso2Wjsog-unsplash-scaled-2.jpg\" alt=\"\" width=\"269\" height=\"179\"><figcaption id=\"caption-attachment-2755\" class=\"wp-caption-text\"><em>Figure 6.7.6 Thirsty! The loss of water in hot temperatures may cause severe dehydration if the water is not replaced by drinking much more than usual.\u00a0<\/em><\/figcaption><\/figure>\n<p>If humidity is low, evaporation of sweat can be an effective way to keep the body from overheating. However, the loss of water and salts in sweat can also be dangerous. In very hot conditions, an adult may lose up to four litres of sweat per hour and up to 14 litres per day. Such water losses may cause severe dehydration if the water is not replaced by drinking much more than usual. The loss of salts may also upset the normal salt balance in the body, which can be dangerous. Becoming acclimatized to heat by gradually increasing the exposure time to high temperatures \u2014 particularly while exercising or doing physical work \u2014 can reduce the risk of these effects.<\/p>\n<p>It may take up to 14 days to attain maximum heat acclimatization. As the body becomes acclimatized, sweat output increases, and sweating begins sooner. The salt content of the sweat also declines, as does the output of urine. These and other physiological changes help the body lose heat through the evaporation of sweat, while maintaining the proper balance of salts and fluids in the body. There may also be increased blood flow to the body surface through the widening of blood vessels near the skin. This is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2756\">vasodilation<\/a>.<\/strong>\u00a0This brings more heat from the body core to the skin, and from there it may be radiated out into the environment.<\/p>\n<p>Becoming acclimatized to heat allows one to safely perform more exercise or work in the heat. It also helps prevent heat-related illnesses\u00a0by reducing\u00a0strain on the body. Heat-related illnesses \u2014 from least to most serious \u2014 include heat cramps, heat exhaustion, and heat stroke.<\/p>\n<ul>\n<li>Heat cramps are muscle spasms caused by loss of water and salts. They often follow prolonged sweating brought on by over-exertion in hot weather.<\/li>\n<li>Heat exhaustion is a condition in which over-heating of the body causes dizziness, headache, profuse sweating, rapid heartbeat. and other symptoms. Without prompt treatment, heat exhaustion can lead to heat stroke.<\/li>\n<li>Heat stroke is potentially life threatening and a medical emergency. Heat stroke results from prolonged exposure to high temperatures, usually in combination with dehydration. It leads to failure of the body's temperature control system and is diagnosed when the core body temperature exceeds 105 degrees F (40 degrees C). Symptoms may include nausea, seizures, confusion, disorientation, and coma.<\/li>\n<\/ul>\n<p>Acclimatization to heat, like other types of acclimatization, is a reversible process. Just as quickly as heat acclimatization occurs, the physiological changes fade away in the absence of heat exposure. The body returns to its baseline state within a week or two of no longer exercising or working at high temperatures.<\/p>\n<div>\n<h1>Other Human Responses to Cold<\/h1>\n<\/div>\n<p>Besides genetic difference in body build, there are two major ways the human body can respond to the cold. One way is by producing more body heat, and the other way is by conserving more body heat. An immediate response to cooling of the body is shivering. This is an involuntary and simultaneous contraction of many tiny muscles in the body. These muscle contractions generate a small amount of heat. Another early response to cold temperature is a narrowing of blood vessels near the skin. This is called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3942\">vasoconstriction<\/a>. <\/strong>This helps to shunt blood away from the body surface so more heat is held at the body core. The skin cools down and radiates less heat into the environment.<\/p>\n<h2>Hunting Response<\/h2>\n<p>At temperatures below freezing, vasoconstriction can be dangerous if it lasts too long. The extremities become too cold because of lack of blood flow, and cold injury (such as frostbite) may occur.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5956\">Frostbite<\/a><\/strong> is tissue destruction that occurs when tissue freezes. You can see a mild-to-moderate case of frostbite of the fingers in Figure 6.7.7. If frostbite is severe, it may lead to gangrene and amputation of the affected extremities.<\/p>\n<figure id=\"attachment_2757\" aria-describedby=\"caption-attachment-2757\" style=\"width: 378px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2757\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Frostbitten_hands-1.jpg\" alt=\"\" width=\"378\" height=\"249\"><figcaption id=\"caption-attachment-2757\" class=\"wp-caption-text\"><em>Figure 6.7.7 Even moderate frostbite may produce blistering of the affected skin.<\/em><\/figcaption><\/figure>\n<p>The body counters the possibility of cold injury with a reaction called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5957\">hunting response<\/a>. <\/strong>This is a process of alternating vasoconstriction and vasodilation in extremities exposed to cold. About five to ten minutes after the start of cold exposure, the blood vessels in the extremities suddenly dilate, which increases blood flow and subsequently the temperature of the extremities. This is soon followed by another phase of vasoconstriction, and then the process repeats.<\/p>\n<p>The hunting response occurs in most people, but several factors may influence the strength of the response. People who live or work regularly in cold environments show an increased hunting response.\u00a0Through acclimatization, however, tropical residents can develop an increased response, which is indistinguishable from that of arctic residents. Genetic factors may play a role in the hunting response, but this is uncertain because it is difficult to differentiate between adaptation and acclimatization.<\/p>\n<h2>Persistent Vasoconstriction<\/h2>\n<p>Where temperatures rarely fall below freezing but are repeatedly very chilly, the hunting response may not occur. Instead, vasoconstriction may persist to keep heat within the body at the expense of cooling the skin. As long as the temperature stays above freezing, cold injury (such as frostbite) will not occur. This type of response has been shown to occur in indigenous desert dwellers in southern Africa and Australia, where the temperature is hot during the day and very cold at night. People in these populations also tend to deposit fat around the organs in their chest and abdomen. The fat serves as insulation, protecting vital structures from the cold.<\/p>\n<h2>High-Fat Diet<\/h2>\n<p>Besides shivering, another way to increase body heat is to\u00a0raise\u00a0the basal metabolic rate. The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3813\">basal metabolic rate<\/a> (BMR)<\/strong>\u00a0is the amount of energy that a person needs to keep the body functioning at rest. The higher the BMR, the\u00a0more heat the body generates,\u00a0even without exercise or physical labor. The BMR can be increased by consuming large quantities of high-calorie fatty foods. People living in very cold subarctic regions, including the Inuit, traditionally ate whale and seal blubber and other high-fat foods, which helped them maintain a high BMR and stay warm.<\/p>\n<div id=\"h5p-269\">\n<div class=\"h5p-content\" data-content-id=\"269\"><\/div>\n<\/div>\n<p><em>Figure 6.7.8\u00a0 Whale and seal blubber (mainly on abundant ring seals) is an important part of the traditional Inuit diet.\u00a0<\/em><\/p>\n<div>\n<h3>Feature: Human Biology in the News<\/h3>\n<\/div>\n<p>Too many news stories report young children being seriously injured or dying from heat stroke in hot vehicles. On average, 38 children die in hot vehicles each year from heat-related deaths after being trapped inside. Most often, this happens by accident, when a parent or caregiver unknowingly leaves a sleeping child in a car. In other cases, children get into cars on their own, and then cannot get out again.<\/p>\n<p>A child\u2019s thermoregulatory system is not as efficient as that of an adult, and a child\u2019s body temperature may increase as much as five times faster. This makes children prime candidates for heat stroke. A motor vehicle is also easily heated by direct sun. The windows of the vehicle allow solar radiation to pass through and heat up objects inside. A dark-coloured dashboard or seat may quickly reach a temperature of more than 180 degrees F (82 degrees C)! These hot surfaces can just as quickly heat the adjacent air, rapidly increasing the temperature of the air trapped inside the vehicle.<\/p>\n<p>Here are several simple tips that parents and caregivers can follow to prevent heat stroke tragedies:<\/p>\n<ul>\n<li>Never leave children alone in or around cars \u2014 not even for a minute.<\/li>\n<li>Always open the back door and check the back seat before leaving your vehicle to be sure no child has been left behind.<\/li>\n<li>Put something you will need, such as your cell phone or handbag, in the back seat so you will have to open the back door to retrieve it whenever you park the car.<\/li>\n<li>Keep a large stuffed animal in the child's car seat, and when the child is placed in the car seat, put the stuffed animal in the front passenger seat as a visual reminder that the child is in the back.<\/li>\n<li>Make sure you have a strict policy in place with everyone involved in the care of your child that you should always be called whenever your child does not show up at daycare or school as scheduled.<\/li>\n<li>Keep vehicles locked at all times, even in driveways and garages. Ask home visitors, child care providers, and neighbors to do the same.<\/li>\n<li>Keep car keys and remote vehicle openers out of reach of children.<\/li>\n<li>If a child is missing, immediately check the inside passenger compartments and trunks of all vehicles in the area. Check vehicles even if they are locked, because a child may lock a vehicle after entering and not be able to unlock it again to get out.<\/li>\n<li>If you see a child alone in a vehicle, call 911 immediately. If the child seems hot or sick, get them out of the vehicle as quickly as possible.<\/li>\n<li>Pay for gas at the pump and use drive-throughs at the bank, pharmacy, or wherever else they are available.<\/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\">6.7 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Both hot and cold temperatures are serious environmental stresses on the human body. In the cold, there is risk of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2742\">hypothermia<\/a>, which is a dangerous decrease in core body temperature. In the heat, there is risk of<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2743\"> hyperthermia<\/a>, which is a dangerous increase in core body temperature.<\/li>\n<li>According to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2748\">Bergmann\u2019s rule<\/a>, body size tends to be negatively correlated with temperature, because larger body size increases heat production and decreases heat loss. The opposite holds true for small body size. Bergmann\u2019s rule applies to many human populations that are hot- or cold-adapted.<\/li>\n<li>According to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3533\">Allen\u2019s rule<\/a>, the length of body extremities is positively correlated with temperature, because longer extremities are better at dissipating excess body heat. The opposite applies to shorter extremities. Allen\u2019s rule applies to relative limb lengths in many human populations that have adapted to heat or cold.<\/li>\n<li>Sweating is the primary way that humans lose body heat. The evaporation of sweat from the skin cools the body. This only works well when the relative humidity is fairly low. At high relative humidity, sweat does not readily evaporate to cool us down. The heat index (HI) indicates how hot it feels due to the humidity.<\/li>\n<li>Gradually working longer and harder in the heat can bring about heat acclimatization, in which the body has improved responses to heat stress. For example, sweating starts earlier, sweat contains less salt, and vasodilation brings heat to the surface to help cool the body. Full acclimatization takes up to 14 days and reverses just as quickly when the heat stress is removed.<\/li>\n<li>The human body can respond to cold by producing more heat (by shivering or increasing the basal metabolic rate) or by conserving heat (by vasoconstriction at the body surface or a layer of fat-insulating internal organs).<\/li>\n<li>At temperatures below freezing, the hunting response occurs to prevent cold injury, such as frostbite. This is a process of alternating vasoconstriction and vasodilation in extremities that are exposed to dangerous cold. Where temperatures are repeatedly cold but rarely below freezing, the hunting response may not occur, and the skin may remain cold due to vasoconstriction alone.<\/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\">6.7 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Compare and contrast hypothermia and hyperthermia.<\/li>\n<li>State Bergmann\u2019s and Allen\u2019s rules.<\/li>\n<li>How do the Maasai and Inuit match the predictions based on Bergmann\u2019s and Allen\u2019s rules?<\/li>\n<li>Explain how sweating cools the body.<\/li>\n<li>What is the heat index?<\/li>\n<li>Relate the heat index to evaporative cooling of the body.<\/li>\n<li>Identify three heat-related illnesses, from least to most serious.<\/li>\n<li>How does heat acclimatization occur?<\/li>\n<li>State two major ways the human body can respond to the cold, and give an example of each.<\/li>\n<li>Explain how and why the hunting response occurs.<\/li>\n<li>Define basal metabolic rate.<\/li>\n<li>How does a high-fat diet help prevent hypothermia?<\/li>\n<li>Explain why frostbite most commonly occurs in the extremities, such as the fingers and toes.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<p><strong>\u00a0<\/strong><\/p>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.7 Explore More<\/span><\/h1>\n<p>&nbsp;<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=PpHM4DfPZQU<\/p>\n<p style=\"text-align: center\">What happens when you get heat stroke? - Douglas J. Casa, TED-Ed, 2014.<\/p>\n<p>https:\/\/youtu.be\/_Ifq73REJiM<\/p>\n<p style=\"text-align: center\">Hailstones' Inupiaq Traditions | Life Below Zero, National Geographic, 2014.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=1L7EI0vKVuU<\/p>\n<p style=\"text-align: center\">How An Igloo Keeps You Warm, It's Okay To Be Smart, 2017.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=fctH_1NuqCQ&amp;t=<\/p>\n<p style=\"text-align: center\">Why do we sweat? - John Murnan, TED-Ed, 2018.<\/p>\n<p>https:\/\/www.youtube.com\/watch?time_continue=44&amp;v=j3sY67aGFXY&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Wim Hof Method, Wim Hof, 2011.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 6.7.1<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Maasai_warrior.jpg\">Maasai warrior<\/a> by <a title=\"User:Ninaras\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Ninaras\">Ninaras<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\">CC BY 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/XNs-qGCVVoI\">Smiling man from <\/a><span class=\"_20NLS _1ByhS\">Maasai Mara, Kenya by <a href=\"https:\/\/unsplash.com\/@sneha_snaps\">Sneha<\/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).\u00a0<\/span><\/li>\n<\/ul>\n<p><strong>Figure 6.7.2<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Inuit-Kleidung_1.jpg?uselang=lv\">Inuit-Kleidung women<\/a> by <a class=\"mw-userlink\" title=\"User: Ansgar Walk\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Ansgar_Walk\">Ansgar Walk<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.lv\">CC BY-SA 3.0<\/a>\u00a0(https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.lv) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Kulusuk,_Inuit_couple_(6822265499).jpg\"> Kulusuk, Tunumiit Inuit couple<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/67769030@N07\" rel=\"nofollow\">Arian Zwegers<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en) license.<\/li>\n<li>\n<div id=\"yui_3_16_0_1_1594911766921_735\" class=\"view attribution-view requiredToShowOnServer clear-float photo-attribution\">\n<div class=\"attribution-info\"><a href=\"https:\/\/www.flickr.com\/photos\/susanvg\/4893451989\">Inuit girls<\/a>\u00a0by <a class=\"owner-name truncate\" title=\"Go to Susan van Gelder's photostream\" href=\"https:\/\/www.flickr.com\/photos\/susanvg\/\" data-track=\"attributionNameClick\">Susan van Gelder<\/a> on <a href=\"http:\/\/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.<\/div>\n<\/div>\n<div id=\"yui_3_16_0_1_1594911766921_993\" class=\"view sub-photo-title-desc-view requiredToShowOnServer\"><\/div>\n<\/li>\n<\/ul>\n<p><strong>Figure 6.7.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bergmann%27s_rule_-_Canis_lupus.jpg\" rel=\"cc:attributionURL\">Bergmann\u2019s_rule_-_Canis_lupus<\/a>\u00a0by <a class=\"new\" title=\"User:Dhaval Vargiya (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Dhaval_Vargiya&amp;action=edit&amp;redlink=1\">Dhaval Vargiya<\/a> at <a href=\"https:\/\/www.flickr.com\/people\/80223459@N05\">Yellowstone National Park<\/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 6.7.4<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/yzLvKZuK4hs\" rel=\"cc:attributionURL\">Sweating<\/a> [photo] by <a href=\"https:\/\/unsplash.com\/@avirichards?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Avi Richards<\/a> <span class=\"_20NLS _1ByhS\">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).\u00a0<\/span><\/p>\n<p><strong>Figure 6.7.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Heat_Index.gif\" rel=\"cc:attributionURL\">Heat_Index<\/a>\u00a0by <a href=\"https:\/\/en.wikipedia.org\/wiki\/National_Oceanic_and_Atmospheric_Administration\">U.S. National Oceanic and Atmospheric Administration<\/a> (NOAA) 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 6.7.6<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/@dylan_alcock?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\" rel=\"cc:attributionURL\">Thirsty<\/a> [photo] by <a href=\"https:\/\/unsplash.com\/@dylan_alcock?utm_source=unsplash&amp;utm_medium=referral&amp;utm_content=creditCopyText\">Dylan Alcock<\/a> <span class=\"_20NLS _1ByhS\">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).\u00a0<\/span><\/p>\n<p><strong>Figure 6.7.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Frostbitten_hands.jpg\" rel=\"cc:attributionURL\">Frostbitten_hands<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/photos\/83654635@N00\" rel=\"nofollow\">Winky from Oxford, UK<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en) license.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 6.7.8<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Ringed_seal_1_2000-08-13.jpg\">Ringed seal preparation<\/a> by <a class=\"mw-userlink\" title=\"User: Ansgar Walk\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Ansgar_Walk\">Ansgar Walk<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.5\/deed.en\">CC BY-SA 2.5<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.5\/deed.en) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/weartpix\/4077647821\/in\/album-72157622616021123\/\">Butchering a narwhal<\/a> by <a class=\"owner-name truncate\" title=\"Go to Spencer &amp; Carole's photostream\" href=\"https:\/\/www.flickr.com\/photos\/weartpix\/\" data-track=\"attributionNameClick\">Spencer &amp; Carole<\/a> on <a href=\"http:\/\/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.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/gridarendal\/31713208470\">Inuit children playing while the family is on seal hunt,<\/a>\u00a0by <a class=\"owner-name truncate\" title=\"Go to GRID-Arendal's photostream\" href=\"https:\/\/www.flickr.com\/photos\/gridarendal\/\" data-track=\"attributionNameClick\">GRID-Arendal<\/a> on <a href=\"http:\/\/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.<\/li>\n<\/ul>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">It's Okay To Be Smart. (2017, January 9). How an igloo keeps you warm. YouTube. https:\/\/www.youtube.com\/watch?v=1L7EI0vKVuU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">National Geographic. (2014, April 7). Hailstones' Inupiaq traditions | Life below zero. YouTube. https:\/\/www.youtube.com\/watch?v=_Ifq73REJiM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2014, July 21). What happens when you get heat stroke? - Douglas J. Casa. YouTube. https:\/\/www.youtube.com\/watch?v=PpHM4DfPZQU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2018, May 15). Why do we sweat? - John Murnan. YouTube. https:\/\/www.youtube.com\/watch?v=fctH_1NuqCQ&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wim Hof. (2011, June 19). Wim Hof Method. YouTube. https:\/\/www.youtube.com\/watch?v=j3sY67aGFXY&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_5023_4157\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4157\"><div tabindex=\"-1\"><p>Created by: CK-12\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_5997\" aria-describedby=\"caption-attachment-5997\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5997\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Milk-Mustache-from-Flickr-CC-BY-SA-Cedar-Summit-Farm-1.jpg\" alt=\"6.10.1\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-5997\" class=\"wp-caption-text\"><em>Figure 6.10.1 Milk mustache!<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Got Lactase?<\/span><\/p>\n<p>Do you remember the American \u201cgot milk?\u201d slogan from the 1990s?\u00a0 It was used in advertisements for milk in which celebrities were pictured wearing milk \u201cmustaches.\u201d While the purpose of the \u201cgot milk?\u201d ads was to sell more milk, there is no denying that drinking milk can actually be good for one\u2019s health. Milk is naturally high in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3721\">protein<\/a> and minerals. It can also be low in fat or even fat-free if treated to remove the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3559\">lipids<\/a> that naturally occur in milk. However, before you reach for a tall, cold glass of milk,\u00a0 you might want to ask yourself another question: \u201cgot lactase?\u201d<\/p>\n<div>\n<h1>Adaptation to Lactose<\/h1>\n<\/div>\n<p>Do you drink milk? Or do you avoid drinking milk and consuming milk products because they cause you discomfort? If the latter is the case, then you may have trouble digesting milk.<\/p>\n<h2>Milk, Lactose, and Lactase<\/h2>\n<p>Milk naturally contains\u00a0more than just\u00a0proteins and lipids \u2014 it also contains carbohydrates. Specifically, milk contains the sugar\u00a0<strong>lactose<\/strong>, which is a disaccharide (two-sugar) compound that consists of one molecule each of galactose and glucose, as shown in the structural formula below (Figure 6.8.2). Lactose makes up between two and eight per cent of milk by weight. The exact amount varies both within and between species.<\/p>\n<figure id=\"attachment_2766\" aria-describedby=\"caption-attachment-2766\" style=\"width: 311px\" class=\"wp-caption alignnone\"><img class=\"wp-image-2766\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-Lactose_Haworth.svg_-1.png\" alt=\"\" width=\"311\" height=\"275\"><figcaption id=\"caption-attachment-2766\" class=\"wp-caption-text\"><em>Figure 6.8.2 Each molecule of lactose consists of one molecule of galactose (left) and one molecule of glucose (right).<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"text-align: initial;font-size: 1em\">Lactose in milk must be broken down into its two component sugars to be absorbed by the small intestine. The enzyme <\/span><strong style=\"text-align: initial;font-size: 1em\">lactase<\/strong><span style=\"text-align: initial;font-size: 1em\"> is needed for this process, as shown in <\/span><span style=\"text-align: initial;font-size: 1em\">Figure 6.8.3<\/span><span style=\"text-align: initial;font-size: 1em\">. Human infants are almost always born with the ability to synthesize lactase. This allows them to readily digest the lactose in their mother\u2019s milk (or infant formula). In the majority of children, however, lactase synthesis begins to decline at about two years of age, and less and less lactase is produced throughout childhood.<\/span><\/p>\n<\/div>\n<figure id=\"attachment_2767\" aria-describedby=\"caption-attachment-2767\" style=\"width: 1024px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-2767\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Lactase-1.png\" alt=\"\" width=\"1024\" height=\"192\"><figcaption id=\"caption-attachment-2767\" class=\"wp-caption-text\"><em>Figure 6.8.3 The enzyme lactase is needed to break down the milk sugar lactose into its galactose and glucose components.<\/em><\/figcaption><\/figure>\n<h2>Lactose Intolerance<\/h2>\n<p><strong>Lactose intolerance<\/strong>\u00a0is the inability of older children and adults to digest lactose in milk. People who are lactose intolerant may be able to drink small quantities of milk without any problems, but if they try to consume larger amounts, they are likely to suffer adverse effects. For example, they may have abdominal bloating and cramping, flatulence (gas), diarrhea, nausea, and vomiting. The symptoms may occur from 30 minutes\u00a0to two hours after milk is consumed, and\u00a0they're\u00a0generally worse when the quantity of milk consumed is greater. The symptoms result from the small intestine's inability to digest and absorb lactose, so the lactose is passed on to the large intestine, where normal intestinal bacteria start breaking it down through the process of fermentation. This process releases gas and causes the other symptoms of lactose intolerance.<\/p>\n<p>Lactose intolerance is actually the original and normal condition of the human species, as well as\u00a0all other mammalian species. Early humans were hunter-gatherers that subsisted on wild plant and animal foods. The animal foods may have included meat and eggs, but did not include milk because animals had not been domesticated. Therefore, beyond the weaning period, milk was not available for people to drink in early human populations. It makes good biological sense to stop synthesizing an enzyme that the body does not need. After a young child is weaned, it is a waste of materials and energy to keep producing lactase when milk is no longer likely to be consumed.<\/p>\n<p>Overall, an estimated 60 per cent of the world\u2019s adult human population is thought to be lactose intolerant today. You can see the geographic distribution of modern human lactose intolerance on the map in Figure 6.8.4. Lactose intolerance (dark blue) approaches 100 per cent in populations throughout southern South America, southern Africa, and East and Southeast Asia.<\/p>\n<div>\n<figure id=\"attachment_2768\" aria-describedby=\"caption-attachment-2768\" style=\"width: 765px\" class=\"wp-caption alignnone\"><img class=\" wp-image-2768\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Lactose-Intolerance-1.png\" alt=\"Worldwide map of Lactose Intolerance\" width=\"765\" height=\"381\"><figcaption id=\"caption-attachment-2768\" class=\"wp-caption-text\"><em>Figure 6.8.4 Worldwide distribution of lactose intolerance in human populations.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Lactose intolerance is not considered a medical problem, because its symptoms can be avoided by avoiding milk or milk products. Dietary control of lactose intolerance may be a matter of trial and error, however, because different people may be able to consume different quantities of milk or milk products before symptoms occur. If you are lactose intolerant, be aware that low-fat and fat-free milk may contain somewhat more lactose than full-fat milk because the former often have added milk solids that are relatively high in lactose.<\/p>\n<h2>Lactase Persistence<\/h2>\n<p><strong>Lactase persistence<\/strong> is the opposite of lactose intolerance. People who are lactase persistent continue to produce the enzyme lactase beyond infancy and generally throughout life. As a consequence they are able to digest lactose and drink milk at older ages without adverse effects. The map in Figure 6.8.4 can also be read to show where lactase persistence occurs today. Populations with a low percentage of lactose intolerance (including most North Americans and Western and Northern Europeans) have high percentages of lactase-persistent people.<\/p>\n<p>Lactase persistence is a uniquely human trait that is not found in any other mammalian species. Why did lactase persistence evolve in humans? When some human populations began domesticating and keeping herds of animals, animal milk became a potential source of food. Animals such as cows, sheep, goats, camels, and even reindeer (see Figure 6.8.5) can be kept for their milk. These animal milks also contain lactose, so natural selection would be strong for any individuals who kept producing lactase beyond infancy and could make use of this nutritious food. Eventually, the trait of lactase persistence would increase in frequency and come to be the predominant trait in dairying populations.<\/p>\n<figure id=\"attachment_2769\" aria-describedby=\"caption-attachment-2769\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-2769\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Reindeer_herding-1.jpg\" alt=\"\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-2769\" class=\"wp-caption-text\"><em>Figure 6.8.5 The Sami were traditionally reindeer herders and their population is nearly 100% lactase persistent. Few Sami still herd reindeer today, but their lactase persistence has persisted.<\/em><\/figcaption><\/figure>\n<p>It is likely that lactase persistence occurs as a result of both genes and environment. Some people inherit genes that help them keep producing lactase after infancy. Geneticists think that several different mutations for lactase persistence arose independently in different populations within the last ten thousand years. Part of lactase persistence may be due to continued exposure to milk in the childhood and adulthood diet. In other words, a person may be genetically predisposed to synthesize lactase at older ages because of a mutation, but they may need the continued stimulation of milk drinking to keep producing lactase.<\/p>\n<div>\n<h1>Thrifty Gene or Drifty Gene?<\/h1>\n<\/div>\n<p>Besides variation in lactase persistence, human populations may vary in how efficiently they use calories in the foods they consume. People in some populations seem able to get by on quantities of food that would be inadequate for others, so they tend to gain weight easily. What explains these differences in people?<\/p>\n<h2>Thrifty Gene Hypothesis<\/h2>\n<p>In 1962, human geneticist <a href=\"https:\/\/en.wikipedia.org\/wiki\/James_V._Neel\">James Neel<\/a> proposed the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2770\">thrifty gene hypothesis<\/a><\/strong>. According to this hypothesis, so-called \u201cthrifty genes\u201d evolved in some human populations because they allowed people to get by on fewer calories and store the rest as body fat when food was plentiful. According to Neel\u2019s hypothesis, thrifty genes would have increased in frequency through natural selection, because they would help people survive during times of famine. People with the genes would be fatter and able to rely on their stored body fat for calories when food was scarce.<\/p>\n<p>Such thrifty genes would have been advantageous in early human populations of hunter-gatherers if food scarcity was a recurrent stress. However, in modern times, when most people have access to enough food year-round, thrifty genes would no longer be advantageous. In fact, under conditions of plentiful food, having thrifty genes would predispose people to gain weight and develop obesity. They would also tend to develop the chronic diseases associated with obesity, particularly type II diabetes.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2771\">Diabetes mellitus<\/a><\/strong>\u00a0is a disease that occurs when there are problems with the pancreatic hormone\u00a0<strong>insulin,<\/strong>\u00a0which normally helps cells take up glucose from the blood and controls blood glucose levels. In type II diabetes, body cells become relatively resistant to insulin, leading to high blood glucose. This causes symptoms\u00a0like\u00a0excessive thirst and urination. Without treatment, diabetes can lead to serious consequences, such as blindness and kidney failure.<\/p>\n<p>Neel proposed his thrifty gene hypothesis not on the basis of genetic evidence for thrifty genes, but as a possible answer to the mystery of why genes that seem to promote diabetes have not been naturally selected out of some populations. The mystery arose from observations that certain populations \u2014 such as South Pacific Islanders, sub-Saharan Africans, and southwestern Native Americans \u2014 developed high levels of obesity and diabetes after they abandoned traditional diets and adopted Western diets.<\/p>\n<h2>Assessing the Thrifty Gene Hypothesis<\/h2>\n<p>One of the assumptions underlying the thrifty gene hypothesis is that human populations that recently developed high rates of obesity and diabetes after Western contact had a long history of recurrent famine. Anthropological evidence contradicts this assumption for at least some of the populations in question. South Pacific Islanders, for example, have long lived in a \u201cland of plenty,\u201d with lush tropical forests year-round on islands surrounded by warm waters full of fish. Another assumption underlying the thrifty gene hypothesis is that hunter-gatherer people became significantly fatter during periods of plenty. Again, there is little or no evidence that hunter-gatherers traditionally deposited large fat stores when food was readily available.<\/p>\n<p>Some geneticists have searched directly for so-called thrifty genes. Studies have revealed many genes with small effects associated with obesity or diabetes. However, these genes can explain only a few percentage points of the total population variation in obesity or diabetes.<\/p>\n<h2>The Drifty Gene and Other Hypotheses<\/h2>\n<p>Given the lack of evidence for the thrifty gene hypothesis, several researchers have suggested alternative hypotheses to explain population variation in obesity and diabetes. One hypothesis posits that susceptibility to obesity and diabetes may be a side effect of heat <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3771\">adaptation<\/a>. According to this idea, some populations evolved lower metabolic rates as an adaptation to heat stress, because lower metabolic rates reduced the amount of heat that the body produced. The lower metabolic rates also predisposed people to gain excess weight and develop obesity and diabetes.<\/p>\n<p>A thrifty phenotype hypothesis has also been proposed. This hypothesis suggests that individuals who have inadequate nutrition during fetal development might develop an insulin-resistant phenotype. The insulin-resistant phenotype would supposedly prepare these individuals for a life of famine, based on the environment within the womb. In a famine-free environment, however, the thrifty phenotype would lead to the development of diabetes.<\/p>\n<p>The most recent alternative to the thrifty gene hypothesis is the drifty gene hypothesis, which was proposed by biologist <a href=\"https:\/\/en.wikipedia.org\/wiki\/John_Speakman\">John Speakman<\/a>. He argues that genes protecting humans from obesity were under strong natural selection pressure for a very long period of time while human ancestors were subject to the risk of predation. According to this view, being able to outrun predators would have been an important factor selecting against fatness. When the risk of predation was lessened \u2014 perhaps as early as two million years ago \u2014 genes keeping fatness in check would no longer be selected for. Without selective pressure for these genes, their frequencies could change randomly due to genetic drift. In some populations, by chance, frequencies of the genes could decrease to relatively low levels, whereas in other populations the frequencies could be much higher.<\/p>\n<div>\n<h1>Feature: Myth vs. Reality<\/h1>\n<\/div>\n<figure id=\"attachment_2772\" aria-describedby=\"caption-attachment-2772\" style=\"width: 267px\" class=\"wp-caption alignright\"><img class=\"wp-image-2772\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Milk-Photo-by-Eiliv-Sonas-Aceron-on-Unsplash-scaled-2.jpg\" alt=\"\" width=\"267\" height=\"400\"><figcaption id=\"caption-attachment-2772\" class=\"wp-caption-text\"><em>Figure 6.8.6 Even if you are lactose intolerant, you may be able to drink milk or consume other dairy products without suffering adverse physical symptoms.<\/em><\/figcaption><\/figure>\n<p><strong>Myth:<\/strong>\u00a0Lactose intolerance is an allergy to milk.<\/p>\n<p><strong>Reality:<\/strong> Lactose intolerance is not an allergy because it is not an immune system response.\u00a0It is a sensitivity to milk caused by lactase deficiency so the sugar in milk cannot be digested. Milk allergy does exist, but it is a different condition that occurs in only about four per cent of people. It results when milk proteins (not milk sugar) trigger an immune reaction. How can you determine whether you have lactose intolerance or milk allergy? If you can drink lactose-free milk without symptoms, it is likely that you are lactose intolerant and not allergic to milk. However, if lactose-free milk also produces symptoms, it is likely that you have milk allergy. Note that it is possible to have both conditions.<\/p>\n<p><strong>Myth:<\/strong>\u00a0If you are lactose intolerant, you will never be able to drink milk or consume other dairy products without suffering adverse physical symptoms.<\/p>\n<p><strong>Reality:<\/strong>\u00a0Lactose intolerance does not mean that consuming milk and other dairy products is out of the question. Besides lactose-free milk, which is widely available, many dairy products have relatively low levels of lactose, so you may be able to consume at least small amounts of them without discomfort.\u00a0You may be able to consume milk in the form of yogurt without any problems because the bacteria in yogurt produce lactase that breaks down the lactose. Greek yogurt may be your best bet, because it is lower in lactose to begin with. Aged cheeses also tend to have relatively low levels of lactose, because of the cheese-making process. Finally, by gradually adding milk or milk products to your diet, you may be able to increase your tolerance to lactose.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">6.8 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Milk contains the sugar lactose, a disaccharide. Lactose must be broken down into its two component sugars to be absorbed by the small intestine, and the enzyme lactase is needed for this process.<\/li>\n<li>In about 60 per cent of people worldwide, the ability to synthesize lactase and digest lactose declines after the first two years of life. These people become lactose intolerant and cannot consume much milk without suffering symptoms of bloating, cramps, and diarrhea.<\/li>\n<li>In populations that herded milking animals for thousands of years, lactase persistence evolved. People who were able to synthesize lactase and digest lactose throughout life were strongly favored by natural selection. People \u2014 including\u00a0many Europeans and European-Americans \u2014\u00a0who descended from these early herders generally still have lactase persistence.<\/li>\n<li>Human populations may vary in how efficiently they use calories in food. Some people (especially South Pacific Islanders, Native Americans, and sub-Saharan Africans) seem to be able to get by on fewer calories than would be adequate for others, so they tend to easily gain weight, become obese, and develop diseases such as diabetes.<\/li>\n<li>The thrifty gene hypothesis answers the question of how genes for this ability could have evolved. It proposes that \u201cthrifty genes\u201d were selected for because they allowed people to use calories efficiently and store body fat when food was plentiful so they had a reserve to use when food was scarce. Thrifty genes become detrimental and lead to obesity and diabetes when food is consistently plentiful.<\/li>\n<li>Several assumptions underlying the thrifty gene hypothesis have been called into question, and genetic research has been unable to actually identify thrifty genes. Alternate hypotheses to the thrifty gene hypothesis have been proposed, including the drifty gene hypothesis. The latter hypothesis explains variation in the tendency to become obese by genetic drift on neutral genes.<\/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\">6.8 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-271\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-271\" class=\"h5p-iframe\" data-content-id=\"271\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Nutritional Adaptation\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Distinguish between the terms lactose and lactase.<\/li>\n<li>What is lactose intolerance, and what percentage of all people have it?<\/li>\n<li>Where and why did lactase persistence evolve?<\/li>\n<li>What is the thrifty gene hypothesis?<\/li>\n<li>How well is the thrifty gene hypothesis supported by evidence?<\/li>\n<li>Describe an alternative hypothesis to the thrifty gene hypothesis.<\/li>\n<li>Do you think that a lack of exposure to dairy products might affect a person\u2019s lactase level? Why or why not?<\/li>\n<li>Describe an experiment you would want to do or data you would want to analyze that would help to test the thrifty phenotype hypothesis. Remember, you are studying people, so be sure it is ethical! Discuss possible confounding factors that you should control for, or that might affect the interpretation of your results.<\/li>\n<li>Explain the relationship between insulin, blood glucose, and type II diabetes.<\/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\">6.8 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=G1NGzycaQV0&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Why Are People Lactose Intolerant?, Super Scienced, 2016.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=UMhLBPPtlrY<\/p>\n<p style=\"text-align: center\">Peter Attia: What if we're wrong about diabetes?, TED, 2013.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=4O8k9qe8fjI<\/p>\n<p style=\"text-align: center\">The Last Nomadic Reindeer Herders in the World, Great Big Story, 2018.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=XIYag5MWhPU<\/p>\n<p style=\"text-align: center\">Experience a Traditional Whale Hunt in Northern Alaska | Short Film Showcase, National Geographic, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 6.8.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/cedarsummitfarm\/7481908244\">IMG_4325 Milk Mustache licking 3<\/a> by <a class=\"owner-name truncate\" title=\"Go to Cedar Summit Farm's photostream\" href=\"https:\/\/www.flickr.com\/photos\/cedarsummitfarm\/\" data-track=\"attributionNameClick\">Cedar Summit Farm<\/a> on <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.<\/p>\n<p><strong>Figure 6.8.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Lactose_Haworth.svg\">Lactose Haworth<\/a> by <a title=\"User:NEUROtiker\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:NEUROtiker\">NEUROtiker<\/a> on Wikimedia Commons is in the\u00a0<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 style=\"text-align: initial;font-size: 1em\">Figure 6.8.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Lactase.png\" rel=\"cc:attributionURL\">Lactase<\/a> by <a class=\"mw-redirect\" title=\"User:Boghog2\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Boghog2\">Boghog2<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain <\/a>(https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 6.8.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Laktoseintoleranz-1.svg\" rel=\"cc:attributionURL\">Lactose Intolerance<\/a> by <a class=\"extiw\" title=\"de:Benutzer:Rainer Zenz\" href=\"https:\/\/de.wikipedia.org\/wiki\/Benutzer:Rainer_Zenz\">Rainer Z<\/a>\u00a0<a class=\"extiw\" title=\"de:Benutzer Diskussion:Rainer Zenz\" href=\"https:\/\/de.wikipedia.org\/wiki\/Benutzer_Diskussion:Rainer_Zenz\">...<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 6.8.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Reindeer_herding.jpg\" rel=\"cc:attributionURL\">Reindeer_herding<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/photos\/51496968@N00\" rel=\"nofollow\">Mats Andersson<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en\">CC BY 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.0\/deed.en) license.<\/p>\n<p><strong>Figure 6.8.6<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/_8bnn1GqX70\" rel=\"cc:attributionURL\">Milk Photo<\/a> [photo] by <span class=\"_1JARO\"><a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@shootdelicious\">Eiliv-Sonas Aceron<\/a> <\/span>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<h2>References<\/h2>\n<p class=\"hanging-indent\">Great Big Story. (2018, November 29). The last nomadic reindeer herders in the world. YouTube. https:\/\/www.youtube.com\/watch?v=4O8k9qe8fjI&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Super Scienced. (2016, February 26). Why are people lactose intolerant? YouTube. https:\/\/www.youtube.com\/watch?v=G1NGzycaQV0&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">National Geographic. (2018, November 27). Experience a traditional whale hunt in northern Alaska | Short film showcase. YouTube. https:\/\/www.youtube.com\/watch?v=XIYag5MWhPU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2013, June 25). Peter Attia: What if we're wrong about diabetes? YouTube. https:\/\/www.youtube.com\/watch?v=UMhLBPPtlrY&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2019, December 15). James V. Neel. In\u00a0<i>Wikipedia. <\/i>https:\/\/en.wikipedia.org\/w\/index.php?title=James_V._Neel&amp;oldid=930860629<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 9). John Speakman. In\u00a0<i>Wikipedia. <\/i>https:\/\/en.wikipedia.org\/w\/index.php?title=John_Speakman&amp;oldid=961610417<\/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_5023_5549\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5549\"><div tabindex=\"-1\"><p>A complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, and chemical synthesis. Found in all forms of life, ATP is often referred to as the \"molecular unit of currency\" of intracellular energy transfer.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4159\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4159\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-275\">\n<div class=\"h5p-content\" data-content-id=\"275\"><\/div>\n<\/div>\n<p><em>Figure 7.2.1 Complex machines.<\/em><\/p>\n<h1>A Fantastic Machine<\/h1>\n<p>These robots were created for research or to do complex tasks, but they look like they might be fun to play with too! They are all complex machines. Think about some other, more familiar machines, such as power drills, washing machines, and lawn mowers. Each machine consists of many parts, and each part does a specific job, yet all the parts work together to perform certain functions. Many people have compared the human body to a machine, albeit an extremely complex one. Like real machines, the human body also consists of many parts that work together to perform certain functions. In this case, these parts and functions keep the organism alive. The human body may be the most fantastic machine on Earth, as you will discover when you learn more about it in this concept.<\/p>\n<div>\n<h1>What the Human Machine Can Do<\/h1>\n<\/div>\n<p>Imagine a machine that has all of the following attributes:<\/p>\n<ul>\n<li>It can generate a \u201cwind\u201d of 166 km\/hr (100 mi\/hr).<\/li>\n<li>It can relay messages faster than 400 km\/hr (249 mi\/hr).<\/li>\n<li>It contains a pump that moves about a million barrels of fluid over its lifetime.<\/li>\n<li>It has a control center that contains billions of individual components.<\/li>\n<li>It can\u00a0repair itself, if necessary.<\/li>\n<li>It may\u00a0not wear out for up to a century or more.<\/li>\n<\/ul>\n<p>This machine\u00a0has all of these abilities, and yet it consists mainly of\u00a0water. What is it? It is the human body.<\/p>\n<div>\n<h1>Organization of the Human Body<\/h1>\n<\/div>\n<p>The human body is a complicated, highly organized structure that consists of trillions of parts that function together to achieve all the functions needed to maintain life. The biology of the human body incorporates:<\/p>\n<ul>\n<li>The body\u2019s structure, the study of which is called <strong>anatomy<\/strong>.<\/li>\n<li>The body\u2019s functioning, the study of which is called <strong>physiology<\/strong>.<\/li>\n<\/ul>\n<p>The organization of the human body can be seen as a hierarchy of increasing size and complexity, starting at the level of\u00a0atoms and molecules, and ending at the level of the entire\u00a0<strong>organism,<\/strong> which is an individual living thing. You can see the intervening levels of organization in Figure 7.2.2. Read about the levels in the sections that follow.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_2798\" aria-describedby=\"caption-attachment-2798\" style=\"width: 915px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2798\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/101_Levels_of_Org_in_Body-1.jpg\" alt=\"\" width=\"915\" height=\"1081\"><figcaption id=\"caption-attachment-2798\" class=\"wp-caption-text\"><em>Figure 7.2.2 This diagram shows the levels of organization of the human body, from atoms to the whole organism.<\/em><\/figcaption><\/figure>\n<h2>Cells<\/h2>\n<p>The basic units of structure and function of the human body \u2014 as in all living things \u2014 are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3573\">cells<\/a>. By the time the average person reaches adulthood, their body has an amazing 37 trillion of them! Each cell carries out basic life processes that allow the body to survive. In addition, most human cells are specialized in structure and function to carry out other specific roles. In fact, the human body may consist of as many as 200 different types of cells, each of which has a special job to do. Just a few of these different human cell types are pictured in Figure 7.2.3. These cells have obvious differences in structure that reflect their different functions. For example, nerve cells have long projections sticking out from the body of the cell. These projections help them carry electrical messages to other cells.<\/p>\n<figure id=\"attachment_2800\" aria-describedby=\"caption-attachment-2800\" style=\"width: 1043px\" class=\"wp-caption alignnone\"><img class=\"wp-image-2800 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Feature_Stem_Cell_new-e1589225900314-1.png\" alt=\"\" width=\"1043\" height=\"224\"><figcaption id=\"caption-attachment-2800\" class=\"wp-caption-text\"><em>Figure 7.2.3 A few of the many different types of cells in the human body are illustrated here. Each type of cell is specialized for a particular role in the body.<\/em><\/figcaption><\/figure>\n<h2>Tissues<\/h2>\n<p>The next level of organization in the human body is tissues. A\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2801\">tissue<\/a><\/strong> is a group of connected cells that have a similar function. There are four basic types of human tissues: epithelial, muscle, nervous, and connective tissues. These four tissue types (shown in Figure 7.2.4) make up all the organs of the human body.<\/p>\n<figure id=\"attachment_2802\" aria-describedby=\"caption-attachment-2802\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-2802\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Four-types-of-tissues-1.png\" alt=\"\" width=\"500\" height=\"412\"><figcaption id=\"caption-attachment-2802\" class=\"wp-caption-text\"><em>Figure 7.2.4 The human body contains these four types of tissues.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Organs and Organ Systems<\/span><\/p>\n<\/div>\n<p>Organs are the next level of organization of the human body. An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2803\">organ<\/a><\/strong> is a structure that consists of two or more types of tissues that work together to do the same job. Examples of human organs include the heart, brain, lungs, skin, and kidneys. Human organs are organized into organ systems, which are shown in Figure 7.2.5. An <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2804\">organ system<\/a><\/strong>\u00a0is a group of organs that work together to carry out a complex overall function. Each organ of the system does part of the larger job.<\/p>\n<div id=\"h5p-276\">\n<div class=\"h5p-content\" data-content-id=\"276\"><\/div>\n<\/div>\n<p><em>Figure 7.2.5 The Human Organ Systems. Some of the system names shown in this illustration differ from the terminology used in this book, but the systems are the same.<\/em><\/p>\n<p>&nbsp;<\/p>\n<div>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">A Well-Oiled Machine<\/span><\/p>\n<\/div>\n<p>All of the organs and organ systems of the human body normally work together like a well-oiled machine, because they are closely regulated by the nervous and endocrine systems. The\u00a0nervous system\u00a0controls virtually all body activities, and the\u00a0endocrine system\u00a0secretes hormones that help to regulate these activities. Functioning together, the organ systems supply\u00a0body cells\u00a0with all the substances they need and eliminate their wastes. They also keep\u00a0temperature,\u00a0pH, and other conditions at just the right levels to support life.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">7.2 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The human body is like an extremely complex machine. It consists of multiple parts that function together to maintain life. The biology of the human body incorporates the body\u2019s structure (or anatomy) and the body\u2019s functioning (or physiology).<\/li>\n<li>The organization of the human body is a hierarchy of increasing size and complexity, starting at the level of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3619\">atoms<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3687\">molecules<\/a>, and ending at the level of the entire organism.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3573\">Cells<\/a>\u00a0are the level of organization above\u00a0atoms and molecules, and they are the basic units of structure and function of the human body. Each cell carries out basic life functions, as well as other specific roles. Variations in cell function are generally reflected in variations in\u00a0cell structure.<\/li>\n<li>The next level of organization above cells is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2801\">tissue<\/a>. A tissue is a group of connected cells that have a similar function. There are four basic types of human tissues: epithelial, muscle, nervous, and connective tissues. These four types of tissues make up all the organs of the human body.<\/li>\n<li>The next level of organization above tissues is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2803\">organ<\/a>. An organ is a structure that consists of two or more types of tissues that work together to do the same job. Examples include the brain and\u00a0heart.<\/li>\n<li>Human organs\u00a0are organized into organ systems. An <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2804\">organ system<\/a> is a group of organs that work together to carry out a complex overall function. For example, the\u00a0skeletal system\u00a0provides structure to the body and protects internal organs.<\/li>\n<li>All of the organs and organ systems of the body normally work together like a well-oiled machine, because they are closely regulated by the nervous and endocrine systems.<\/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\">7.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>How is the human body like a complex machine?<\/li>\n<li>Describe the difference between human anatomy and human physiology.<\/li>\n<li>\n<div id=\"h5p-277\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-277\" class=\"h5p-iframe\" data-content-id=\"277\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Level of organization in the human body\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Relate\u00a0cell structure to cell function, and give examples of specific cell types in the human body.<\/li>\n<li>Define tissue, and identify the four types of tissues that make up the human body.<\/li>\n<li>What is an organ? Give three examples of organs in the human body.<\/li>\n<li>Define organ systems. Name five examples in the human body.<\/li>\n<li>How is the human body regulated so all of its organs and organ systems work together?<\/li>\n<li>\n<div id=\"h5p-278\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-278\" class=\"h5p-iframe\" data-content-id=\"278\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"6.2 review questions\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Which organ system\u2019s function is to provide structure to the body and protect internal organs?<\/li>\n<li>Give one example of how the respiratory and circulatory systems work together.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 style=\"margin-top: 2.14286em;margin-bottom: 1.42857em;line-height: 1.28571em;color: #333333\"><span style=\"color: #ffffff\">7.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=i-icXZ2tMRM<\/p>\n<p style=\"text-align: center\">Rob Knight: How our microbes make us who we are, TED, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?time_continue=202&amp;v=I43hq13MnYM&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Computers That Think Like Humans, Fw: Thinking, 2014.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 7.2.1<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/unsplash.com\/photos\/YKW0JjP7rlU\">White and brown human robot illustration<\/a> by <span class=\"_1JARO\"><a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@franckinjapan\">Franck V.<\/a><\/span> 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\/1WBN-JKSmKI\">Mighty Mouse, a Robotic Vehicle Range (RVR)<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@scienceinhd\">Science in HD<\/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:\/\/commons.wikimedia.org\/wiki\/File:Lauron4c_2009_FZI_Karlsruhe.jpg\">Lauron4c 2009 FZI Karlsruhe<\/a> from the FZI Research Center for Information Technology - Department IDS (Germany) on Wikimedia Commons is released for free use.<\/li>\n<li>NASA Mars Rover (artist's concept) by <a href=\"https:\/\/photojournal.jpl.nasa.gov\/catalog\/PIA04413\">NASA\/JPL\/Cornell University, Maas Digital LLC <\/a>(#PIA04413)\u00a0 on Wikimedia Commons is in the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a>\u00a0(https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/li>\n<\/ul>\n<p><strong>Figure 7.2.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:101_Levels_of_Org_in_Body.jpg\" rel=\"cc:attributionURL\">101_Levels_of_Org_in_Body<\/a> by <a href=\"http:\/\/OpenStax.https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-2-structural-organization-of-the-human-body\">OpenStax<\/a>\u00a0 on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en\" rel=\"license\">CC BY 4.0 <\/a>(https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) licence.<\/p>\n<p><strong>Figure 7.2.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:422_Feature_Stem_Cell_new.png\" rel=\"cc:attributionURL\">Feature_Stem_Cell_new<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-6-cellular-differentiation\">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\/deed.en) license.<\/p>\n<p><strong>Figure 7.2.4<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/9.2\/\" rel=\"cc:attributionURL\">Four types of tissues<\/a> by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/9.2\/\">CK-12 Foundation\/ Zachary Wilson<\/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=2.193208365.186153724.1598904551-1392032960.1592870652\">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<p><strong>Figure 7.2.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Organ_Systems_I.jpg\">Organ Systems 1<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-2-structural-organization-of-the-human-body\">Connexions\/ OpenStax<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0\/deed.en) license.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">References<\/span><\/p>\n<p class=\"hanging-indent\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2013, April 25). <span class=\"os-title-label\">Figure\u00a0<\/span><span class=\"os-number\">1.3<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"42861\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight first text last\" data-timestamp=\"1594951484732\" data-highlight-id=\"6aeb8ede-949a-42a7-8c5b-539b9c5c7092\" data-highlighted=\"true\">Levels of<\/span>\u00a0Structural Organization of the Human Body<\/span> [digital image]. In <em>Anatomy and Physiology<\/em> (Section 1.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-2-structural-organization-of-the-human-body<\/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, April 25). Figure\u00a0<\/span><span class=\"os-number\">1.4<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"7375\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight first text last\" data-timestamp=\"1594955809917\" data-highlight-id=\"528f84b2-6176-4d78-a9ff-058c8cf1e4df\" data-highlighted=\"true\">Organ Systems<\/span> of the Human Body [digital image]. In <em>Anatomy and Physiology<\/em> (Section 1.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/1-2-structural-organization-of-the-human-body\u00a0<\/span><\/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, April 25). Figure\u00a0<\/span><span class=\"os-number\">3.36<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"16759\" class=\"os-title\" data-type=\"title\">Stem Cells<\/span><span class=\"os-divider\"> [digital image]. In <em>Anatomy and Physiology<\/em> (Section 3.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/3-6-cellular-differentiation<\/span><\/p>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2016). Figure 4 The human body contains these four types of tissues [digital image]. In <em>CK-12 College Human Biology<\/em> (Section 9.12) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/9.2\/<\/p>\n<p class=\"hanging-indent\">Fw: Thinking. (2014, May 14). Computers that think like humans. YouTube. https:\/\/www.youtube.com\/watch?v=I43hq13MnYM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED. (2015, Febuary 23). Rob Knight: How our microbes make us who we are. YouTube. https:\/\/www.youtube.com\/watch?v=i-icXZ2tMRM&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_5023_4160\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4160\"><div tabindex=\"-1\"><div>\n<p>Created by Christine Miller<\/p>\n<div id=\"h5p-283\">\n<div class=\"h5p-content\" data-content-id=\"283\"><\/div>\n<\/div>\n<p><em>Figure 7.4.1 Construction \u2014 It's important to have the right materials for the job.\u00a0\u00a0<\/em><\/p>\n<h1>The Right Material for the Job<\/h1>\n<p>Building a house is a big job and one that requires a lot of different materials for specific purposes.\u00a0 As you can see in Figure 7.4.1, many different types of materials are used to build a complete house, but each type of material fulfills certain functions.\u00a0 You wouldn't use insulation to cover your roof, and you wouldn't use lumber to wire your home.\u00a0 Just as a builder chooses the appropriate materials to build each aspect of a home (wires for electrical, lumber for framing, shingles for roofing), your body uses the right <em>cells<\/em> for each type of role.\u00a0 When many cells work together to perform a specific function, this is termed a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2801\">tissue<\/a>.<\/p>\n<h1>Tissues<\/h1>\n<\/div>\n<p>Groups of connected cells form tissues. The cells in a tissue may all be the same type, or they may be of multiple types. In either case, the cells in the tissue work together to carry out a specific function, and they are always specialized to be able to carry out that function better than any other type of tissue.\u00a0 There are four main types of human tissues: connective, epithelial, muscle, and nervous tissues. We use tissues to build organs and organ systems.\u00a0 The 200 types of cells that the body can produce based on our single set of DNA can create all the types of tissue in the body.<\/p>\n<h1>Epithelial Tissue<\/h1>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2814\">Epithelial tissue<\/a><\/strong>\u00a0is made up of cells that line inner and outer body surfaces, such as the skin and the inner surface of the digestive tract. Epithelial tissue that lines inner body surfaces and body openings is called\u00a0<strong>mucous membrane.<\/strong>\u00a0This type of epithelial tissue produces\u00a0<strong>mucus<\/strong>, a slimy substance that coats mucous membranes and traps pathogens, particles, and debris. Epithelial tissue protects the body and its internal organs, secretes substances (such as hormones) in addition to mucus, and absorbs substances (such as nutrients).<\/p>\n<p>The key identifying feature of epithelial tissue is that it contains a free surface and a basement membrane.\u00a0 The free surface is not attached to any other cells and is either open to the outside of the body, or is open to the inside of a hollow organ or body tube.\u00a0 The basement membrane anchors the epithelial tissue to underlying cells.<\/p>\n<p>Epithelial tissue is identified and named by shape and layering.\u00a0 Epithelial cells exist in three main shapes: squamous, cuboidal, and columnar.\u00a0 These specifically shaped cells can, depending on function, be layered several different ways: simple, stratified, pseudostratified, and transitional.<\/p>\n<p>Epithelial tissue forms coverings and linings and is responsible for a range of functions including diffusion, absorption, secretion and protection.\u00a0 The shape of an epithelial cell can maximize its ability to perform a certain function.\u00a0 The thinner an epithelial cell is, the easier it is for substances to move through it to carry out diffusion and\/or absorption.\u00a0 The larger an epithelial cell is, the more room it has in its cytoplasm to be able to make products for secretion, and the more protection it can provide for underlying tissues. Their are three main shapes of epithelial cells: squamous (which is shaped like a pancake- flat and oval), cuboidal (cube shaped), and columnar (tall and rectangular).<\/p>\n<div id=\"h5p-284\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-284\" class=\"h5p-iframe\" data-content-id=\"284\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Epithelial Cell Shapes\"><\/iframe><\/div>\n<\/div>\n<p><em>Figure 7.4.2 The shape of epithelial tissues is important.\u00a0\u00a0<\/em><\/p>\n<p>Epithelial tissue will also organize into different layerings depending on their function.\u00a0 For example, multiple layers of cells provide excellent protection, but would no longer be efficient for diffusion, whereas a single layer would work very well for diffusion, but no longer be as protective; a special type of layering called transitional is needed for organs that stretch, like your bladder.\u00a0 Your tissues exhibit the layering that makes them most efficient for the function they are supposed to perform. There are four main layerings found in epithelial tissue: simple (one layer of cells), stratified (many layers of cells), pseudostratified (appears stratified, but upon closer inspection is actually simple), and transitional (can stretch, going from many layers to fewer layers).<\/p>\n<div id=\"h5p-285\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-285\" class=\"h5p-iframe\" data-content-id=\"285\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Epithelial Cell Layering\"><\/iframe><\/div>\n<\/div>\n<p><em>Figure 7.4.3 The layerings found in epithelial tissues is important.\u00a0\u00a0<\/em><\/p>\n<p>See Table 7.4.1 for a summary of the different layering types and shapes epithelial cells can form and their related functions and locations.<\/p>\n<p style=\"text-align: left\"><strong>Table 7.4.1 <\/strong><\/p>\n<p style=\"text-align: left\"><em>Summary of Epithelial Tissue Cells<\/em><\/p>\n<p><img class=\"size-full wp-image-2830 aligncenter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Summary_of_Epithelial_Tissue_Cells-from-wikipedia-1.jpg\" alt=\"\" width=\"937\" height=\"1502\"><\/p>\n<p>So far, we have identified epithelial tissue based on shape and layering.\u00a0 The representative diagrams we have seen so far are helpful for visualizing the tissue structures, but it is important to look at real examples of these cells.\u00a0 Since cells are too tiny to see with the naked eye, we rely on microscopes to help us study them.\u00a0\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2879\">Histology<\/a><\/strong> is the study of the microscopic anatomy and cells and tissues.\u00a0 See Table 7.4.2 to see some examples of slides of epithelial tissues prepared for the purpose of histology.<\/p>\n<p><strong>Table 7.4.2<\/strong><\/p>\n<p><em>Epithelial Tissues and Histological Samples<\/em><\/p>\n<p>&nbsp;<\/p>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 84.3373%;height: 843px\" border=\"0\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"width: 8.45179%;height: 14px\">Epithelial Tissue Type<\/td>\n<td style=\"width: 16.9932%;height: 14px\">Tissue Diagram<\/td>\n<td style=\"width: 52.855%;height: 14px\">Histological Sample<\/td>\n<\/tr>\n<tr style=\"height: 286px\">\n<td style=\"width: 8.45179%;height: 286px\">Stratified squamous<\/p>\n<p>(from skin)<\/td>\n<td style=\"width: 16.9932%;height: 286px\"><img class=\"wp-image-2830 aligncenter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Summary_of_Epithelial_Tissue_Cells-from-wikipedia-e1589313321713-1.jpg\" alt=\"\" width=\"107\" height=\"39\"><\/td>\n<td style=\"width: 52.855%;height: 286px\"><img class=\"wp-image-2836\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Epithelial_Tissues_Stratified_Squamous_Epithelium_40230842160-scaled-e1589313552577-1.jpg\" alt=\"\" width=\"328\" height=\"300\"><\/td>\n<\/tr>\n<tr style=\"height: 227px\">\n<td style=\"width: 8.45179%;height: 227px\">Simple cuboidal<\/p>\n<p>(from kidney tubules)<\/td>\n<td style=\"width: 16.9932%;height: 227px\"><img class=\"wp-image-2830 aligncenter\" style=\"font-size: 14.4px\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Summary_of_Epithelial_Tissue_Cells-from-wikipedia-e1589313076678-1.jpg\" alt=\"\" width=\"158\" height=\"36\"><\/td>\n<td style=\"width: 52.855%;height: 227px\"><img class=\"wp-image-2833\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Simple-cuboidal-epithelial-tissue-histology-by-Berkshire-Community-College-on-flickr-1.jpg\" alt=\"\" width=\"393\" height=\"222\"><\/td>\n<\/tr>\n<tr style=\"height: 167px\">\n<td style=\"width: 8.45179%;height: 167px\">Pseudostratified ciliated columnar<\/p>\n<p>(from trachea)<\/td>\n<td style=\"width: 16.9932%;height: 167px\"><img class=\"wp-image-2830 aligncenter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Summary_of_Epithelial_Tissue_Cells-from-wikipedia-e1589313435536-1.jpg\" alt=\"\" width=\"151\" height=\"87\"><\/td>\n<td style=\"width: 52.855%;height: 167px\"><img class=\"wp-image-2837\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Pseudostratified_Epithelium-e1589314776658-1.jpg\" alt=\"\" width=\"415\" height=\"298\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h1>Connective Tissue<\/h1>\n<p>Bone and blood are examples of connective tissue.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2815\">Connective tissue<\/a><\/strong> is very diverse. In general, it forms a framework and support structure for\u00a0body tissues\u00a0and organs.\u00a0It's\u00a0made up of living cells\u00a0separated by non-living material, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3913\">extracellular matrix<\/a>, which can be\u00a0solid\u00a0or\u00a0liquid.\u00a0The extracellular matrix of bone, for example, is a rigid mineral framework. The extracellular matrix of blood is\u00a0liquid\u00a0plasma.<\/p>\n<p>The key identifying feature of connective tissue is that is is composed of a scattering of cells in a non-cellular matrix. There are three main categories of connective tissue, based on the nature of the matrix. They \u00a0look very different from one another, which is a reflection of their different functions:<\/p>\n<ol>\n<li>Fibrous connective tissue: is characterized by a matrix which is flexible and is made of protein fibres including collagen, elastin and possibly reticular fibres.\u00a0 These tissues are found making up tendons, ligaments, and body membranes.<\/li>\n<li>Supportive connective tissue: is characterized by a solid matrix and is what is used to make bone and cartilage.\u00a0 These tissues are used for support and protection.<\/li>\n<li>Fluid connective tissue: is characterized by a fluid matrix and includes both blood and lymph.<\/li>\n<\/ol>\n<h2>Fibrous Connective Tissue<\/h2>\n<p>Fibrous connective tissue contains cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3919\">fibroblasts<\/a>.\u00a0 These cells produce fibres of collagen, elastin, or reticular fibre which makes up the matrix of this type of connective tissue.\u00a0 Based on how tightly packed these fibres are and how they are oriented changes the properties, and therefore the function of the fibrous connective tissue.<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Loose fibrous connective tissue:\u00a0<\/strong> composed of a loose and disorganized weave of collagen and elastin fibres, creating a tissue that is thin and flexible, yet still tough.\u00a0 This tissue, which is also sometimes referred to as \"areolar tissue\", is found in membranes and surrounding blood vessels and most body organs.\u00a0 As you can see from the diagram in Figure 7.4.4, loose fibrous connective tissue fulfills the definition of connectives tissue since it is a scattering of cells (fibroblasts) in a non-cellular matrix (a mesh of collagen and elastin fibres).\u00a0 There are two types of specialized loose fibrous connective tissue: reticular and adipose.\u00a0 Adipose tissue stores fat and reticular tissue forms the spleen and lymph nodes.<br \/>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 68.8679%;height: 373px\" border=\"0\">\n<tbody>\n<tr style=\"height: 172px\">\n<td style=\"width: 46.3774%;height: 172px\">\n<figure id=\"attachment_2857\" aria-describedby=\"caption-attachment-2857\" style=\"width: 343px\" class=\"wp-caption alignnone\"><img class=\" wp-image-2857\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Loose-fibrous-connective-tissue-1.jpg\" alt=\"Loose Fibrous Connective Tissue\" width=\"343\" height=\"284\"><figcaption id=\"caption-attachment-2857\" class=\"wp-caption-text\"><em>Figure 7.4.4 Diagram of loose fibrous connective tissue consists of a scattering of fibroblasts in a non-cellular matrix of loosely woven collagen and elastin fibres.<\/em><\/figcaption><\/figure>\n<\/td>\n<td style=\"width: 40.5573%;height: 172px\">\n<figure id=\"attachment_2858\" aria-describedby=\"caption-attachment-2858\" style=\"width: 323px\" class=\"wp-caption alignnone\"><img class=\"wp-image-2858\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Connective_Tissue_Loose_Aerolar_39977986150-scaled-e1589924098592-1.jpg\" alt=\"Loose Fibrous Connective Tissue\" width=\"323\" height=\"295\"><figcaption id=\"caption-attachment-2858\" class=\"wp-caption-text\"><em>Figure 7.4.5 Microscopic view of loose fibrous connective tissue.<\/em><\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<li><strong>Dense Fibrous Connective<\/strong> <strong>Tissue:\u00a0<\/strong>composed of a dense mat of parallel collagen fibres and a scattering of fibroblasts, creating a tissue that is very strong.\u00a0 Dense fibrous connective tissue forms tendons and ligaments, which connect bones to muscles and\/or bones to neighbouring bones.<br \/>\n<table class=\"grid aligncenter\" style=\"border-collapse: collapse;width: 85.6604%;height: 159px\" border=\"0\">\n<tbody>\n<tr>\n<td style=\"width: 50%\">\n<figure id=\"attachment_2865\" aria-describedby=\"caption-attachment-2865\" style=\"width: 343px\" class=\"wp-caption alignnone\"><img class=\" wp-image-2865\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Dense-Fibrous-Connective-Tissue-1.jpg\" alt=\"Dense Fibrous Connective Tissue\" width=\"343\" height=\"340\"><figcaption id=\"caption-attachment-2865\" class=\"wp-caption-text\"><em>Figure 7.4.6 Dense fibrous connective tissue is composed of fibroblasts and a dense parallel packing of collagen fibres.<\/em><\/figcaption><\/figure>\n<\/td>\n<td style=\"width: 50%\">\n<figure id=\"attachment_2866\" aria-describedby=\"caption-attachment-2866\" style=\"width: 362px\" class=\"wp-caption alignnone\"><img class=\" wp-image-2866\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Dense_connective_tissue-400x-e1589925818790-1.jpg\" alt=\"Dense Fibrous Connective Tissue\" width=\"362\" height=\"326\"><figcaption id=\"caption-attachment-2866\" class=\"wp-caption-text\"><em>Figure 7.4.7 Microscopic view of dense fibrous connective tissue.<\/em><\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ul>\n<h2>Supportive Connective Tissue<\/h2>\n<p>Supportive connective tissue exhibits the defining feature of connective tissue in that it is a scattering of cells in a non-cellular matrix; what sets it apart from other connective tissues is its solid matrix.\u00a0 In this tissue group, the matrix is solid- either bone or cartilage.\u00a0 While fibrous connective tissue contained cells called fibroblasts which produced fibres, supportive connective tissue contains cells that either create bone (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3545\">osteocytes<\/a>) or cells that create cartilage (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2872\">chondrocytes<\/a>).<\/p>\n<h3>Cartilage<\/h3>\n<p>Chondrocytes produce the cartilage matrix in which they reside.\u00a0 Cartilage is made up of protein fibres and chondrocytes in lacunae.\u00a0 This is tissue is strong yet flexible and is used many places in the body for protection and support.\u00a0 Cartilage is one of the few tissues that is not vascular (doesn't have a direct blood supply) meaning it relies on diffusion to obtain nutrients and gases; this is the cause of slow healing rates in injuries involving cartilage.\u00a0 There are three main types of cartilage:<\/p>\n<ul>\n<li><strong>Hyaline cartilage<\/strong>: a smooth, strong and flexible tissue.\u00a0 Found at the ends of ribs and long bones, in the nose, and comprising the entire fetal skeleton.<\/li>\n<li><strong>Fibrocartilage<\/strong>: a very strong tissue containing thick bundles of collagen.\u00a0 Found in joints that need cushioning from high impact (knees, jaw).<\/li>\n<li><strong>Elastic cartilage<\/strong>: contains elastic fibres in addition to collagen,\u00a0 giving support with the benefit of elasticity.\u00a0 Found in earlobes and the epiglottis.<br \/>\n<figure id=\"attachment_2873\" aria-describedby=\"caption-attachment-2873\" style=\"width: 550px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2873\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Types_of_Cartilage-new-1.jpg\" alt=\"Types of Connective Tissue\" width=\"550\" height=\"651\"><figcaption id=\"caption-attachment-2873\" class=\"wp-caption-text\"><em>Figure 7.4.8 Three types of cartilage, each with distinct characteristics based on the nature of the matrix.<\/em><\/figcaption><\/figure>\n<\/li>\n<\/ul>\n<h3 style=\"margin-top: 2.14286em;margin-bottom: 1.42857em;line-height: 1.28571em\">Bone<\/h3>\n<p>Osteocytes produce the bone matrix in which they reside.\u00a0 Since bone is very solid, these cells reside in small spaces called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2870\">lacunae<\/a>.\u00a0 This bone tissue is composed of collagen fibres embedded in calcium phosphate giving it strength without brittleness.\u00a0 There are two types of bone: compact and spongy.<\/p>\n<ul>\n<li><strong>Compact bone:<\/strong> has a dense matrix organized into cylindrical units called osteons.\u00a0 Each osteon contains a central canal (sometimes called a Harversian Canal) which allows for space for blood vessels and nerves, as well as concentric rings of bone matrix and osteocytes in lacunae, as per the diagram here.\u00a0 Compact bone is found in long bones and forms a shell around spongy bone.<\/li>\n<\/ul>\n<figure id=\"attachment_2875\" aria-describedby=\"caption-attachment-2875\" style=\"width: 609px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2875\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Compact_bone_histology_2014-scaled-2.jpg\" alt=\"Compact Bone\" width=\"609\" height=\"405\"><figcaption id=\"caption-attachment-2875\" class=\"wp-caption-text\"><em>Figure 7.4.9 Compact bone is composed of organized units called osteons.<\/em><\/figcaption><\/figure>\n<ul>\n<li>Spongy bone: a very porous type of bone which most often contains bone marrow.\u00a0 It is found at the end of long bones, and makes up the majority of the ribs, shoulder blades and flat bones of the cranium.<\/li>\n<\/ul>\n<figure id=\"attachment_2876\" aria-describedby=\"caption-attachment-2876\" style=\"width: 347px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-2876 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Bone_normal_and_degraded_micro_structure-e1589929753605-1.jpg\" alt=\"Spongy Bone\" width=\"347\" height=\"376\"><figcaption id=\"caption-attachment-2876\" class=\"wp-caption-text\"><em>Figure 7.4.10 Spongy bone contains a latticework of bone and open spaces to house bone marrow. Due to its structure, it is strong yet flexible, which is why it is found at the end of long bones.<\/em><\/figcaption><\/figure>\n<h3>Fluid Connective Tissue<\/h3>\n<p>Fluid connective tissue has a matrix that is fluid; unlike the other two categories of connective tissue, the cells that reside in the matrix do not actually <em>produc<\/em>e the matrix. Fibroblasts make the fibrous matrix, chondrocytes make the cartilaginous matrix, osteocytes make the bony matrix, yet blood cells <strong>do not<\/strong> make the fluid matrix of either lymph or plasma.\u00a0 This tissue still fits the definition of connective tissue in that it is still a scattering of cells in a non-cellular matrix.<\/p>\n<p>There are two types of fluid connective tissue:<\/p>\n<ul>\n<li><strong>Blood:<\/strong> blood contains three types of cells suspended in plasma, and is contained in the cardiovascular system.\n<ul>\n<li>Eryththrocytes, more commonly called red blood cells, are present in high numbers (roughly 5 million cells per mL) and are responsible for delivering oxygen from to the lungs to all the other areas of the body. These cells are relatively small in size with a diameter of around 7 micrometres and live no longer than 120 days.<\/li>\n<li>Leukocytes, often referred to as white blood cells, are present in lower numbers (approximately 5 thousand cells per mL) are responsible for various immune functions.\u00a0 They are typically larger than erythrocytes, but can live much longer, particularly white blood cells responsible for long term immunity.\u00a0 The number of leukocytes in your blood can go up or down based on whether or not you are fighting an infection.<\/li>\n<li>Thrombocytes, also known as platelets, are very small cells responsible for blood clotting.\u00a0 Thrombocytes are not actually true cells, they are fragments of a much larger cell called a megakaryocyte.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Lymph:<\/strong> contains a liquid matrix and white blood cells and is contained in the lymphatic system, which ultimately drains into the cardiovascular system.<\/li>\n<\/ul>\n<div id=\"h5p-286\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-286\" class=\"h5p-iframe\" data-content-id=\"286\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Fluid Connective Tissue - Blood - Image Hotspot\"><\/iframe><\/div>\n<\/div>\n<p><em>Figure 7.4.11 A stained lymphocyte surrounded by red blood cells viewed using a light microscope.\u00a0<\/em><\/p>\n<h1>Muscular Tissue<\/h1>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2817\">Muscular tissue<\/a><\/strong> is made up of cells\u00a0 that have the unique ability to contract- which is the defining feature of muscular tissue.\u00a0 There are three major types of muscle tissue, as pictured in Figure 7.4.12 skeletal, smooth, and cardiac muscle tissues.<\/p>\n<h2>Skeletal Muscle<\/h2>\n<p>Skeletal muscles are voluntary muscles, meaning that you exercise conscious control over them.\u00a0 Skeletal muscles are attached to bones by tendons, a type of connective tissue. When these muscles shorten to pull on the bones to which they are attached, they enable the body to move. When you are exercising, reading a book, or making dinner, you are using skeletal muscles to move your body to carry out these tasks.<\/p>\n<p>Under the microscope, skeletal muscles are striated (or striped) in appearance, because of their internal structure which contains alternating protein fibres of actin and myosin.\u00a0 Skeletal muscle is described as multinucleated, meaning one \"cell\" has many nuclei.\u00a0 This is because in utero, individual cells destined to become skeletal muscle fused, forming muscle fibres in a process known as myogenesis.\u00a0 You will learn more about skeletal muscle and how it contracts in the Muscular System.<\/p>\n<figure id=\"attachment_2887\" aria-describedby=\"caption-attachment-2887\" style=\"width: 489px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2887\" src=\"http:\/\/humanbiology.pressbooks.tru.ca\/wp-content\/uploads\/sites\/6\/2020\/05\/Skeletal_muscle_\u6a2a\u7eb9\u808c1.jpg#fixme\" alt=\"Skeletal Muscle\" width=\"489\" height=\"275\"><figcaption id=\"caption-attachment-2887\" class=\"wp-caption-text\"><em>Figure 7.4.12 Skeletal muscle is striated and multinucleated.<\/em><\/figcaption><\/figure>\n<h2>Smooth Muscle<\/h2>\n<p><strong>Smooth\u00a0muscles<\/strong> are nonstriated muscles- they still contain the muscle fibres actin and myosin, but not in the same alternating arrangement seen in skeletal muscle.\u00a0 \u00a0Smooth muscle is found in the tubes of the body - in the walls of blood vessels and in the reproductive, gastrointestinal, and respiratory tracts. Smooth muscles are not under voluntary control meaning that they operate unconsciously, via the autonomic nervous system.\u00a0 Smooth muscles move substances through a wave of contraction which cascades down the length of a tube, a process termed <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>.\u00a0 <\/strong><\/p>\n<p>Watch the YouTube video \"<a href=\"https:\/\/www.youtube.com\/watch?v=kVjeNZA5pi4\">What is Peristalsis<\/a>\" by <a href=\"https:\/\/www.youtube.com\/channel\/UCxTlkZfjArUobBAeVwzJjYg\/feed\">Mister Science<\/a> to see peristalsis in action.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=kVjeNZA5pi4<\/p>\n<p style=\"text-align: center\">What is Peristalsis, Mister Science, 2018.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_2889\" aria-describedby=\"caption-attachment-2889\" style=\"width: 391px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-2889 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Smooth_Muscle_new-e1590202536987-1.jpg\" alt=\"Smooth Muscle\" width=\"391\" height=\"380\"><figcaption id=\"caption-attachment-2889\" class=\"wp-caption-text\"><em>Figure 7.4.13 Smooth muscle is non-striated and each oval-shaped cell contains a single nuclei. (Micrograph provided by the Regents of University of Michigan Medical School \u00a9 2012)<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_2888\" aria-describedby=\"caption-attachment-2888\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2888\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/PeristalsisN-1.jpg\" alt=\"Peristalsis\" width=\"410\" height=\"306\"><figcaption id=\"caption-attachment-2888\" class=\"wp-caption-text\"><em>Figure 7.4.14 Peristalsis is a wave-like contraction of smooth muscle which pushes the contents of a tube ahead of the wave of contraction.<\/em><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<h2>Cardiac Muscle<\/h2>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nCardiac muscles<\/strong><span style=\"font-weight: normal;text-align: initial;font-size: 1em\"> work involuntarily, meaning they are regulated by the autonomic nervous system.\u00a0 This is probably a good thing, since you wouldn't want to have to consciously concentrate on keeping your heart beating all the time! Cardiac muscle, which is found only in the heart, is mononucleated and striated (due to alternating bands of myosin and actin). Their contractions cause the heart to pump blood. In order to make sure entire sections of the heart contract in unison, cardiac muscle tissue contains special cell junctions called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2891\">intercalated discs<\/a>, which conduct the electrical signals used to \"tell\" the chambers of the heart when to contract.<\/span><\/p>\n<figure id=\"attachment_2893\" aria-describedby=\"caption-attachment-2893\" style=\"width: 584px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2893\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Cardiac-Muscle-1-1.jpg\" alt=\"Cardiac Muscle\" width=\"584\" height=\"438\"><figcaption id=\"caption-attachment-2893\" class=\"wp-caption-text\"><em>Figure 7.4.15 Cardiac muscle cells contain a single nucleus, have a striated appearance, and are joined by specialized junctions called intercalated discs.<\/em><\/figcaption><\/figure>\n<h2>Nervous Tissue<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2818\">Nervous tissue<\/a><\/strong> is made up of neurons and a group of cells called neuroglia (also known as glial cells).\u00a0 Nervous tissue makes up the central nervous system (mainly the brain and spinal cord) and peripheral nervous system (the network of nerves that runs throughout the rest of the body).\u00a0 The defining feature of nervous tissue is that it is specialized to be able to generate and conduct nerve impulses.\u00a0 This function is carried out by neurons, and the purpose of neuroglia is to support neurons.<\/p>\n<p>A neuron has several parts to its structure:<\/p>\n<ul>\n<li>Dendrites which collect incoming nerve impulses<\/li>\n<li>A cell body, or soma, which contains the majority of the neuron's organelles, including the nucleus<\/li>\n<li>An axon, which carries nerve impulses away from the soma, to the next neuron in the chain<\/li>\n<li>A myelin sheath, which encases the axon and increases that rate at which nerve impulses can be conducted<\/li>\n<li>Axon terminals, which maintain physical contact with the dendrites of neighbouring neurons<\/li>\n<\/ul>\n<figure id=\"attachment_2896\" aria-describedby=\"caption-attachment-2896\" style=\"width: 411px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2896\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Neuron.svg_-1.png\" alt=\"\" width=\"411\" height=\"221\"><figcaption id=\"caption-attachment-2896\" class=\"wp-caption-text\"><em>Figure 7.4.16 Neurons a cell which specialize in conducting electrical impulses.<\/em><\/figcaption><\/figure>\n<div>\n<p>Neuroglia can be understood as support staff for the neuron.\u00a0 The neurons have such an important job, they need cells to bring them nutrients, take away cell waste, and build their mylein sheath.\u00a0 There are many types of neuroglia, which are categorized based on their function and\/or their location in the nervous system.\u00a0 Neuroglia outnumber neurons by as much as 50 to 1, and are much smaller.\u00a0 See the diagram in 7.4.17 to compare the size and number of neurons and neuroglia.<\/p>\n<figure id=\"attachment_2897\" aria-describedby=\"caption-attachment-2897\" style=\"width: 553px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-2897\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nervous-Tissue-close-up-1.jpg\" alt=\"Nervous Tissue\" width=\"553\" height=\"415\"><figcaption id=\"caption-attachment-2897\" class=\"wp-caption-text\"><em>Figure 7.4.17 Neuroglia, the small cells seen here, outnumber neurons (the two larger cells) by as much as 50 to 1.<\/em><\/figcaption><\/figure>\n<p>Try out this memory game to test your tissues knowledge:<\/p>\n<div id=\"h5p-287\">\n<div class=\"h5p-content\" data-content-id=\"287\"><\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">7.4 Summary<\/span><\/h1>\n<\/header>\n<ul>\n<li>\u00a0Tissues are made up of cells working together.<\/li>\n<li>There are four main types of tissues: epithelial, connective, muscular and nervous.<\/li>\n<li>Epithelial tissue makes up the linings and coverings of the body and is characterized by having a free surface and a basement membrane.\u00a0 Types of epithelial tissue are distinguished by shape of cell (squamous, cuboidal or columnar) and layering (simple, stratified, pseudostratified and transitional).\u00a0 Different epithelial tissues can carry out diffusion, secretion, absorption, and\/or protection depending on their particular cell shape and layering.<\/li>\n<li>Connective tissue provides structure and support for the body and is characterized as a scattering of cells in a non-cellular matrix.\u00a0 There are three main categories of connective tissue, each characterized by a particular type of matrix:\n<ul>\n<li>Fibrous connective tissue contains protein fibres.\u00a0 Both loose and dense fibrous connective tissue belong in this category.<\/li>\n<li>Supportive connective tissue contains a very solid matrix, and includes both bone and cartilage.<\/li>\n<li>Fluid connective tissue contains cells in a fluid matrix with the two types of blood and lymph.<\/li>\n<\/ul>\n<\/li>\n<li>Muscular tissue's defining feature is that it is contractile.\u00a0 There are three types of muscular tissue:\u00a0 skeletal muscle which is found attached to the skeleton for voluntary movement, smooth muscle which moves substances through body tubes, and cardiac muscle which moves blood through the heart.<\/li>\n<li>Nervous tissue contains specialized cells called neurons which can conduct electrical impulses.\u00a0 Also found in nervous tissue are neuroglia, which support neurons by providing nutrients, removing wastes, and creating myelin sheath.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">7.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Define the term tissue.<\/li>\n<li>\n<div id=\"h5p-288\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-288\" class=\"h5p-iframe\" data-content-id=\"288\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Epithelial Tissue\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>If a part of the body needed a lining that was both protective, but still able to absorb nutrients, what would be the best type of epithelial tissue to use?<\/li>\n<li>\n<div id=\"h5p-289\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-289\" class=\"h5p-iframe\" data-content-id=\"289\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Connective Tissue\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Where do you find skeletal muscle?\u00a0 Smooth muscle? Cardiac muscle?<\/li>\n<li>\n<div id=\"h5p-290\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-290\" class=\"h5p-iframe\" data-content-id=\"290\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Guess the Tissue\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What are some of the functions of neuroglia?<\/li>\n<li>\n<div id=\"h5p-292\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-292\" class=\"h5p-iframe\" data-content-id=\"292\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Neuron\"><\/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\">7.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=O0ZvbPak4ck<\/p>\n<p style=\"text-align: center\">Types of Human Body Tissue, MoomooMath and Science, 2017.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=uHbn7wLN_3k<\/p>\n<p style=\"text-align: center\">How to 3D print human tissue - Taneka Jones, TED-Ed, 2019.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=1Qfmkd6C8u8<\/p>\n<p style=\"text-align: center\">How bones make blood - Melody Smith, TED-Ed, 2020.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 7.4.1<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/unsplash.com\/photos\/Za9oagRJNLM\">Construction man kneeling in front of wall<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@charlesdeluvio\">Charles Deluvio<\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/qJa6WDmRNwM\">Beige wooden frame<\/a> by\u00a0<a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@charlesdeluvio\">Charles Deluvio<\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/_Agl-CUoQvc\">Tambour on green<\/a> by <a href=\"https:\/\/unsplash.com\/@chatelp\">Pierre Ch\u00e2tel-Innocenti<\/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).<\/li>\n<li><a href=\"https:\/\/pixabay.com\/es\/photos\/construcci%C3%B3n-esp%C3%A1rragos-fontaner%C3%ADa-273291\/\">Tags: Construction Studs Plumbing Wiring<\/a> by <a class=\"hover_opacity\" href=\"https:\/\/pixabay.com\/es\/users\/JWahl-167616\/\">JWahl<\/a> on <a href=\"http:\/\/pixabay.com\">Pixabay<\/a> is used under the <a href=\"https:\/\/pixabay.com\/es\/service\/license\/\">Pixabay License<\/a> (https:\/\/pixabay.com\/es\/service\/license\/).<\/li>\n<\/ul>\n<p><strong>Figure 7.4.2 and Figure 7.4.3<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Simple_columnar_epithelium_tissue.svg\">Simple columnar epithelium tissue<\/a>\u00a0by<span style=\"font-size: 14.4px\"> <a class=\"new\" title=\"User:Kamilx3 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Kamilx3&amp;action=edit&amp;redlink=1\">Kamil Danak<\/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) license.\u00a0<\/span><\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Simple_cuboidal_epithelium.svg\">Simple cuboidal epithelium<\/a> by <span style=\"font-size: 14.4px\"><a class=\"new\" title=\"User:Kamilx3 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Kamilx3&amp;action=edit&amp;redlink=1\">Kamil Danak<\/a><\/span>\u00a0on 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) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Simple_squamous_epithelium.svg#mw-jump-to-license\">Simple squamous epithelium<\/a> by<span style=\"font-size: 14.4px\"> <a class=\"new\" title=\"User:Kamilx3 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Kamilx3&amp;action=edit&amp;redlink=1\">Kamil Danak<\/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) license.\u00a0<\/span><\/li>\n<\/ul>\n<p><strong>Figure 7.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_33_02_06.jpg\" rel=\"cc:attributionURL\">Loose fibrous connective tissue<\/a> by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:-LfhWRES@4\/Animal-Primary-Tissues\">CNX OpenStax. Biology<\/a>. on Wikimedial 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 7.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/146824358@N03\/39977986150\/\">Connective Tissue: Loose Aerolar<\/a> by <a href=\"http:\/\/blogs.berkshirecc.edu\/bccoer\" rel=\"noreferrer nofollow\">Berkshire Community College Bioscience Image Library<\/a>\u00a0on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> Universal public domain dedication (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) license.<\/p>\n<p><strong>Figure 7.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_33_02_07.jpg\" rel=\"cc:attributionURL\">Dense Fibrous Connective Tissue<\/a> by by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:-LfhWRES@4\/Animal-Primary-Tissues\">CNX OpenStax. Biology<\/a>. on Wikimedial 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 7.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Dense_connective_tissue-400x.jpg\" rel=\"cc:attributionURL\">Dense_connective_tissue-400x<\/a> by <a class=\"new\" title=\"User:J Jana (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:J_Jana&amp;action=edit&amp;redlink=1\">J Jana<\/a> on Wikimedia Commons is used under a\u00a0 <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 7.4.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:412_Types_of_Cartilage-new.jpg\" rel=\"cc:attributionURL\">Types_of_Cartilage-new<\/a> by<span style=\"text-align: initial;font-size: 1em\">\u00a0<a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-3-connective-tissue-supports-and-protects\">OpenStax College<\/a> on <span style=\"font-size: 1em\">Wikipedia Commons is used under a <\/span><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 7.4.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Compact_bone_histology_2014.jpg\" rel=\"cc:attributionURL\">Compact_bone_histology_2014<\/a> by <a title=\"User:Athikhun.suw\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Athikhun.suw\">Athikhun.suw<\/a> on Wikimedia Commons is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.en) license.<\/p>\n<p><strong>Figure 7.4.10<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Bone_normal_and_degraded_micro_structure.jpg\" rel=\"cc:attributionURL\">Bone_normal_and_degraded_micro_structure<\/a> by <a class=\"new\" title=\"User:Gtirouflet (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Gtirouflet&amp;action=edit&amp;redlink=1\">Gtirouflet<\/a> 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.<\/p>\n<p><strong>Figure 7.4.11<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Lymphocyte2.jpg\">Lymphocyte2<\/a> by <a class=\"mw-userlink\" title=\"User:NicolasGrandjean\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:NicolasGrandjean\">NicolasGrandjean<\/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) license.\u00a0 [No machine-readable author provided. NicolasGrandjean\u00a0is assumed, based on copyright claims.]<\/p>\n<p><strong>Figure 7.4.12<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Skeletal_muscle_%E6%A8%AA%E7%BA%B9%E8%82%8C1.JPG\" rel=\"cc:attributionURL\">Skeletal_muscle_\u6a2a\u7eb9\u808c1<\/a> by <a title=\"User:\u4e4c\u62c9\u8de8\u6c2a\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:%E4%B9%8C%E6%8B%89%E8%B7%A8%E6%B0%AA\">\u4e4c\u62c9\u8de8\u6c2a<\/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 7.4.13<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1021_Smooth_Muscle_new.jpg\" rel=\"cc:attributionURL\">Smooth_Muscle_new<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-8-smooth-muscle\">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>\u00a0(https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.en) license.<\/p>\n<p><strong>Figure 7.4.14<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2404_PeristalsisN.jpg\" rel=\"cc:attributionURL\">Peristalsis<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-2-digestive-system-processes-and-regulation\">OpenStax<\/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\/deed.en) license.<\/p>\n<p><strong>Figure 7.4.15<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/89557913@N00\/6197702211\/in\/photostream\/\" rel=\"cc:attributionURL\">400x Cardiac Muscle<\/a>\u00a0by\u00a0<a href=\"https:\/\/www.flickr.com\/photos\/89557913@N00\/\" rel=\"dc:creator\">Jessy731<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used and adapted by Christine Miller under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\">CC BY-NC 2.0<\/a>\u00a0(https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Figure 7.4.16<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Neuron.svg\" rel=\"cc:attributionURL\">Neuron.svg<\/a> by <a class=\"new\" title=\"User:Dhp1080 (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Dhp1080&amp;action=edit&amp;redlink=1\">User:Dhp1080<\/a> 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.<\/p>\n<p><strong>Figure 7.4.17<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/89557913@N00\/6198225348\/in\/album-72157627663341815\/\" rel=\"cc:attributionURL\">400x Nervous Tissue <\/a>\u00a0by\u00a0<a href=\"https:\/\/www.flickr.com\/photos\/89557913@N00\/\" rel=\"dc:creator\">Jessy731<\/a> on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/\" rel=\"license\">CC BY-NC 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/2.0\/) license.<\/p>\n<p><strong>Table 7.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:423_Table_04_02_Summary_of_Epithelial_Tissue_CellsN.jpg#\/media\/File:423_Table_04_02_Summary_of_Epithelial_Tissue_CellsN.jpg\">Summary of Epithelial Tissue Cells<\/a>, <span style=\"text-align: initial;font-size: 1em\">by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-2-epithelial-tissue\">OpenStax College<\/a> on <span style=\"font-size: 1em\">Wikipedia Commons is used under a <\/span><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>Table 7.4.2<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Epithelial_Tissues_Stratified_Squamous_Epithelium_(40230842160).jpg\" rel=\"cc:attributionURL\">Epithelial_Tissues_Stratified_Squamous_Epithelium_(40230842160)<\/a> by<br \/>\n<a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/146824358@N03\" rel=\"nofollow\">Berkshire Community College Bioscience Image Library<\/a>\u00a0on Wikimedia Commons is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> Universal Public Domain Dedication (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) license.<\/li>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/146824358@N03\/41681552782\/\" rel=\"cc:attributionURL\">Simple cuboidal epithelial tissue histology<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/146824358@N03\/\">Berkshire Community College<\/a> on <a href=\"http:\/\/Flickr.com\">Flickr<\/a> is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> Universal Public Domain Dedication (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2304_Pseudostratified_Epithelium.jpg\" rel=\"cc:attributionURL\">Pseudostratified_Epithelium<\/a> by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/22-1-organs-and-structures-of-the-respiratory-system\">OpenStax College<\/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.<\/li>\n<\/ul>\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, April 25). Figure 4.8 Summary of epithelial tissue cells [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 4.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-2-epithelial-tissue<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" 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, April 25). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" data-highlighted=\"true\">4.16<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"65771\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" data-highlighted=\"true\">Types of cartilage [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 4.3). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/4-3-connective-tissue-supports-and-protects <\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span id=\"65771\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" data-highlighted=\"true\"><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, April 25). <\/span>Figure 10.23 Smooth muscle [digital micrograph].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 10.8). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/10-8-smooth-muscle (Micrograph provided by the Regents of University of Michigan Medical School \u00a9 2012)<\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span id=\"65771\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" data-highlighted=\"true\"><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, April 25). <\/span><\/span><\/span>Figure 22.5 Pseudostratified ciliated columnar epithelium <span id=\"65771\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1595304353878\" data-highlight-id=\"24812396-94bb-4ad8-9c2b-9493f84bc468\" data-highlighted=\"true\">[digital micrograph].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 22.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/22-1-organs-and-structures-of-the-respiratory-system <\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1595349068914\" data-highlight-id=\"cfc8b754-6300-4e64-bbd6-b284869dd483\" data-highlighted=\"true\"><span id=\"65771\" class=\"os-title\" data-type=\"title\">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, April 25). <\/span>Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text\" data-timestamp=\"1595349068914\" data-highlight-id=\"cfc8b754-6300-4e64-bbd6-b284869dd483\" data-highlighted=\"true\">23.5<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"4684\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1595349068914\" data-highlight-id=\"cfc8b754-6300-4e64-bbd6-b284869dd483\" data-highlighted=\"true\">Peristalsis [diagram]. <span id=\"65771\" class=\"os-title\" data-type=\"title\">In <em>Anatomy and Physiology<\/em> (Section 23.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-2-digestive-system-processes-and-regulation<\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\">Mister Science. (2018). What is peristalsis? YouTube. https:\/\/www.youtube.com\/watch?v=kVjeNZA5pi4<\/p>\n<p class=\"hanging-indent\">MoomooMath and Science. (2017, May 18). Types of human body tissue. YouTube. https:\/\/www.youtube.com\/watch?v=O0ZvbPak4ck&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\"><span style=\"text-align: initial;font-size: 1em\">Open Stax. (2016, May 27). Figure 6 Loose connective tissue [digital image]. In <em>OpenStax Biology<\/em> (Section 33.2). OpenStax CNX. https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:-LfhWRES@4\/Animal-Primary-Tissues<\/span><\/p>\n<p class=\"hanging-indent\"><span style=\"text-align: initial;font-size: 1em\">Open Stax. (2016, May 27). Figure 7 Fibrous connective tissue from the tendon [digital image]. In <em>OpenStax Biology<\/em> (Section 33.2). OpenStax CNX. https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:-LfhWRES@4\/Animal-Primary-Tissues<\/span><\/p>\n<p class=\"hanging-indent\"><span style=\"text-align: initial;font-size: 1em\">TED-Ed. (2019, October 17). How to 3D print human tissue - Taneka Jones. YouTube. https:\/\/www.youtube.com\/watch?v=uHbn7wLN_3k&amp;feature=youtu.be<\/span><\/p>\n<p class=\"hanging-indent\">TED-Ed. (2020, January 27). How bones make blood - Melody Smith. YouTube. https:\/\/www.youtube.com\/watch?v=1Qfmkd6C8u8&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_5023_3031\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_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_5023_5149\">sexual intercourse<\/a> on day 14 of her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5293\">menstrual cycle<\/a> to optimize their chances of having his <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> meet her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_2218\">hormones<\/a> from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">FSH<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5306\">LH<\/a> from the pituitary and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2659\">estrogen<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3411\">progesterone<\/a> from the ovary \u2014 specifically from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">follicle <\/a>which surrounds the maturing egg and becomes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_2677\">fertilization<\/a> of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2694\">gametes<\/a>\u00a0and, in females, the carrying of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_3408\">gonads<\/a>\u00a0(<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a> in males, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a> in females) that produce gametes (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5099\">ova<\/a>) and sex hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a> in males and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_5090\">epididymis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5091\">penis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5095\"><em>vas deferens<\/em><\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5096\">prostate gland<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_5196\">head<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5197\">acrosome<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5198\">midpiece<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2151\">flagellum<\/a>. The process of producing sperm is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_2103\">diploid<\/a> stem cell called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5199\">spermatogonium<\/a>, which undergoes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_5213\">erectile dysfunction<\/a> (ED), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1983\">epididymitis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5227\">prostate cancer<\/a>, and<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_5086\">fetus<\/a>.<\/li>\n<li>Female reproductive system organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5101\">oviducts<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5143\">vagina<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5153\">clitoris<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_2428\">symbiotic<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2588\">bacteria<\/a> and an acidic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_5153\">clitoris<\/a>, two pairs of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5154\">labia<\/a>, and openings for the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_5288\">breasts<\/a>\u00a0are technically not reproductive organs, but their <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_2103\">diploid<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_5301\">ovarian cycle<\/a>. It includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_5308\">uterine cycle<\/a>. It includes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_5319\">cervical cancer<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5328\">vaginitis<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_5351\">barrier methods<\/a>, hormonal methods, intrauterine devices, behavioural methods, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_2906\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2906\"><div tabindex=\"-1\"><p>Created by:\u00a0CK-12\/Adapted by Christine Miller<\/p>\n<div>\n<figure id=\"attachment_231\" aria-describedby=\"caption-attachment-231\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-231\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Borrelia_hermsii_Bacteria_13758011613.jpg\" alt=\"Image shows a large red blood cell, with a filamentous green bacterium resting on its surface.\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-231\" class=\"wp-caption-text\"><em>Figure 4.3.1 A bacterium attacks a human erythrocyte. Both are cells.<\/em><\/figcaption><\/figure>\n<h1>Bacteria\u00a0Attack!<\/h1>\n<\/div>\n<p>The colourful image in Figure 4.3.1 shows a bacterial cell (in green) attacking human red blood cells. The bacterium causes a disease called relapsing fever. The bacterial and human cells look very different in size and shape. Although all living cells have certain things in common \u2014 such as a plasma membrane and cytoplasm \u2014 different types of cells, even within the same organism, may have their own unique structures and functions. Cells with different functions generally have different shapes that suit them for their particular job. Cells vary not only in shape, but also in size, as this example shows. In most organisms, however, even the largest cells are no bigger than the period at the end of this sentence. Why are cells so small?<\/p>\n<div>\n<h1>Explaining Cell Size<\/h1>\n<\/div>\n<p>Most organisms, even very large ones, have microscopic cells. Why don't cells get bigger instead of remaining tiny and multiplying? Why aren't you one giant cell rolling around school? What limits cell size?<\/p>\n<p>Once you know how a cell functions, the answers to these questions are clear. To carry out life processes, a cell must be able to quickly pass substances in and out of the cell. For example, it must be able to pass\u00a0nutrients\u00a0and oxygen into the cell and waste products out of the cell. Anything that enters or leaves a cell must cross its outer surface. The size of a cell is limited by its need to pass substances across that outer surface.<\/p>\n<p>Look at the three cubes in Figure 4.3.2. A<span style=\"text-align: initial;font-size: 1em\"> larger cube has less surface area relative to its volume than a smaller cube. This relationship also applies to cells \u2014 a larger cell has less surface area relative to its volume than a smaller cell. A cell with a larger volume also needs more nutrients and oxygen, and produces more waste. Because all of these substances must pass through the surface of the cell, a cell with a large volume will not have enough surface area to allow it to meet its needs. The <\/span><em style=\"text-align: initial;font-size: 1em\">larger<\/em><span style=\"text-align: initial;font-size: 1em\"> the cell is, the <\/span><em style=\"text-align: initial;font-size: 1em\">smaller<\/em><span style=\"text-align: initial;font-size: 1em\"> its ratio of surface area to volume, and the more difficult it will be for the cell to get rid of its waste and take in necessary substances. This is what limits the size of the cell.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_234\" aria-describedby=\"caption-attachment-234\" style=\"width: 741px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-232\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Cell-Size.png\" alt=\"Image shows three cubes: a small, a medium and a large. The cube with length of 1 has a surface area to volume ratio of 6:1. The cube with a length of 2 has a surface area to volume ratio of 3:1 and the cube with the length of 3 has a surface area to volume ratio of 2:1.\" width=\"741\" height=\"556\"><figcaption id=\"caption-attachment-234\" class=\"wp-caption-text\"><em>Figure 4.3.2 Surface area to volume ratio.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Cell Form and Function<\/h1>\n<\/div>\n<p>Cells with different functions often have varying shapes. The cells pictured below (Figure 4.3.3) are just a few examples of the many different shapes that human cells may have. Each type of cell\u00a0 has characteristics that help it do its job. The job of the nerve cell, for example, is to carry messages to other cells. The nerve cell has many long extensions that reach out in all directions, allowing it to pass messages to many other cells at once. Do you see the tail of each tiny sperm cell? Its tail helps a sperm cell \"swim\" through fluids in the female reproductive tract in order to reach an egg cell. The white blood cell has the job of destroying bacteria and other pathogens. It is a large cell that can engulf foreign invaders.<\/p>\n<div>\n<div id=\"h5p-35\">\n<div class=\"h5p-content\" data-content-id=\"35\"><\/div>\n<\/div>\n<p><em>Figure 4.3.3 Human cells may have many different shapes that help them to do their jobs.<\/em><\/p>\n<\/div>\n<div>\n<h1>Cells With and Without a\u00a0Nucleus<\/h1>\n<\/div>\n<p>The\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2402\">nucleus<\/a>\u00a0is a basic\u00a0cell structure\u00a0present in many \u2014 but not\u00a0<em>all \u2014<\/em>\u00a0living cells. The\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2402\">nucleus<\/a>\u00a0of a cell is a structure in the cytoplasm that is surrounded by a membrane (the nuclear membrane) and contains\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a>. Based on whether or not they have a nucleus, there are two basic types of cells: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1572\">prokaryotic<\/a> cells and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1573\">eukaryotic<\/a> cells.<\/p>\n<h2>Prokaryotic Cells<\/h2>\n<figure id=\"attachment_234\" aria-describedby=\"caption-attachment-234\" style=\"width: 392px\" class=\"wp-caption alignright\"><img class=\"wp-image-233\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/2000px-Average_prokaryote_cell-_en.svg_.png\" alt=\"Image shows a diagram of a bacterium. The bacterium is smaller than a typical eukaryotic cell, has fewer organelles and contains no membrane-bound organelles.\" width=\"392\" height=\"319\"><figcaption id=\"caption-attachment-234\" class=\"wp-caption-text\"><em>Figure 4.3.3 Bacteria are prokaryotes, meaning they do not have a nucleus. Their DNA is contained in a region called the nucleoid.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1572\">Prokaryotic<\/a> cells<\/strong> are cells without a nucleus. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a> in prokaryotic cells is in the cytoplasm, rather than enclosed within a nuclear membrane.\u00a0 In addition, these cells are typically smaller than eukaryotic cells and contain fewer organelles.\u00a0 Prokaryotic cells are found in single-celled organisms, such as the bacterium represented by the model in Figure 4.3.3. Organisms with prokaryotic cells are called <strong>prokaryotes<\/strong>. They were the first type of organisms to evolve, and they are still the most common organisms today.<\/p>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Eukaryotic Cells<\/h2>\n<figure id=\"attachment_234\" aria-describedby=\"caption-attachment-234\" style=\"width: 2500px\" class=\"wp-caption alignnone\"><img class=\"size-full wp-image-234\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Animal-Cell-1.png\" alt=\"Image shows a diagram of a eukaryotic cell. The cell has many organelles labelled, including: nucleus, nucleolus, rough endoplasmic reticulum, smooth endoplasmic reticulum, Golgi body, vesicles, mitochondria and centrioles.\" width=\"2500\" height=\"1000\"><figcaption id=\"caption-attachment-234\" class=\"wp-caption-text\"><em>Figure 4.3.4 Eukaryotic cells, like this animal cell, contain a nucleus and many other membrane-bound organelles.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1573\">Eukaryotic<\/a> cells<\/strong> are cells that contain a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2402\">nucleus<\/a>. A typical eukaryotic cell is represented by the model in Figure 4.3.4. Eukaryotic cells are usually larger than prokaryotic cells. They are found in some single-celled and all multicellular organisms. Organisms with eukaryotic cells are called <strong>eukaryotes<\/strong>, and they range from\u00a0fungi\u00a0to\u00a0humans.<\/p>\n<p>Besides a nucleus, eukaryotic cells also contain other\u00a0organelles. An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2083\">organelle<\/a><\/strong>\u00a0is a structure within the cytoplasm that performs a specific job in the cell.\u00a0Organelles\u00a0called\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a>, for example, provide\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2340\">energy<\/a>\u00a0to the cell, and organelles called vesicles store substances in the cell. Organelles allow <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1573\">eukaryotic<\/a> cells to carry out more functions than <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1572\">prokaryotic<\/a> cells can.<\/p>\n<p>Interestingly, scientists think that mitochondria were once free-living prokaryotes that infected (or were engulfed by) larger cells. The two organisms developed a symbiotic relationship that was beneficial to both of them, resulting in the smaller prokaryote becoming an organelle within the larger cell. This is called endosymbiotic theory, and it is supported by a lot of evidence, including the fact that <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a> have their own <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a> separate from the DNA in the nucleus of the eukaryotic cell. Endosymbiotic theory will be described in more detail in later sections, and it's also discussed in the video below.<\/p>\n<div>\n<p>https:\/\/www.youtube.com\/watch?v=FGnS-Xk0ZqU<\/p>\n<p class=\"title style-scope ytd-video-primary-info-renderer\" style=\"text-align: center\">Endosymbiotic Theory, Amoeba Sisters, 2017.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\">4.3 Summary<\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Cells must be very small so they have a large enough surface area-to-volume ratio to maintain normal cell processes.<\/li>\n<li>Cells with different functions often have different shapes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1572\">Prokaryotic<\/a> cells do not have a nucleus. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1573\">Eukaryotic <\/a>cells\u00a0<em>do<\/em>\u00a0have a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2402\">nucleus<\/a>, along with other\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2083\">organelles<\/a>.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<div>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">4.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Explain why most cells are very small.<\/li>\n<li>Discuss variations in the form and function of cells.<\/li>\n<li>\n<div id=\"h5p-36\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-36\" class=\"h5p-iframe\" data-content-id=\"36\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Cell Variation\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-37\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-37\" class=\"h5p-iframe\" data-content-id=\"37\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Prokaryote vs. Eukaryote T\/F\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Do human cells have organelles? Explain your answer.<\/li>\n<li>Which are usually larger \u2013 prokaryotic or eukaryotic cells? What do you think this means for their relative ability to take in needed substances and release wastes? Discuss your answer.<\/li>\n<li>DNA in eukaryotes is enclosed within the _______ \u00a0________.<\/li>\n<li>Name three different types of cells in humans.<\/li>\n<li>Which organelle provides energy in eukaryotic cells?<\/li>\n<li>What is a function of a vesicle in a cell?<\/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\">4.3 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?time_continue=1&amp;v=9i7kAt97XYU&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">How we think complex cells evolved - Adam Jacobson, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=Pxujitlv8wc<\/p>\n<p style=\"text-align: center\">Prokaryotic vs. Eukaryotic Cells (updated), Amoeba Sisters, 2018.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 4.3.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Borrelia_hermsii_Bacteria_(13758011613).jpg\" rel=\"cc:attributionURL\">Borrelia_hermsii_Bacteria_(13758011613)<\/a> by <a href=\"https:\/\/www.flickr.com\/people\/54591706@N02\">NAID<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<p><strong>Figure 4.3.2<\/strong><\/p>\n<p>Cell Size by Christine Miller is released into the <a href=\"https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/\" rel=\"license\">Public Domain<\/a> (https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/).<\/p>\n<p><strong>Figure 4.3.3<\/strong><\/p>\n<ul>\n<li><a style=\"font-size: 1em\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:BioTek-Wikipedia-Image.tif\">Chondrocyte. BioTek-Wikipedia-Image<\/a><span style=\"font-size: 1em\"> by BioTek Instruments, Inc. on Wikimedia Commons is used under a <\/span><a style=\"font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en\">CC BY-SA 3.0<\/a><span style=\"font-size: 1em\"> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/deed.en) license. <\/span><\/li>\n<li><a style=\"font-size: 1em\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Neutrophil_with_anthrax_copy.jpg\">Neutrophil with anthrax copy<\/a><span style=\"font-size: 1em\"> by Volker Brinkmann from <\/span><a style=\"font-size: 1em\" href=\"https:\/\/journals.plos.org\/plospathogens\/issue?id=10.1371\/issue.ppat.v01.i03\">PLOS Pathogens<\/a><span style=\"font-size: 1em\"> on Wikimedia Commons is used under a\u00a0<\/span><a style=\"font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en\">CC BY 2.5<\/a><span style=\"font-size: 1em\"> (https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en) license.\u00a0<\/span><\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:PLoSBiol4.e126.Fig6fNeuron.jpg\"><em>PLoSBio<\/em>l4.e126.Fig6fNeuron<\/a> by Lee, et al. from <a href=\"https:\/\/journals.plos.org\/plosbiology\/article?id=10.1371\/journal.pbio.0040029\">PLOS Biology<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en\">CC BY 2.5<\/a> (https:\/\/creativecommons.org\/licenses\/by\/2.5\/deed.en) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sperm_(265_33)_human.jpg\">Sperm (265 33) human<\/a> by <a class=\"extiw\" title=\"cs:Josef Reischig\" href=\"https:\/\/cs.wikipedia.org\/wiki\/Josef_Reischig\">Doc. RNDr. Josef Reischig, CSc.<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\">CC BY-SA 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/3.0) license.<\/li>\n<\/ul>\n<\/div>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 4.3.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Average_prokaryote_cell-_en.svg\" rel=\"cc:attributionURL\">Model of a prokaryotic cell: bacterium<\/a> by Mariana Ruiz Villarreal [<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: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 4.3.5<\/strong><\/p>\n<p>Animal Cell adapted by Christine Miller is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\" rel=\"license\">CC0 1.0<\/a> (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en) public domain dedication license. (Original image, <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Animal_Cell_Unannotated.svg\">Animal Cell Unannotated,<\/a> is by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Kelvin13\">Kelvin Song<\/a> on Wikimedia Commons.)<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Amoeba Sisters. (2017, May 3). Endosymbiotic theory. YouTube. https:\/\/www.youtube.com\/watch?v=FGnS-Xk0ZqU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Amoeba Sisters. (2018, July 30). Prokaryotic vs. eukaryotic cells (updated). YouTube. https:\/\/www.youtube.com\/watch?v=Pxujitlv8wc&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Brinkmann, V. (November 2005). Neutrophil engulfing Bacillus anthracis. <em>PLoS Pathogens 1<\/em> (3): Cover page [digital image]. DOI:10.1371. https:\/\/journals.plos.org\/plospathogens\/issue?id=10.1371\/issue.ppat.v01.i03<\/p>\n<p class=\"hanging-indent\">Lee, W.C.A., Huang, H., Feng, G., Sanes, J.R., Brown, E.N., et al. (2005, December 27) Figure 6f, slightly altered (plus scalebar, minus letter \"f\".) [digital image]. Dynamic Remodeling of Dendritic Arbors in GABAergic Interneurons of Adult Visual Cortex. <em>PLoS Biology, 4<\/em>(2), e29. doi:10.1371\/journal.pbio.0040029. https:\/\/journals.plos.org\/plosbiology\/article?id=10.1371\/journal.pbio.0040029<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, February 17). How we think complex cells evolved - Adam Jacobson. https:\/\/www.youtube.com\/watch?v=9i7kAt97XYU&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_5023_3949\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_3949\"><div tabindex=\"-1\"><p>A nervous system cell that provides support for neurons and helps them transmit nerve impulses.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4180\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4180\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3516\" aria-describedby=\"caption-attachment-3516\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3516\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Arm-tattoo-by-telly-telly-on-flickr-scaled-2.jpg\" alt=\"10.1.1 Tattoo\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-3516\" class=\"wp-caption-text\"><em>Figure 10.1.1 Tattoos can last forever.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study: Wearing His Heart on His Sleeve<\/h1>\n<\/div>\n<p>Aiko, 22, and Larissa, 23, met through mutual friends and hit it off right away. They began dating and just four months later, they are now madly in love. They spend as much time as they can with each other, and have decided to move in together when Larissa\u2019s roommate moves out. They are even discussing getting married one day.<\/p>\n<p>Inspired by his passion for Larissa, Aiko is considering getting her name tattooed on his arm. As you probably know, tattoos are designs on the skin created by injecting pigments into the skin with a needle. Aiko looks up different tattoo styles online, and starts to envision what he would want in a tattoo.<\/p>\n<p>One day at a street festival, Aiko sees a sign that says \u201cHenna Tattoos.\u201d Henna tattoos are not technically tattoos \u2014 they are temporary designs that artists can create on the skin using a paste made out of the leaves of the henna plant. The henna stains the skin a reddish-brown colour, and once the paste is scraped off, the design typically remains on the skin for a few weeks. The use of henna to create designs on the skin is called mehndi. It is traditionally used by people in and from regions such as India, Pakistan, the Middle East, and Africa to celebrate special occasions, particularly weddings. Mendhi is often done on the palms of the hands and soles of the feet, where the designs usually come out darker than on other areas of the skin. You can see some examples of henna art in the images below.<\/p>\n<div>\n<div id=\"h5p-356\">\n<div class=\"h5p-content\" data-content-id=\"356\"><\/div>\n<\/div>\n<p><em>Figure 10.1.2 Examples of henna art.\u00a0<\/em><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<p>Aiko asks the mehndi artist to inscribe Larissa\u2019s name on his arm, so that he can see whether he likes it without making the permanent commitment of a real tattoo. Two days later, Aiko visits his parents. They are not familiar with mehndi, and they have a moment of panic when they think he got a real tattoo. Aiko reassures them that it is temporary, but tells them that he is thinking about getting a real tattoo.<\/p>\n<p>His parents are concerned. His father points out that he has not known Larissa long \u2014 what if they break up and he regrets the tattoo? His mother additionally worries about whether tattoos are safe. Aiko says that he doesn\u2019t think he will regret the decision, but if he does, he can cover it up with another tattoo or get it removed with laser treatments. He also tells them that he would go to an artist and shop that are reputable, and take appropriate safety precautions. His parents warn him that getting a tattoo removed may not be as simple as he thinks, and that he should think very carefully before making such a permanent decision.<\/p>\n<p>Humans have long decorated and adorned their skin with tattoos, makeup, and piercings. They also colour, cut, straighten, curl, and remove their hair; and paint, grow, and cut their nails. The skin, hair, and nails make up the integumentary system. As you read this chapter, you will learn about the important biological functions that these organs carry out, beyond being a convenient canvas for personal expression. At the end of the chapter you will find out if Aiko got his tattoo. You will also learn more about how tattoos, mehndi, and laser tattoo removal work, as well as the important considerations to protect your health if you are thinking about getting a tattoo.<\/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 10 Overview: Integumentary System<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter you will learn about the structure and functions of the integumentary system,\u00a0along with\u00a0its relationships to culture, evolution, and health. Specifically, you will learn about:<\/p>\n<ul>\n<li>The functions of the organs of the integumentary system \u2014 the skin, hair, and nails \u2014 including protecting the body, helping to regulate homeostasis, and sensing and interacting with the external world.<\/li>\n<li>The two main layers of the skin: the thinner outer layer (called the epidermis) and the thicker inner layer (called the dermis).<\/li>\n<li>The cells and layers of the epidermis and their functions, including synthesizing vitamin D and protecting the body against injury, pathogens, UV light exposure, and water loss.<\/li>\n<li>The composition of epidermal cells and how the epidermis grows.<\/li>\n<li>The composition and layers of the dermis and their functions, including cushioning other tissues, regulating body temperature, sensing the environment, and excreting wastes.<\/li>\n<li>The specialized structures in the dermis, which include sweat and sebaceous (oil) glands, hair follicles, and sensory receptors that detect touch, temperature, and pain.<\/li>\n<li>The structure and biological functions of hair, which include retaining body heat, detecting sensory stimuli, and protecting the body against UV light, pathogens, and small particles.<\/li>\n<li>How hair grows, how variations in hair colour and texture arise, and hypotheses about the evolution of hair in humans.<\/li>\n<li>The sociocultural roles of hair, including its expression of characteristics like sex and age, as well as cultural identity and social cues.<\/li>\n<li>The structure and functions of nails, which includes protecting the fingers and toes, enhancing the detection of sensory stimuli, and acting as tools.<\/li>\n<li>How nails grow and how they can reflect and affect our health.<\/li>\n<li>Skin cancer \u2014 which is the most common form of cancer \u2014 and its types and risk factors.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<p>As you read the chapter and learn more about the skin, think about the following questions:<\/p>\n<ol>\n<li>Why do you think real tattoos are permanent, but mehndi is not?<\/li>\n<li>Why do you think mehndi might come out darker on the palms of the hands and soles of the feet than on other areas of the skin?<\/li>\n<li>What do you think are some of the health concerns about tattoos?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 10.1.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/21082191@N00\/2230680151\/\" rel=\"cc:attributionURL\">Arm tattoo<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/shesarenegade\/\" rel=\"dc:creator\">telly telly<\/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>\u00a0 (https:\/\/creativecommons.org\/licenses\/by\/2.0\/) license.<\/p>\n<p><strong>Figure 10.1.2<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Henna_for_hair.jpg\">Henna for hair<\/a> by Andrey \"<a class=\"mw-userlink\" title=\"User:A.I.\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:A.I.\">A.I.<\/a>\" Sitnik ( <a class=\"external text\" href=\"http:\/\/www.sitnik.ru\/\" rel=\"nofollow\">www.sitnik.ru<\/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).<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Henna_on_foot_in_Morocco.jpg?uselang=en\">Henna on foot in Morocco<\/a> by <a title=\"User:Uspn\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Uspn\">Bj\u00f8rn Christian T\u00f8rrissen<\/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) license.<\/li>\n<li><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Mehndi_front.JPG\">Mehndi (front)<\/a> by <a title=\"User:AKS.9955\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:AKS.9955\">AKS.9955<\/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.<\/li>\n<li><a href=\"https:\/\/pixabay.com\/ja\/photos\/%E6%89%8B-%E3%82%B8%E3%83%A5%E3%82%A8%E3%83%AA%E3%83%BC-%E8%A3%85%E9%A3%BE%E5%93%81-%E6%8C%87-3444087\/\">Tags: Hand Jewelry Ornaments. . .Henna<\/a> by <a href=\"https:\/\/pixabay.com\/ja\/users\/benbernardbags-8304671\/\">BenBernardBags<\/a> on <a href=\"http:\/\/pixabay.com\">Pixabay<\/a> is used under the <a href=\"https:\/\/pixabay.com\/ja\/service\/license\/\">Pixabay License<\/a> (https:\/\/pixabay.com\/ja\/service\/license\/).<\/li>\n<\/ul>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4179\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4179\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3498\" aria-describedby=\"caption-attachment-3498\" style=\"width: 409px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3498\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Insulin_Application-1.jpg\" alt=\"9.7.1 Blood glucose testing\" width=\"409\" height=\"435\"><figcaption id=\"caption-attachment-3498\" class=\"wp-caption-text\"><em>Figure 9.7.1 Got to keep the balance.<\/em><\/figcaption><\/figure>\n<div>\n<h1>A Shot in the Arm<\/h1>\n<\/div>\n<p>Giving yourself an injection can be difficult, but for someone with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2969\">diabetes<\/a>, it may be a matter of life or death. The person in the photo has diabetes and is injecting themselves with insulin, the hormone that helps control the level of glucose in the blood. Insulin is produced by the pancreas.<\/p>\n<div>\n<h1>Introduction to the Pancreas<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3197\">pancreas<\/a><\/strong> is a large gland located in the upper left abdomen behind the stomach, as shown in Figure 9.7.2. The pancreas is about 15 cm (6 in) long, and it has a flat, oblong shape. Structurally, the pancreas is divided into a head, body, and tail. Functionally, the pancreas serves as both an endocrine gland and an exocrine gland.<\/p>\n<ul>\n<li>As an endocrine gland, the pancreas is part of the endocrine system. As such, it releases hormones (such as insulin) directly into the bloodstream for transport to cells throughout the body.<\/li>\n<li>As an exocrine gland, the pancreas is part of the digestive system. As such, it releases digestive enzymes into ducts that carry the enzymes to the gastrointestinal tract, where they assist with digestion. In this concept, the focus is on the pancreas as an endocrine gland. You can read about the pancreas as an exocrine gland in <a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/chapter\/17-6-accessory-organs-of-digestion\/\">Chapter 15 Digestive System.<\/a><\/li>\n<\/ul>\n<figure id=\"attachment_3499\" aria-describedby=\"caption-attachment-3499\" style=\"width: 2047px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3499\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0699_PancreasAnatomy2-1.png\" alt=\"Location of the pancreas\" width=\"2047\" height=\"1638\"><figcaption id=\"caption-attachment-3499\" class=\"wp-caption-text\"><em>Figure 9.7.2 The pancreas is located behind the stomach and near the upper part of the small intestine (duodenum). Its ducts carry digestive enzymes into the small intestine. The endocrine hormones it produces are secreted into the blood.<\/em><\/figcaption><\/figure>\n<div>\n<h1>The Pancreas as an Endocrine Gland<\/h1>\n<\/div>\n<p>The tissues within the pancreas that have an endocrine role exist as clusters of cells called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3500\">pancreatic islets<\/a>.<\/strong> They are also called the islets of Langerhans. You can see pancreatic tissue, including islets, in Figure 9.7.3. There are approximately three million pancreatic islets, and they are crisscrossed by a dense network of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3831\">capillaries<\/a>. The capillaries are lined by layers of islet cells that have direct contact with the blood vessels, into which they secrete their endocrine hormones.<\/p>\n<figure id=\"attachment_3502\" aria-describedby=\"caption-attachment-3502\" style=\"width: 637px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3502\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Exocrine_and_Endocrine_Pancreas-1.jpg\" alt=\"Pancreas: Endocrine and Exocrine Gland\" width=\"637\" height=\"827\"><figcaption id=\"caption-attachment-3502\" class=\"wp-caption-text\"><em>Figure 9.7.3 The anatomy of the pancreas. The inset diagram shows pancreatic islet cells that produce endocrine hormones. It also shows the cells (called acinar cells) that secrete exocrine substances involved in digestion into pancreatic ducts.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>The pancreatic islets consist of four main types of cells, each of which secretes a different endocrine hormone.\u00a0All of the hormones produced by the pancreatic islets, however, play crucial roles in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3359\">glucose<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3681\">metabolism<\/a> and the regulation of blood glucose levels, among other functions.<\/p>\n<ol>\n<li>Islet cells called alpha (\u03b1) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3951\">glucagon<\/a>. The function of glucagon is to increase the level of glucose in the blood. It does this by stimulating the liver to convert stored glycogen into glucose, which is released into the bloodstream.<\/li>\n<li>Islets cells called beta (\u03b2) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2590\">insulin<\/a>. The function of insulin is to decrease the level of glucose in the blood. It does this by promoting the absorption of glucose from the blood into fat, liver, and skeletal muscle cells. In these tissues, the absorbed glucose is converted into glycogen, fats (triglycerides), or both.<\/li>\n<li>Islet cells called delta (\u03b4) cells secrete the hormone\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3503\">somatostatin<\/a>.<\/strong>\u00a0This hormone is also called growth hormone inhibiting hormone, because it inhibits the anterior lobe of the pituitary gland from producing growth hormone. Somatostatin also inhibits the secretion of pancreatic endocrine hormones and pancreatic exocrine enzymes.<\/li>\n<li>Islet cells called gamma (\u03b3) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3504\">pancreatic polypeptide<\/a>. The function of pancreatic polypeptide is to help regulate the secretion of both endocrine and exocrine substances by the pancreas.<\/li>\n<\/ol>\n<div>\n<h1>Disorders of the Pancreas<\/h1>\n<\/div>\n<p>There are a variety of disorders that affect the pancreas. They include pancreatitis, pancreatic cancer, and diabetes mellitus.<\/p>\n<h2>Pancreatitis<\/h2>\n<figure id=\"attachment_3506\" aria-describedby=\"caption-attachment-3506\" style=\"width: 390px\" class=\"wp-caption alignright\"><img class=\" wp-image-3506\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Jaundice_eye_new-1.jpg\" alt=\"Jaundice due to Pancreatitis\" width=\"390\" height=\"165\"><figcaption id=\"caption-attachment-3506\" class=\"wp-caption-text\"><em>Figure 9.7.4 Jaundice, or yellowing of the skin and whites of the eyes, is a common sign of pancreatitis.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3505\">Pancreatitis<\/a><\/strong> is inflammation of the pancreas. It has a variety of possible causes, including gallstones, chronic alcohol use, infections (such as measles or mumps), and certain medications. Pancreatitis occurs when digestive enzymes produced by the pancreas damage the gland\u2019s tissues, which causes problems with fat digestion. The disorder is usually associated with intense pain in the central abdomen, and the pain may radiate to the back. Yellowing of the skin and whites of the eyes (see Figure 9.7.4), which is called jaundice, is a common sign of pancreatitis. People with pancreatitis may also have pale stools and dark urine. Treatment of pancreatitis includes administering drugs to manage pain, and addressing the underlying cause of the disease, for example, by removing gallstones.<\/p>\n<h2>Pancreatic Cancer<\/h2>\n<p>There are several different types of pancreatic cancer that may affect either the endocrine or the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3909\">exocrine<\/a> tissues of the gland. Cancers affecting the endocrine tissues are all relatively rare. However, their incidence has been rising sharply. It is unclear to what extent this reflects increased detection, especially through medical imaging techniques. Unfortunately, pancreatic cancer is usually diagnosed at a relatively late stage when it is too late for surgery, which is the only way to cure the disorder. In 2020 it is estimated that 6,000 Canadians will be newly diagnosed with pancreatic cancer, and that during this same year, 5,300 will die of pancreatic cancer.<\/p>\n<p>While it is rare before the age of 40, pancreatic cancer occurs most often after the age of 60. Factors that increase the risk of developing pancreatic cancer include smoking, obesity, diabetes, and a family history of the disease. About one in four cases of pancreatic cancer are attributable to smoking. Certain rare genetic conditions are also risk factors for pancreatic cancer.<\/p>\n<h2>Diabetes Mellitus<\/h2>\n<p>By far the most common type of pancreatic disorder is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2771\">diabetes mellitus<\/a>, more commonly called simply diabetes. There are many different types of diabetes, but diabetes mellitus is the most common. It occurs in two major types, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">type 1 diabetes<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">type 2 diabetes<\/a>. The two types have different causes and may also have different treatments, but they generally produce the same initial symptoms, which include excessive urination and thirst. These symptoms occur because the kidneys excrete more urine in an attempt to rid the blood of excess glucose. Loss of water in urine stimulates greater thirst. Other signs and symptoms of diabetes are listed in Figure 9.7.5.<\/p>\n<figure id=\"attachment_3508\" aria-describedby=\"caption-attachment-3508\" style=\"width: 738px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-3508\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Main_symptoms_of_diabetes.svg_-1.png\" alt=\"Symptoms of Diabetes\" width=\"738\" height=\"755\"><figcaption id=\"caption-attachment-3508\" class=\"wp-caption-text\"><em>Figure 9.7.5 This chart shows symptoms shared by both type 1 and type 2 diabetes in black and symptoms more common in type 1 diabetes in blue.<\/em><\/figcaption><\/figure>\n<p>When diabetes is not well controlled, it is likely to have several serious long-term consequences. Most of these consequences are due to damage to small blood vessels caused by high <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3359\">glucose<\/a> levels in the blood. Damage to blood vessels, in turn, may lead to increased risk of coronary artery disease and stroke. Damage to blood vessels in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3139\">retina<\/a> of the eye can result in gradual vision loss and blindness. Damage to blood vessels in the kidneys can lead to chronic kidney disease, sometimes requiring dialysis or kidney transplant. Long-term consequences of diabetes may also include damage to the nerves of the body, known as diabetic neuropathy. In fact, this is the most common complication of diabetes. Symptoms of diabetic neuropathy may include numbness, tingling, and pain in the extremities.<\/p>\n<h3>Type 1 Diabetes<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">Type 1 diabetes<\/a><\/strong>\u00a0is a chronic autoimmune disorder in which the immune system attacks the insulin-secreting beta cells of the pancreas. As a result, people with type 1 diabetes lack the insulin needed to keep blood glucose levels within the normal range. Type 1 diabetes may develop in people of any age, but is most often diagnosed before adulthood. For type 1 diabetics, insulin injections are critical for survival.<\/p>\n<h3>Type 2 Diabetes<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">Type 2 diabetes<\/a><\/strong>\u00a0is the single most common form of diabetes. The cause of high blood glucose in this form of diabetes usually includes a combination of insulin resistance and impaired insulin secretion. Both genetic and environmental factors play roles in the development of type 2 diabetes.\u00a0Type 2 diabetes can be managed with\u00a0changes in diet and physical activity, which may increase insulin sensitivity and help reduce blood glucose levels to normal ranges. Medications may also be used as part of the treatment, as may insulin injections.<\/p>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<p>Some patients with type 1 diabetes have been given pancreatic islet cells transplants from other human donors. If the transplanted cells are not rejected by the recipient\u2019s immune system, they can cure the patient of diabetes. However,\u00a0because of a shortage of appropriate human donors, only about\u00a0one thousand\u00a0such surgeries have been performed over the past ten years.<\/p>\n<p>In June of 2016, a research team led by Dr. David K.C. Cooper at the Thomas E. Starzl Transplantation Institute in Pittsburgh, Pennsylvania, reported on their work developing pig islet cells for transplant into human diabetes patients. The researchers genetically engineered the pig islet cells to be protected from the human immune response. As a result, patients receiving the transplanted cells would require only minimal suppression of their immune system after the surgery. The pig islet cells would also be less likely to transmit pathogenic agents, because the animals could be raised in a controlled environment.<\/p>\n<p>The researchers have successfully transplanted the pig islet cells into monkey models of type 1 diabetes. As of June 2016, the scientists were looking for funding to undertake clinical trials in humans with type 1 diabetes. Dr. Cooper predicted then that if the human trials go as well as expected, the pig islet cells could be available for curing patients in as little as two years.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">9.7 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_5023_3197\">pancreas<\/a> is a gland located in the upper left abdomen behind the stomach that functions as both an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3761\">endocrine gland<\/a> and an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3909\">exocrine gland<\/a>. As an endocrine gland, the pancreas releases hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2590\">insulin<\/a>) directly into the bloodstream. As an exocrine gland, the pancreas releases digestive enzymes into ducts that carry them to the gastrointestinal tract.<\/li>\n<li>Tissues in the pancreas that have an endocrine role exist as clusters of cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3500\">pancreatic islets<\/a>. The islets consist of four main types of cells, each of which secretes a different endocrine hormone. Alpha (\u03b1) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3951\">glucagon<\/a>, beta (\u03b2) cells secrete insulin, delta (\u03b4) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3503\">somatostatin<\/a>, and gamma (\u03b3) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3504\">pancreatic polypeptide<\/a>.<\/li>\n<li>The endocrine hormones secreted by the pancreatic islets all play a role, either directly or indirectly, in glucose metabolism and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3669\">homeostasis<\/a> of blood glucose levels. For example, insulin stimulates the uptake of glucose by cells and decreases the level of glucose in the blood, whereas glucagon stimulates the conversion of glycogen to glucose and increases the level of glucose in the blood.<\/li>\n<li>Disorders of the pancreas include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3505\">pancreatitis<\/a>, pancreatic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2771\">diabetes mellitus<\/a>. Pancreatitis is painful inflammation of the pancreas that has many possible causes. Pancreatic cancer of the endocrine tissues is rare, but increasing in frequency. It is generally discovered too late to cure surgically. Smoking is a major risk factor for pancreatic cancer.<\/li>\n<li>Diabetes mellitus is the most common type of pancreatic disorder. In diabetes, inadequate\u00a0activity\u00a0of insulin results in high blood levels of glucose. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">Type 1 diabetes<\/a> is a chronic autoimmune disorder in which the immune system attacks the insulin-secreting beta cells of the pancreas. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">Type 2 diabetes<\/a> is usually caused by a combination of insulin resistance and impaired insulin secretion due to a variety of environmental and genetic factors.<\/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\">9.7 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Describe the structure and location of the pancreas.<\/li>\n<li>Distinguish between the endocrine and exocrine functions of the pancreas.<\/li>\n<li>\n<div id=\"h5p-353\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-353\" class=\"h5p-iframe\" data-content-id=\"353\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"9.7 Drag and Drop\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-354\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-354\" class=\"h5p-iframe\" data-content-id=\"354\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"9.7 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What is pancreatitis? What are possible causes and effects of pancreatitis?<\/li>\n<li>Describe the incidence, prognosis, and risk factors of cancer of the endocrine tissues of the pancreas.<\/li>\n<li>Compare and contrast type 1 and type 2 diabetes.<\/li>\n<li>If the alpha islet cells of the pancreas were damaged to the point that they no longer functioned, how would this affect blood glucose levels? Assume that no outside regulation of this system is occurring and explain your answer. Further, would administration of insulin be more likely to help or hurt\u00a0this condition? Explain your answer.<\/li>\n<li>Explain why diabetes causes excessive thirst.<\/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\">9.7 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;t=2s<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=qlzLSbAGMqA&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Type 2 diabetes in children, Children's Health, 2008.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=da1vvigy5tQ<\/p>\n<p style=\"text-align: center\">Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU, TEDx Talks, 2015.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 9.7.1<\/strong><\/p>\n<section class=\"standard post-785 chapter type-chapter status-publish hentry focusable\" data-type=\"chapter\">\n<div class=\"media-atttributions\">\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Insulin_Application.jpg\" rel=\"cc:attributionURL\">Insulin_Application<\/a> by <a class=\"extiw\" title=\"w:cs:User:Mr Hyde\" href=\"https:\/\/en.wikipedia.org\/wiki\/cs:User:Mr_Hyde\">Mr Hyde<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"w:cs:\" href=\"https:\/\/en.wikipedia.org\/wiki\/cs:\">Czech Wikipedia<\/a> (Original text: moje foto) on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 9.7.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0699_PancreasAnatomy2.png\" rel=\"cc:attributionURL\">Blausen_0699_PancreasAnatomy2<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/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 9.7.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2424_Exocrine_and_Endocrine_Pancreas.jpg\" rel=\"cc:attributionURL\">Exocrine_and_Endocrine_Pancreas<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder\">OpenStax College<\/a> 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\/deed.en) license.<\/p>\n<p><strong>Figure 9.7.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Jaundice_eye_new.jpg\" rel=\"cc:attributionURL\">Jaundice_eye_new<\/a> by <a class=\"mw-userlink\" title=\"User:Info-farmer\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Info-farmer\">Info-farmer<\/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 image, File:<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Jaundice_eye.jpg\">Jaundice eye.jpg<\/a>, is from <a class=\"extiw\" title=\"w:Centers for Disease Control and Prevention\" href=\"https:\/\/en.wikipedia.org\/wiki\/Centers_for_Disease_Control_and_Prevention\">Centers for Disease Control and Prevention<\/a>'s\u00a0<a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/\" rel=\"nofollow\">Public Health Image Library<\/a>\u00a0(PHIL), with identification number\u00a0<b><a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/details.aspx?pid=2860\" rel=\"nofollow\">#2860<\/a><\/b><a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/details.aspx?pid=2860\" rel=\"nofollow\">)<\/a><\/p>\n<p><strong>Figure 9.7.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Main_symptoms_of_diabetes.svg\" rel=\"cc:attributionURL\">Main_symptoms_of_diabetes.svg<\/a> by <a class=\"extiw\" title=\"en:User:Mikael H\u00e4ggstr\u00f6m\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Mikael_H%C3%A4ggstr%C3%B6m\">Mikael H\u00e4ggstr\u00f6m<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"glossary\"><span style=\"font-size: 1.424em;font-weight: bold;color: #333333\">References<\/span><\/div>\n<\/section>\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, July 19). Figure 23.26 Exocrine and endocrine pancreas [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 23.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder<\/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\">Children's Health. (2008, June 13). Type 2 diabetes in children. YouTube. https:\/\/www.youtube.com\/watch?v=qlzLSbAGMqA&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\"><span class=\"author\">Hering, B. J.<\/span>,\u00a0<span class=\"author\">Cozzi, E.<\/span>,\u00a0<span class=\"author\">Spizzo, T.<\/span>,\u00a0<span class=\"author\">Cowan, P. J.<\/span>,\u00a0<span class=\"author\">Rayat, G. R.<\/span>,\u00a0<span class=\"author\">Cooper, D. K. C.<\/span>,\u00a0<span class=\"author\">Denner, J<\/span>. (2016, March 4). <span class=\"articleTitle\">First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes\u2014Executive summary<\/span>.\u00a0<i>Xenotransplantation<\/i>\u00a0<em><span class=\"pubYear\">2016<\/span><\/em>, <span class=\"vol\">23<\/span>:\u00a0<span class=\"pageFirst\">3<\/span>\u2013\u00a0<span class=\"pageLast\">13<\/span>. https:\/\/doi.org\/10.1111\/xen.12231<\/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<p class=\"hanging-indent\">TEDx Talks. (2015, May 4).\u00a0Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU. YouTube. https:\/\/www.youtube.com\/watch?v=da1vvigy5tQ&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_5023_4184\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4184\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3911\" aria-describedby=\"caption-attachment-3911\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3911\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Nails-by-allison-christine-vPrqHSLdF28-unsplash-scaled-e1591304396521-1.jpg\" alt=\"10.6.1\" width=\"400\" height=\"400\"><figcaption id=\"caption-attachment-3911\" class=\"wp-caption-text\"><em>Figure 10.6.1 Neat nails!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Nail Art<\/h1>\n<\/div>\n<p>Painting nails with coloured polish for aesthetic reasons is nothing new. In fact, there is evidence of this practice dating back to at least 3000 BCE. Today, painting and otherwise decorating the nails is big business, with annual revenues in the billions of dollars in North America alone! With all the attention (and money) given to nails as decorative objects, it\u2019s easy to forget that they also have important biological functions.<\/p>\n<div>\n<h1>What Are Nails?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3403\">Nail<\/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 accessory organs of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>. They are made of sheets of dead <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a> and are found on the far (or distal) ends of the fingers and toes. The keratin in nails makes them hard, but flexible. Nails serve a number of purposes, including protecting the digits, enhancing sensations, and acting as tools.<\/span><\/p>\n<div>\n<h1>Nail Anatomy<\/h1>\n<\/div>\n<figure id=\"attachment_3918\" aria-describedby=\"caption-attachment-3918\" style=\"width: 300px\" class=\"wp-caption alignright\"><img class=\" wp-image-3918\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0406_FingerNailAnatomy-1.png\" alt=\"10.5 Nail Anatomy\" width=\"300\" height=\"600\"><figcaption id=\"caption-attachment-3918\" class=\"wp-caption-text\"><em>Figure 10.6.2 The top diagram in this diagram shows the external, visible part of the nail and the cuticle. The bottom diagram shows internal structures in a cross-section of the nail and nail bed.<\/em><\/figcaption><\/figure>\n<p>A nail has three main parts: the root, plate, and free margin. Other structures around or under the nail include the nail bed, cuticle, and nail fold. These structures are shown in Figure 10.6.2.<\/p>\n<ul>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3912\">nail root<\/a><\/strong>\u00a0is the portion of the nail found under the surface of the skin at the near (or proximal) end of the nail. It is where the nail begins.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">nail plate<\/a><\/strong>\u00a0(or body) is the portion of the nail that is external to the skin. It is the visible part of the nail.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3916\">free margin<\/a><\/strong>\u00a0is the portion of the nail that protrudes beyond the distal end of the finger or toe. This is the part that is cut or filed to keep the nail trimmed.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3914\">nail bed<\/a><\/strong> is the area of skin under the nail plate. It is pink in\u00a0colour, due to the presence of capillaries in the\u00a0dermis.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">cuticle<\/a><\/strong>\u00a0is a layer of dead epithelial\u00a0cells\u00a0that overlaps and covers the edge of the nail plate. It helps to seal the edges of the nail to prevent infection of the underlying tissues.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3915\">nail fold<\/a><\/strong>\u00a0is a groove in the skin in which the side edges of the nail plate are embedded.<\/li>\n<\/ul>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<div>\n<h1>Nail Growth<\/h1>\n<\/div>\n<p>Nails grow from a deep layer of living epidermal tissue, known as the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3920\">nail matrix<\/a>,<\/strong> at the proximal end of the nail (see the bottom of the diagram in Figure 10.6.2). The nail matrix surrounds the nail root. It contains stem cells that divide to form keratinocytes, which are cells that produce keratin and make up the nail.<\/p>\n<h2>Formation of the Nail Root and Nail Plate<\/h2>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a> produced by the nail matrix accumulate to form tough, hard, translucent sheets of dead\u00a0cells\u00a0filled with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>. The sheets make up the nail root, which slowly grows out of the skin and becomes the nail plate when it reaches the skin surface. As the nail grows longer, the cells of the nail root and nail plate are pushed toward the distal end of the finger or toe by new cells being formed in the nail matrix. The upper epidermal cells of the nail bed also move along with the nail plate as it grows toward the tip of the digit.<\/p>\n<p>The proximal end of the nail plate near the root has a whitish crescent shape called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3921\">lunula<\/a><\/strong>. This is where a small amount of the nail matrix is visible through the nail plate. The lunula is most pronounced in the nails of the thumbs, and may not be visible in the nails of the little fingers.<\/p>\n<h2>Rate of Nail Growth<\/h2>\n<p>Nails grow at an average rate of 3 mm a month. Fingernails, however, grow up to four times as fast as toenails. If a fingernail is lost, it takes between three and six months to regrow completely, whereas a toenail takes between 12 and 18 months to regrow. The actual rate of growth of an individual\u2019s nails depends on many factors, including age, sex, season, diet, exercise level, and genes. If protected from breaking, nails can sometimes grow to be very long. The Chinese doctor in the photo below (Figure 10.6.3) has very long nails on two fingers of his left hand. This picture was taken in 1920 in China, where having long nails was a sign of aristocracy since it implied that one was wealthy enough to not have to do physical labour.<\/p>\n<figure id=\"attachment_3922\" aria-describedby=\"caption-attachment-3922\" style=\"width: 313px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3922\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Chinese_doctor_with_long_finger_nails_an_aristocrat_ca.1920_CHS-249-scaled-2.jpg\" alt=\"10.6 Fingernails and aristocracy\" width=\"313\" height=\"500\"><figcaption id=\"caption-attachment-3922\" class=\"wp-caption-text\"><em>Figure 10.6.3 Nails, like hair, can have sociocultural relevance, as the man in this photo illustrates. His long nails indicate his aristocratic heritage.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Functions of Nails<\/h1>\n<\/div>\n<p>Both fingernails and toenails protect the soft tissues of the fingers and toes from injury. Fingernails also serve to enhance sensation and precise movements of the fingertips through the counter-pressure exerted on the pulp of the fingers by the nails. In addition, fingernails can function as several different types of tools. For example, they enable a fine precision grip like tweezers, and can also be used for cutting and scraping.<\/p>\n<div>\n<h1>Nails and Health<\/h1>\n<\/div>\n<p>Healthcare providers, particularly EMTs, often examine the fingernail beds as a quick and easy indicator of oxygen saturation of the blood, or the amount of blood reaching the extremities. If the nail beds are bluish or purple, it is generally a sign of low oxygen saturation. To see if blood flow to the extremities is adequate, a blanch test may be done. In this test, a fingernail is briefly depressed to turn the nail bed white by forcing the blood out of its capillaries. When the pressure is released, the pink colour of the nail bed should return within a second or two if there is normal blood flow. If the return to a pink colour is delayed, then it can be an indicator of low blood volume, due to dehydration or shock.<\/p>\n<figure id=\"attachment_3923\" aria-describedby=\"caption-attachment-3923\" style=\"width: 386px\" class=\"wp-caption alignleft\"><img class=\" wp-image-3923\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Toenail-fungus-Nagelpilz-3-1.jpg\" alt=\"10.6 Toenail fungus\" width=\"386\" height=\"290\"><figcaption id=\"caption-attachment-3923\" class=\"wp-caption-text\"><em>Figure 10.6.4 Fungus infections of the toenails are common. They often look worse than they are. Generally, they are more unsightly than painful or dangerous.<\/em><\/figcaption><\/figure>\n<p>How the visible portion of the nails appears can be used as an indicator of recent health status. In fact, nails have been used as diagnostic tools for hundreds \u2014 if not thousands \u2014 of years. Nail abnormalities, such as deep grooves, brittleness, discolouration, or unusually thin or thick nails, may indicate various illnesses, nutrient deficiencies, drug reactions, or other health problems.<\/p>\n<p>Nails \u2014 especially toenails \u2014 are common sites of fungal infections (shown in Figure 10.6.4), causing nails to become thickened and yellowish in colour. Toenails are more often infected than fingernails because they are often confined in shoes, which creates a dark, warm, moist environment where fungi can thrive. Toes also tend to have less blood flow than fingers, making it harder for the immune system to detect and stop infections in toenails.<\/p>\n<p>Although nails are harder and tougher than skin, they are also more permeable. Harmful substances may be absorbed through the nails and cause health problems. Some of the substances that can pass through the nails include the herbicide Paraquat, fungicidal agents such as miconazole (e.g., Monistat), and sodium hypochlorite, which is an ingredient in common household bleach. Care should be taken to protect the nails from such substances when handling or immersing the hands in them by wearing latex or rubber gloves.<\/p>\n<div>\n<h1>Feature: Reliable Sources<\/h1>\n<figure id=\"attachment_3924\" aria-describedby=\"caption-attachment-3924\" style=\"width: 400px\" class=\"wp-caption alignright\"><img class=\"wp-image-3924 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Pedicure-in-progress-from-wikimedia-commons-1.jpg\" alt=\"10.6.5 Nail salon\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-3924\" class=\"wp-caption-text\"><em>Figure 10.6.5 Nail salons must follow very strict cleanliness guidelines in order to reduce the chances of transmitting pathogens from one customer to the next.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Do you get regular manicures or pedicures from a nail technician? If so, there is a chance that you are putting your health at risk. Nail tools that are not properly disinfected between clients may transmit infections from one person to another. Cutting the cuticles with scissors may create breaks in the skin that let infective agents enter the body. Products such as acrylics, adhesives, and UV gels that are applied to the nails may be harmful, especially if they penetrate the nails and enter the skin.<\/p>\n<p>Use the Internet to find several reliable sources that address the health risks of professional manicures or pedicures. Try to find answers to the following questions:<\/p>\n<ol>\n<li>What training and certification are required for professional nail technicians?<\/li>\n<li>What licenses and inspections are required for nail salons?<\/li>\n<li>What hygienic practices should be followed in nail salons to reduce the risk of infections being transmitted to clients?<\/li>\n<li>Which professional nail products are potentially harmful to the\u00a0human body\u00a0and which are safer?<\/li>\n<li>How likely is it to have an adverse health consequence when you get a professional manicure or pedicure?<\/li>\n<li>What steps can you take to ensure that a professional manicure or pedicure is safe?<\/li>\n<\/ol>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">10.6 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_5023_3403\">Nails<\/a>\u00a0are accessory organs of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>, consisting of sheets of dead, keratin-filled <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a>. The keratin in nails makes them hard, but flexible.<\/li>\n<li>A nail has three main parts: the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3912\">nail root<\/a> (which is under the epidermis), the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">nail plate<\/a> (which is the visible part of the nail), and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3916\">free margin<\/a> (which is the distal edge of the nail). Other structures under or around a nail include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3914\">nail bed<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">cuticle<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3915\">nail fold<\/a>.<\/li>\n<li>A nail grows from a deep layer of living epidermal tissues \u2014 called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3920\">nail matrix<\/a> \u2014 at the proximal end of the nail. Stem cells in the nail matrix keep dividing to allow nail growth, forming first the nail root and then the nail plate as the nail continues to grow longer and emerges from the\u00a0epidermis.<\/li>\n<li>Fingernails grow faster than toenails. Actual rates of growth depend on many factors, such as age, sex, and season.<\/li>\n<li>Functions of nails include protecting the digits, enhancing sensations and precise movements of the fingertips, and acting as tools.<\/li>\n<li>The colour of the nail bed can be used to quickly assess oxygen and blood flow in a patient. How the nail plate grows out can reflect recent health problems, such as illness or nutrient deficiency.<\/li>\n<li>Nails \u2014 and especially toenails \u2014 are prone to fungus infections. Nails are more permeable than skin and can absorb several harmful substances, such as herbicides.<\/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\">10.6 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What are nails?<\/li>\n<li>\n<div id=\"h5p-371\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-371\" class=\"h5p-iframe\" data-content-id=\"371\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.6 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain why most of the nail plate looks pink.<\/li>\n<li>Describe a lunula.<\/li>\n<li>Explain how a nail grows.<\/li>\n<li>Identify three functions of nails.<\/li>\n<li>Give several examples of how nails are related to health.<\/li>\n<li>What is the cuticle of the nail composed of?\u00a0What is the function of the cuticle?\u00a0Why is it a bad idea to cut the cuticle during a manicure?<\/li>\n<li>Is the nail plate composed of living or dead cells?<\/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\">10.6 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=G35kPhbUZdg<\/p>\n<p style=\"text-align: center\">Longest Fingernails - Guinness World Records 60th Anniversary,<br \/>\nGuinness World Records, 2014.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=aTSVHwzkYI4&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">5 Things Your Nails Can Say About Your Health, SciShow, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=7w2gCBL1MCg<\/p>\n<p style=\"text-align: center\">Claws vs. Nails - Matthew Borths, TED-Ed, 2019.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 10.6.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/vPrqHSLdF28\" rel=\"cc:attributionURL\">Nails by allison-christine-vPrqHSLdF28<\/a>\u00a0[photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@happpyal\">allison christine<\/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 10.6.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0406_FingerNailAnatomy.png\" rel=\"cc:attributionURL\">Blausen_0406_FingerNailAnatomy<\/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 10.6.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Chinese_doctor_with_long_finger_nails_(an_aristocrat),_ca.1920_(CHS-249).jpg\" rel=\"cc:attributionURL\">Chinese_doctor_with_long_finger_nails_(an_aristocrat),_ca.1920_(CHS-249)<\/a> by Pierce, C.C. (Charles C.), 1861-1946 from the <a href=\"http:\/\/digitallibrary.usc.edu\/cdm\/ref\/collection\/p15799coll65\/id\/8203\">USC Digital Library<\/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 10.6.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Nagelpilz-3.jpg\" rel=\"cc:attributionURL\">Toenail fungus Nagelpilz-3<\/a> by <a class=\"new mw-userlink\" title=\"User:Pepsyrock (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Pepsyrock&amp;action=edit&amp;redlink=1\">Pepsyrock<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/public_domain).<\/p>\n<p><strong>Figure 10.6.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Pedicure_1.jpg\" rel=\"cc:attributionURL\">OLYMPUS DIGITAL CAMERA<\/a> by <a class=\"extiw\" title=\"en:User:Stoive\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Stoive\">Stoive<\/a> at the English language Wikipedia, 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>(http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license.<\/p>\n<p><span style=\"font-size: 1.424em;font-weight: bold\"><br \/>\nReferences<\/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\">Guiness World Records. (2014, December 8). Longest fingernails - Guinness World Records 60th Anniversary. YouTube. https:\/\/www.youtube.com\/watch?v=G35kPhbUZdg<\/p>\n<p class=\"hanging-indent\">SciShow. (2015, September 14). 5 things your nails can say about your health. YouTube. https:\/\/www.youtube.com\/watch?v=aTSVHwzkYI4<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2019, October 29). Claws vs. nails - Matthew Borths. YouTube. https:\/\/www.youtube.com\/watch?v=7w2gCBL1MCg<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4185\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4185\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3926\" aria-describedby=\"caption-attachment-3926\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3926\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Stolen_Moment_in_the_Sun-1.jpg\" alt=\"10.7.1 Sunbathing\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-3926\" class=\"wp-caption-text\"><em>Figure 10.7.1 I hope they're wearing sunscreen!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Bathing in Sunshine<\/h1>\n<\/div>\n<p>Summer sun may feel good on your body, but its invisible <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3537\">UV rays<\/a> wreak havoc on your skin. Exposing the skin to UV light causes photo-aging: premature wrinkling, brown discolourations, and other unattractive signs of sun exposure. Even worse, UV light increases your risk of skin cancer.<\/p>\n<div>\n<h1>What Is Skin Cancer?<\/h1>\n<\/div>\n<p>Skin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a> is a disease in which skin cells grow out of control. It is caused mainly by excessive exposure to UV light, which damages <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a>. Therefore, skin cancer most often develops on areas of the skin that are frequently exposed to UV light. However, it can also occur on areas that are rarely exposed to UV light. Skin cancer affects people of all skin colours, including those with dark skin. It also affects more people altogether than all other cancers combined. One in five Canadians develops skin cancer in his or her lifetime.<\/p>\n<div>\n<h1>Types of Skin Cancer<\/h1>\n<\/div>\n<p>Skin cancer begins in the outer layer of skin, the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3899\">epidermis<\/a>. There are three common types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma.<\/p>\n<h2>Basal Cell Carcinoma<\/h2>\n<figure id=\"attachment_3930\" aria-describedby=\"caption-attachment-3930\" style=\"width: 382px\" class=\"wp-caption alignright\"><img class=\" wp-image-3930\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Basal_cell_carcinoma_ulcerated-1.jpg\" alt=\"10.6 Basal Cell Carcinoma\" width=\"382\" height=\"255\"><figcaption id=\"caption-attachment-3930\" class=\"wp-caption-text\">Figure 10.7.2 Basal cell carcinoma<\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3927\">Basal cell carcinoma<\/a><\/strong> occurs in basal cells of the epidermis. Basal cells are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3163\">stem 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\"> in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3542\">stratum basale<\/a> layer that divide to form all the keratinocytes of the epidermis. Basal cell carcinoma is the most common form of skin cancer and 1 in 8 Canadians will develop basal cell carcinoma during their lifetime.\u00a0 A basal cell carcinoma may appear as a pearly or waxy sore, like the one shown in Figure 10.7.2. Basal cell carcinomas rarely spread (or undergo <\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3928\">metastasis<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">)<\/span><strong style=\"text-align: initial;font-size: 1em\">,<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0so they can generally be cured with a\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3929\">biopsy<\/a>,<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0in which the lesion is cut out of the skin and analyzed in a medical lab.<\/span><\/p>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Squamous Cell Carcinoma<\/span><\/p>\n<\/div>\n<figure id=\"attachment_3932\" aria-describedby=\"caption-attachment-3932\" style=\"width: 192px\" class=\"wp-caption alignleft\"><img class=\" wp-image-3932\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Squamous_cell_carcinoma_1-1.jpg\" alt=\"10.7 Squamous cell carcinoma\" width=\"192\" height=\"237\"><figcaption id=\"caption-attachment-3932\" class=\"wp-caption-text\">Figure 10.7.3 Squamous cell carcinoma<\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3931\">Squamous cell carcinoma<\/a><\/strong> occurs in squamous cells of the epidermis. Squamous cells are flattened, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>-filled cells in upper layers of the epidermis. Squamous cell carcinoma is the second most common form of skin cancer. More than two million cases occur in the United States each year. A squamous cell carcinoma may appear as a firm, red nodule, or as a flat lesion with a scaly or crusty surface, like the one pictured in Figure 10.7.3. Squamous cell carcinomas are generally localized and unlikely to metastasize, so they are usually curable surgically.<\/p>\n<p>&nbsp;<\/p>\n<div>\n<p><span style=\"font-size: 1.424em;font-weight: bold\">Melanoma<\/span><\/p>\n<\/div>\n<figure id=\"attachment_3934\" aria-describedby=\"caption-attachment-3934\" style=\"width: 251px\" class=\"wp-caption alignleft\"><img class=\" wp-image-3934\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Melanoma-1.jpg\" alt=\"10.7 Melanoma\" width=\"251\" height=\"175\"><figcaption id=\"caption-attachment-3934\" class=\"wp-caption-text\">Figure 10.7.4 Melanoma<\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3933\">Melanoma<\/a><\/strong> occurs in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3526\">melanocytes<\/a> of the epidermis. Melanocytes are the melanin-producing cells in the stratum basale of the epidermis. Melanoma is the rarest type of skin cancer, accounting for less than one per cent of all skin cancer cases. Melanoma, however, is the most deadly type of skin cancer. It causes the vast majority of skin cancer deaths, because melanoma is malignant. If not treated, it will metastasize and spread to other parts of the body. If melanoma is detected early and while it is still localized in the skin, most patients survive for at least five years. If melanoma is discovered only after it has already metastasized to distant organs, there is only a 17% of patients surviving for five years. You can see an example of a melanoma in Figure 10.7.4.<\/p>\n<p>Melanoma can develop anywhere on the body. It may develop in otherwise normal skin, or an existing mole may become cancerous. Signs of melanoma may include a:<\/p>\n<ul>\n<li>Mole that changes in size, feel, or colour.<\/li>\n<li>Mole that bleeds.<\/li>\n<li>Large brown spot on the skin sprinkled with darker specks.<\/li>\n<li>Small lesion with an irregular border and parts that appear red, white, blue, or blue-black.<\/li>\n<li>Dark lesion on the palms, soles, fingertips, toes, or mucous membranes.<\/li>\n<\/ul>\n<div>\n<h1>Skin Cancer Risk Factors<\/h1>\n<\/div>\n<p>Exposure to UV radiation causes about 90 per cent of all skin cancer cases. The connection between skin cancer and UV light is so strong that the World Health Organization has classified UV radiation (whether from tanning beds or the sun) as a Group 1 carcinogen (cancer-causing agent). Group 1 carcinogens are those carcinogens that are known with virtual <em>certainty<\/em>\u00a0to cause\u00a0cancer. In addition to UV light,\u00a0Group 1 carcinogens\u00a0include tobacco and plutonium.\u00a0In terms of numbers of cancers caused, UV radiation is far worse than tobacco. More people develop skin cancer because of UV light exposure than develop lung\u00a0cancer\u00a0because of smoking. The increase in cancer risk due to UV light is especially great if you have ever had blistering sunburns as a child or teen.<\/p>\n<p>Besides UV light exposure, other risk factors for skin cancer include:<\/p>\n<ul>\n<li>Having light coloured skin.<\/li>\n<li>Having a lot of moles.<\/li>\n<li>Being diagnosed with precancerous skin lesions.<\/li>\n<li>Having a family history of skin cancer.<\/li>\n<li>Having a personal history of skin cancer.<\/li>\n<li>Having a weakened immune system.<\/li>\n<li>Being exposed to other forms of radiation or to certain toxic substances such as arsenic.<\/li>\n<\/ul>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<p>As with most types of cancer, skin cancer is easiest to treat and most likely to be cured the earlier it is detected. The skin is one of the few organs that you can monitor for cancer yourself, as long as you know what to look for. A brown spot on the skin is likely to be a harmless mole, but it could be a sign of skin cancer. As shown in Figure 10.7.5 below, unlike moles, skin cancers may be asymmetrical, have irregular borders, may be very dark in colour, and may have a relatively great diameter. These characteristics can be remembered with the acronym ABCD.<\/p>\n<div>\n<figure id=\"attachment_3935\" aria-describedby=\"caption-attachment-3935\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3935\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/ABCDs-of-skin-cancer-1.png\" alt=\"10.7 ABCDs of skin cancer\" width=\"500\" height=\"137\"><figcaption id=\"caption-attachment-3935\" class=\"wp-caption-text\">Figure 10.7.5 ABCDs of skin cancer<\/figcaption><\/figure>\n<\/div>\n<p>With the help of\u00a0mirrors, you should check all of your skin regularly. Look for new skin growths or changes in any existing moles, freckles, bumps, or birthmarks. Report anything suspicious or different to your doctor.<\/p>\n<p>If you have risk factors for skin cancer, it\u2019s a good idea to have an annual skin check by a dermatologist. This helps ensure that cancerous or precancerous lesions will be detected before they grow too large and become difficult to cure, or in the case of melanoma, before they metastasize.<\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">10.7 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Skin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a> is a disease in which skin cells grow out of control. It is caused mainly by excessive exposure to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3537\">UV light<\/a>, which damages <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a>. Skin cancer affects more Canadians than all other cancers combined. There are three common types of skin cancer: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3927\">basal cell carcinoma<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3931\">squamous cell carcinoma<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3933\">melanoma<\/a>. Carcinomas are more common and unlikely to metastasize. Melanoma is rare and likely to metastasize. It causes most skin cancer deaths.<\/li>\n<li>Besides exposure to UV light, risk factors for skin cancer include having light coloured skin, having lots of moles, and a family history of skin cancer, among several others.<\/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\">10.7 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is skin cancer?<\/li>\n<li>How common is skin cancer?<\/li>\n<li>\n<div id=\"h5p-372\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-372\" class=\"h5p-iframe\" data-content-id=\"372\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.7 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Compare and contrast the three common types of skin cancer.<\/li>\n<li>Identify factors that increase the risk of skin cancer.<\/li>\n<li>How does exposure to UV light cause skin cancer?<\/li>\n<li>In which layer of the skin does skin cancer normally start?<\/li>\n<li>Which two skin cancers described in this section start in the same sub-layer? Include the name of the sub-layer and the cells affected in each of these cancers.<\/li>\n<li>Which type of skin cancer is most likely to spread to other organs? Explain your answer.<\/li>\n<li>Which form of skin cancer is the most deadly?<\/li>\n<li>What are some ways people can reduce their risk of getting skin cancer? 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\">10.7 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=60e-t4zglBk&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">The skin 'beauty' and the sun 'beast': Charareh Pourzand at TEDxBathUniveristy, TEDx Talks, 2014.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=ID-O-Ion3EQ&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Cancer of the Vulva, Robert Miller, 2014.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=BmFEoCFDi-w<\/p>\n<p style=\"text-align: center\">How do cancer cells behave differently from healthy ones? - George Zaidan, TED-Ed, 2012.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 10.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Stolen_Moment_in_the_Sun.jpg\" rel=\"cc:attributionURL\">Stolen_Moment_in_the_Sun<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/79908182@N00\" rel=\"nofollow\">Angie Garrett<\/a> on Wikimedia Commons 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 10.7.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Basal_cell_carcinoma,_ulcerated.jpg\" rel=\"cc:attributionURL\">Basal_cell_carcinoma,_ulcerated<\/a> by Kelly Nelson (Photographer) from <a class=\"extiw\" title=\"en:National Cancer Institute\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Cancer_Institute\">National Cancer Institute<\/a> (part of the <a class=\"extiw\" title=\"en:National Institutes of Health\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Institutes_of_Health\">National Institutes of Health)<\/a> with the ID\u00a0<a class=\"external text\" href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=9237\" rel=\"nofollow\">9237<\/a> on Wikimedia Commons was 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)<b>.<\/b><\/p>\n<p><strong>Figure 10.7.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Squamous_cell_carcinoma_(1).jpg\" rel=\"cc:attributionURL\">Squamous_cell_carcinoma_(1)<\/a> by Kelly Nelson (Photographer) from <a class=\"extiw\" title=\"en:National Cancer Institute\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Cancer_Institute\">National Cancer Institute<\/a> (part of the <a class=\"extiw\" title=\"en:National Institutes of Health\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Institutes_of_Health\">National Institutes of Health)<\/a> with the ID\u00a0<a class=\"external text\" href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=9248\" rel=\"nofollow\">9248<\/a> on Wikimedia Commons was 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)<b>.<\/b><\/p>\n<p><strong>Figure 10.7.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Melanoma.jpg\" rel=\"cc:attributionURL\">Melanoma<\/a> by Unknown author\u00a0(Photographer) from <a class=\"extiw\" title=\"en:National Cancer Institute\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Cancer_Institute\">National Cancer Institute<\/a> (part of the <a class=\"extiw\" title=\"en:National Institutes of Health\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Institutes_of_Health\">National Institutes of Health)<\/a> with the <a href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=9186\">AV-8500-3850\/ ID 9186<\/a> on Wikimedia Commons was 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)<b>.<\/b><\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 10.7.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/12.7\/\" rel=\"cc:attributionURL\">ABCDs of skin cancer<\/a> by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/12.7\/\">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. (Original images courtesy of NCI: ID numbers <a href=\"http:\/\/visualsonline.cancer.gov\/details.cfm?imageid=2362\">2362;<\/a> <a href=\"http:\/\/visualsonline.cancer.gov\/details.cfm?imageid=2363\">2363<\/a>; <a href=\"http:\/\/visualsonline.cancer.gov\/details.cfm?imageid=2364\">2364;<\/a> and <a href=\"http:\/\/visualsonline.cancer.gov\/details.cfm?imageid=2184\">2184<\/a>)<\/p>\n<div><img src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/logo_ck12.png\" alt=\"\"> <span style=\"font-size: 1em\">\u00a9<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/\">CK-12 Foundation<\/a> <span style=\"font-size: 1em\">Licensed under\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/\"><img class=\"alignnone size-full wp-image-8217\" title=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\" src=\"https:\/\/www.ck12info.org\/wp-content\/uploads\/2016\/05\/icon_licence.png\" alt=\"CK-12 Foundation is licensed under Creative Commons AttributionNonCommercial 3.0 Unported (CC BY-NC 3.0)\"><\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/terms-of-use\/\">Terms of Use<\/a><span style=\"font-size: 1em\">\u00a0\u2022\u00a0<\/span><a style=\"font-size: 1em\" href=\"http:\/\/www.ck12.org\/about\/attribution\/\">Attribution<\/a><\/div>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2016). Figure 5 ABCDs of skin cancer[digital image]. In <em>CK-12 College Human Biology<\/em> (Section 12.7) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/12.7\/<\/p>\n<p class=\"hanging-indent\">Public Health Agency of Canada. (2019, December 9). Non melanoma skin cancer. Canada.ca. <a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/chronic-diseases\/cancer\/non-melanoma-skin-cancer.html\">https:\/\/www.canada.ca\/en\/public-health\/services\/chronic-diseases\/cancer\/non-melanoma-skin-cancer.html<\/a><\/p>\n<p class=\"hanging-indent\">Robert Miller. (2014, July 22). Cancer of the vulva. YouTube. https:\/\/www.youtube.com\/watch?v=ID-O-Ion3EQ<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2012, December 5). How do cancer cells behave differently from healthy ones? - George Zaidan. YouTube. https:\/\/www.youtube.com\/watch?v=BmFEoCFDi-w<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2014, March 28). The skin 'beauty' and the sun 'beast': Charareh Pourzand at TEDxBathUniveristy. YouTube. https:\/\/www.youtube.com\/watch?v=60e-t4zglBk<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_1796\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_1796\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3498\" aria-describedby=\"caption-attachment-3498\" style=\"width: 409px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3498\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Insulin_Application-1.jpg\" alt=\"9.7.1 Blood glucose testing\" width=\"409\" height=\"435\"><figcaption id=\"caption-attachment-3498\" class=\"wp-caption-text\"><em>Figure 9.7.1 Got to keep the balance.<\/em><\/figcaption><\/figure>\n<div>\n<h1>A Shot in the Arm<\/h1>\n<\/div>\n<p>Giving yourself an injection can be difficult, but for someone with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2969\">diabetes<\/a>, it may be a matter of life or death. The person in the photo has diabetes and is injecting themselves with insulin, the hormone that helps control the level of glucose in the blood. Insulin is produced by the pancreas.<\/p>\n<div>\n<h1>Introduction to the Pancreas<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3197\">pancreas<\/a><\/strong> is a large gland located in the upper left abdomen behind the stomach, as shown in Figure 9.7.2. The pancreas is about 15 cm (6 in) long, and it has a flat, oblong shape. Structurally, the pancreas is divided into a head, body, and tail. Functionally, the pancreas serves as both an endocrine gland and an exocrine gland.<\/p>\n<ul>\n<li>As an endocrine gland, the pancreas is part of the endocrine system. As such, it releases hormones (such as insulin) directly into the bloodstream for transport to cells throughout the body.<\/li>\n<li>As an exocrine gland, the pancreas is part of the digestive system. As such, it releases digestive enzymes into ducts that carry the enzymes to the gastrointestinal tract, where they assist with digestion. In this concept, the focus is on the pancreas as an endocrine gland. You can read about the pancreas as an exocrine gland in <a href=\"http:\/\/humanbiology.pressbooks.tru.ca\/chapter\/17-6-accessory-organs-of-digestion\/\">Chapter 15 Digestive System.<\/a><\/li>\n<\/ul>\n<figure id=\"attachment_3499\" aria-describedby=\"caption-attachment-3499\" style=\"width: 2047px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3499\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0699_PancreasAnatomy2-1.png\" alt=\"Location of the pancreas\" width=\"2047\" height=\"1638\"><figcaption id=\"caption-attachment-3499\" class=\"wp-caption-text\"><em>Figure 9.7.2 The pancreas is located behind the stomach and near the upper part of the small intestine (duodenum). Its ducts carry digestive enzymes into the small intestine. The endocrine hormones it produces are secreted into the blood.<\/em><\/figcaption><\/figure>\n<div>\n<h1>The Pancreas as an Endocrine Gland<\/h1>\n<\/div>\n<p>The tissues within the pancreas that have an endocrine role exist as clusters of cells called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3500\">pancreatic islets<\/a>.<\/strong> They are also called the islets of Langerhans. You can see pancreatic tissue, including islets, in Figure 9.7.3. There are approximately three million pancreatic islets, and they are crisscrossed by a dense network of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3501\">capillaries<\/a>. The capillaries are lined by layers of islet cells that have direct contact with the blood vessels, into which they secrete their endocrine hormones.<\/p>\n<figure id=\"attachment_3502\" aria-describedby=\"caption-attachment-3502\" style=\"width: 637px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3502\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Exocrine_and_Endocrine_Pancreas-1.jpg\" alt=\"Pancreas: Endocrine and Exocrine Gland\" width=\"637\" height=\"827\"><figcaption id=\"caption-attachment-3502\" class=\"wp-caption-text\"><em>Figure 9.7.3 The anatomy of the pancreas. The inset diagram shows pancreatic islet cells that produce endocrine hormones. It also shows the cells (called acinar cells) that secrete exocrine substances involved in digestion into pancreatic ducts.<\/em><\/figcaption><\/figure>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<p>The pancreatic islets consist of four main types of cells, each of which secretes a different endocrine hormone.\u00a0All of the hormones produced by the pancreatic islets, however, play crucial roles in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_317\">glucose<\/a> <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_176\">metabolism<\/a> and the regulation of blood glucose levels, among other functions.<\/p>\n<ol>\n<li>Islet cells called alpha (\u03b1) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3405\">glucagon<\/a>. The function of glucagon is to increase the level of glucose in the blood. It does this by stimulating the liver to convert stored glycogen into glucose, which is released into the bloodstream.<\/li>\n<li>Islets cells called beta (\u03b2) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2590\">insulin<\/a>. The function of insulin is to decrease the level of glucose in the blood. It does this by promoting the absorption of glucose from the blood into fat, liver, and skeletal muscle cells. In these tissues, the absorbed glucose is converted into glycogen, fats (triglycerides), or both.<\/li>\n<li>Islet cells called delta (\u03b4) cells secrete the hormone\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3503\">somatostatin<\/a>.<\/strong>\u00a0This hormone is also called growth hormone inhibiting hormone, because it inhibits the anterior lobe of the pituitary gland from producing growth hormone. Somatostatin also inhibits the secretion of pancreatic endocrine hormones and pancreatic exocrine enzymes.<\/li>\n<li>Islet cells called gamma (\u03b3) cells secrete the hormone <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3504\">pancreatic polypeptide<\/a>. The function of pancreatic polypeptide is to help regulate the secretion of both endocrine and exocrine substances by the pancreas.<\/li>\n<\/ol>\n<div>\n<h1>Disorders of the Pancreas<\/h1>\n<\/div>\n<p>There are a variety of disorders that affect the pancreas. They include pancreatitis, pancreatic cancer, and diabetes mellitus.<\/p>\n<h2>Pancreatitis<\/h2>\n<figure id=\"attachment_3506\" aria-describedby=\"caption-attachment-3506\" style=\"width: 390px\" class=\"wp-caption alignright\"><img class=\" wp-image-3506\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Jaundice_eye_new-1.jpg\" alt=\"Jaundice due to Pancreatitis\" width=\"390\" height=\"165\"><figcaption id=\"caption-attachment-3506\" class=\"wp-caption-text\"><em>Figure 9.7.4 Jaundice, or yellowing of the skin and whites of the eyes, is a common sign of pancreatitis.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3505\">Pancreatitis<\/a><\/strong> is inflammation of the pancreas. It has a variety of possible causes, including gallstones, chronic alcohol use, infections (such as measles or mumps), and certain medications. Pancreatitis occurs when digestive enzymes produced by the pancreas damage the gland\u2019s tissues, which causes problems with fat digestion. The disorder is usually associated with intense pain in the central abdomen, and the pain may radiate to the back. Yellowing of the skin and whites of the eyes (see Figure 9.7.4), which is called jaundice, is a common sign of pancreatitis. People with pancreatitis may also have pale stools and dark urine. Treatment of pancreatitis includes administering drugs to manage pain, and addressing the underlying cause of the disease, for example, by removing gallstones.<\/p>\n<h2>Pancreatic Cancer<\/h2>\n<p>There are several different types of pancreatic cancer that may affect either the endocrine or the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3398\">exocrine<\/a> tissues of the gland. Cancers affecting the endocrine tissues are all relatively rare. However, their incidence has been rising sharply. It is unclear to what extent this reflects increased detection, especially through medical imaging techniques. Unfortunately, pancreatic cancer is usually diagnosed at a relatively late stage when it is too late for surgery, which is the only way to cure the disorder. In 2020 it is estimated that 6,000 Canadians will be newly diagnosed with pancreatic cancer, and that during this same year, 5,300 will die of pancreatic cancer.<\/p>\n<p>While it is rare before the age of 40, pancreatic cancer occurs most often after the age of 60. Factors that increase the risk of developing pancreatic cancer include smoking, obesity, diabetes, and a family history of the disease. About one in four cases of pancreatic cancer are attributable to smoking. Certain rare genetic conditions are also risk factors for pancreatic cancer.<\/p>\n<h2>Diabetes Mellitus<\/h2>\n<p>By far the most common type of pancreatic disorder is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2771\">diabetes mellitus<\/a>, more commonly called simply diabetes. There are many different types of diabetes, but diabetes mellitus is the most common. It occurs in two major types, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">type 1 diabetes<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">type 2 diabetes<\/a>. The two types have different causes and may also have different treatments, but they generally produce the same initial symptoms, which include excessive urination and thirst. These symptoms occur because the kidneys excrete more urine in an attempt to rid the blood of excess glucose. Loss of water in urine stimulates greater thirst. Other signs and symptoms of diabetes are listed in Figure 9.7.5.<\/p>\n<figure id=\"attachment_3508\" aria-describedby=\"caption-attachment-3508\" style=\"width: 738px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-3508\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Main_symptoms_of_diabetes.svg_-1.png\" alt=\"Symptoms of Diabetes\" width=\"738\" height=\"755\"><figcaption id=\"caption-attachment-3508\" class=\"wp-caption-text\"><em>Figure 9.7.5 This chart shows symptoms shared by both type 1 and type 2 diabetes in black and symptoms more common in type 1 diabetes in blue.<\/em><\/figcaption><\/figure>\n<p>When diabetes is not well controlled, it is likely to have several serious long-term consequences. Most of these consequences are due to damage to small blood vessels caused by high <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_317\">glucose<\/a> levels in the blood. Damage to blood vessels, in turn, may lead to increased risk of coronary artery disease and stroke. Damage to blood vessels in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3139\">retina<\/a> of the eye can result in gradual vision loss and blindness. Damage to blood vessels in the kidneys can lead to chronic kidney disease, sometimes requiring dialysis or kidney transplant. Long-term consequences of diabetes may also include damage to the nerves of the body, known as diabetic neuropathy. In fact, this is the most common complication of diabetes. Symptoms of diabetic neuropathy may include numbness, tingling, and pain in the extremities.<\/p>\n<h3>Type 1 Diabetes<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">Type 1 diabetes<\/a><\/strong>\u00a0is a chronic autoimmune disorder in which the immune system attacks the insulin-secreting beta cells of the pancreas. As a result, people with type 1 diabetes lack the insulin needed to keep blood glucose levels within the normal range. Type 1 diabetes may develop in people of any age, but is most often diagnosed before adulthood. For type 1 diabetics, insulin injections are critical for survival.<\/p>\n<h3>Type 2 Diabetes<\/h3>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">Type 2 diabetes<\/a><\/strong>\u00a0is the single most common form of diabetes. The cause of high blood glucose in this form of diabetes usually includes a combination of insulin resistance and impaired insulin secretion. Both genetic and environmental factors play roles in the development of type 2 diabetes.\u00a0Type 2 diabetes can be managed with\u00a0changes in diet and physical activity, which may increase insulin sensitivity and help reduce blood glucose levels to normal ranges. Medications may also be used as part of the treatment, as may insulin injections.<\/p>\n<div>\n<h1>Feature: Human Biology in the News<\/h1>\n<\/div>\n<p>Some patients with type 1 diabetes have been given pancreatic islet cells transplants from other human donors. If the transplanted cells are not rejected by the recipient\u2019s immune system, they can cure the patient of diabetes. However,\u00a0because of a shortage of appropriate human donors, only about\u00a0one thousand\u00a0such surgeries have been performed over the past ten years.<\/p>\n<p>In June of 2016, a research team led by Dr. David K.C. Cooper at the Thomas E. Starzl Transplantation Institute in Pittsburgh, Pennsylvania, reported on their work developing pig islet cells for transplant into human diabetes patients. The researchers genetically engineered the pig islet cells to be protected from the human immune response. As a result, patients receiving the transplanted cells would require only minimal suppression of their immune system after the surgery. The pig islet cells would also be less likely to transmit pathogenic agents, because the animals could be raised in a controlled environment.<\/p>\n<p>The researchers have successfully transplanted the pig islet cells into monkey models of type 1 diabetes. As of June 2016, the scientists were looking for funding to undertake clinical trials in humans with type 1 diabetes. Dr. Cooper predicted then that if the human trials go as well as expected, the pig islet cells could be available for curing patients in as little as two years.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">9.7 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_5023_3197\">pancreas<\/a> is a gland located in the upper left abdomen behind the stomach that functions as both an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2939\">endocrine gland<\/a> and an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3398\">exocrine gland<\/a>. As an endocrine gland, the pancreas releases hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2590\">insulin<\/a>) directly into the bloodstream. As an exocrine gland, the pancreas releases digestive enzymes into ducts that carry them to the gastrointestinal tract.<\/li>\n<li>Tissues in the pancreas that have an endocrine role exist as clusters of cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3500\">pancreatic islets<\/a>. The islets consist of four main types of cells, each of which secretes a different endocrine hormone. Alpha (\u03b1) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3405\">glucagon<\/a>, beta (\u03b2) cells secrete insulin, delta (\u03b4) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3503\">somatostatin<\/a>, and gamma (\u03b3) cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3504\">pancreatic polypeptide<\/a>.<\/li>\n<li>The endocrine hormones secreted by the pancreatic islets all play a role, either directly or indirectly, in glucose metabolism and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_173\">homeostasis<\/a> of blood glucose levels. For example, insulin stimulates the uptake of glucose by cells and decreases the level of glucose in the blood, whereas glucagon stimulates the conversion of glycogen to glucose and increases the level of glucose in the blood.<\/li>\n<li>Disorders of the pancreas include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3505\">pancreatitis<\/a>, pancreatic <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1600\">cancer<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2771\">diabetes mellitus<\/a>. Pancreatitis is painful inflammation of the pancreas that has many possible causes. Pancreatic cancer of the endocrine tissues is rare, but increasing in frequency. It is generally discovered too late to cure surgically. Smoking is a major risk factor for pancreatic cancer.<\/li>\n<li>Diabetes mellitus is the most common type of pancreatic disorder. In diabetes, inadequate\u00a0activity\u00a0of insulin results in high blood levels of glucose. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3507\">Type 1 diabetes<\/a> is a chronic autoimmune disorder in which the immune system attacks the insulin-secreting beta cells of the pancreas. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2970\">Type 2 diabetes<\/a> is usually caused by a combination of insulin resistance and impaired insulin secretion due to a variety of environmental and genetic factors.<\/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\">9.7 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Describe the structure and location of the pancreas.<\/li>\n<li>Distinguish between the endocrine and exocrine functions of the pancreas.<\/li>\n<li>\n<div id=\"h5p-139\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-139\" class=\"h5p-iframe\" data-content-id=\"139\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Label the brain\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>\n<div id=\"h5p-140\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-140\" class=\"h5p-iframe\" data-content-id=\"140\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Brain\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What is pancreatitis? What are possible causes and effects of pancreatitis?<\/li>\n<li>Describe the incidence, prognosis, and risk factors of cancer of the endocrine tissues of the pancreas.<\/li>\n<li>Compare and contrast type 1 and type 2 diabetes.<\/li>\n<li>If the alpha islet cells of the pancreas were damaged to the point that they no longer functioned, how would this affect blood glucose levels? Assume that no outside regulation of this system is occurring and explain your answer. Further, would administration of insulin be more likely to help or hurt\u00a0this condition? Explain your answer.<\/li>\n<li>Explain why diabetes causes excessive thirst.<\/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\">9.7 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=8dgoeYPoE-0&amp;t=2s<\/p>\n<p style=\"text-align: center\">What does the pancreas do? - Emma Bryce, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=qlzLSbAGMqA&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Type 2 diabetes in children, Children's Health, 2008.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=da1vvigy5tQ<\/p>\n<p style=\"text-align: center\">Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU, TEDx Talks, 2015.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 9.7.1<\/strong><\/p>\n<section class=\"standard post-785 chapter type-chapter status-publish hentry focusable\" data-type=\"chapter\">\n<div class=\"media-atttributions\">\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Insulin_Application.jpg\" rel=\"cc:attributionURL\">Insulin_Application<\/a> by <a class=\"extiw\" title=\"w:cs:User:Mr Hyde\" href=\"https:\/\/en.wikipedia.org\/wiki\/cs:User:Mr_Hyde\">Mr Hyde<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"w:cs:\" href=\"https:\/\/en.wikipedia.org\/wiki\/cs:\">Czech Wikipedia<\/a> (Original text: moje foto) on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p><strong>Figure 9.7.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0699_PancreasAnatomy2.png\" rel=\"cc:attributionURL\">Blausen_0699_PancreasAnatomy2<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/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 9.7.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2424_Exocrine_and_Endocrine_Pancreas.jpg\" rel=\"cc:attributionURL\">Exocrine_and_Endocrine_Pancreas<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder\">OpenStax College<\/a> 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\/deed.en) license.<\/p>\n<p><strong>Figure 9.7.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Jaundice_eye_new.jpg\" rel=\"cc:attributionURL\">Jaundice_eye_new<\/a> by <a class=\"mw-userlink\" title=\"User:Info-farmer\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Info-farmer\">Info-farmer<\/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 image, File:<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Jaundice_eye.jpg\">Jaundice eye.jpg<\/a>, is from <a class=\"extiw\" title=\"w:Centers for Disease Control and Prevention\" href=\"https:\/\/en.wikipedia.org\/wiki\/Centers_for_Disease_Control_and_Prevention\">Centers for Disease Control and Prevention<\/a>'s\u00a0<a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/\" rel=\"nofollow\">Public Health Image Library<\/a>\u00a0(PHIL), with identification number\u00a0<b><a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/details.aspx?pid=2860\" rel=\"nofollow\">#2860<\/a><\/b><a class=\"external text\" href=\"https:\/\/phil.cdc.gov\/details.aspx?pid=2860\" rel=\"nofollow\">)<\/a><\/p>\n<p><strong>Figure 9.7.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Main_symptoms_of_diabetes.svg\" rel=\"cc:attributionURL\">Main_symptoms_of_diabetes.svg<\/a> by <a class=\"extiw\" title=\"en:User:Mikael H\u00e4ggstr\u00f6m\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Mikael_H%C3%A4ggstr%C3%B6m\">Mikael H\u00e4ggstr\u00f6m<\/a> on Wikimedia Commons is released into the <a class=\"extiw\" title=\"w:public domain\" href=\"https:\/\/en.wikipedia.org\/wiki\/public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain)<i>.<\/i><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"glossary\"><span style=\"font-size: 1.424em;font-weight: bold;color: #333333\">References<\/span><\/div>\n<\/section>\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, July 19). Figure 23.26 Exocrine and endocrine pancreas [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 23.6). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/23-6-accessory-organs-in-digestion-the-liver-pancreas-and-gallbladder<\/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\">Children's Health. (2008, June 13). Type 2 diabetes in children. YouTube. https:\/\/www.youtube.com\/watch?v=qlzLSbAGMqA&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\"><span class=\"author\">Hering, B. J.<\/span>,\u00a0<span class=\"author\">Cozzi, E.<\/span>,\u00a0<span class=\"author\">Spizzo, T.<\/span>,\u00a0<span class=\"author\">Cowan, P. J.<\/span>,\u00a0<span class=\"author\">Rayat, G. R.<\/span>,\u00a0<span class=\"author\">Cooper, D. K. C.<\/span>,\u00a0<span class=\"author\">Denner, J<\/span>. (2016, March 4). <span class=\"articleTitle\">First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes\u2014Executive summary<\/span>.\u00a0<i>Xenotransplantation<\/i>\u00a0<em><span class=\"pubYear\">2016<\/span><\/em>, <span class=\"vol\">23<\/span>:\u00a0<span class=\"pageFirst\">3<\/span>\u2013\u00a0<span class=\"pageLast\">13<\/span>. https:\/\/doi.org\/10.1111\/xen.12231<\/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<p class=\"hanging-indent\">TEDx Talks. (2015, May 4).\u00a0Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU. YouTube. https:\/\/www.youtube.com\/watch?v=da1vvigy5tQ&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_5023_2890\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2890\"><div tabindex=\"-1\"><p id=\"x-ck12-NDJmYTczYjUzYjNkNmFjNDNhMGRmYWU0YWJjZmQzMzY.-0ah\">Created by CK-12\/Adapted by Christine Miller<\/p>\n<p>As you read in the beginning of this chapter, new parents Samantha and Aki left their pediatrician\u2019s office still unsure whether or not to vaccinate baby James. Dr. Rodriguez gave them a list of reputable sources where they could look up information about the safety of vaccines,\u00a0including\u00a0the Centers for Disease Control and Prevention (CDC). Samantha and Aki read that the consensus within the scientific community is that there is no link between vaccines and autism. They find a long list of studies published in peer-reviewed scientific journals that disprove any link. Additionally, some of the studies are \u201cmeta-analyses\u201d that analyzed the findings from many individual studies. The new parents are reassured by the fact that many different researchers, using a large number of subjects in numerous well-controlled and well-reviewed studies, all came to the same conclusion.<\/p>\n<figure id=\"attachment_2260\" aria-describedby=\"caption-attachment-2260\" style=\"width: 300px\" class=\"wp-caption alignright\"><img class=\"wp-image-2260\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/avel-chuklanov-DUmFLtMeAbQ-unsplash-scaled-2.jpg\" alt=\"\" width=\"300\" height=\"200\"><figcaption id=\"caption-attachment-2260\" class=\"wp-caption-text\"><em>Figure 1.8.1 Do your research!<\/em><\/figcaption><\/figure>\n<p id=\"x-ck12-MWQzNDU3ZWI2Y2U1ODJhYjNhODU5MWRkYTc4YzI0YTQ.-jpt\">Samantha also went back to the web page that originally scared her about the safety of vaccines. She found that the author was not a medical doctor or scientific researcher, but rather a self-proclaimed \u201cchild wellness expert.\u201d He sold books and advertising on his site, some of which were related to claims of vaccine injury. She realized that he was both an unqualified and potentially biased source of information.<\/p>\n<p id=\"x-ck12-Mzc1ZWJjM2E0MTllZDM2ZTU5ZDYzZjI3YTFiYjIzYTk.-sry\">Samantha also realized that some of his arguments were based on correlations between autism and vaccines, but, as the saying goes, \u201ccorrelation does not imply causation.\u201d For instance, the recent rise in autism rates may have occurred during the same time period as an increase in the number of vaccines given in childhood, but Samantha could think of many other environmental and social factors that have also changed during this time period. There are just too many variables to come to the conclusion that vaccines, or anything else, are the cause of the rise in autism rates based on that type of argument alone. Also, she learned that the age of onset of autism symptoms happens to typically be around the time that the MMR vaccine is first given, so the apparent association in the timing may just be a coincidence.<\/p>\n<p id=\"x-ck12-NDI2ZDk3MTRkZTk4ODdjNGRmNjFkZTA2NWVmZDRjMjQ.-crs\">Finally, Samantha came across news about\u00a0 a measles outbreak in Vancouver, British Columbia in the winter of 2019. Measles wasn\u2019t just a disease of the past! She learned that measles and whooping cough, which had previously been rare thanks to widespread vaccinations, are now on the rise, and that people choosing not to vaccinate their children seems to be one of the contributing factors. She realized that it is important to vaccinate her baby against these diseases, not only to protect him from their potentially deadly effects, but also to protect others in the population.<\/p>\n<p id=\"x-ck12-YzI1YTFhNDI3MTVkOGYzYjljZTNiOTE0NWYxNTNhNjI.-ets\">In their reading, Samantha and Aki learn that scientists do not yet know the causes of autism, but they feels reassured by the abundance of data that disproves any link with vaccines. Both parents think that the potential benefits of protecting their baby\u2019s health against deadly diseases outweighs any unsubstantiated claims about vaccines. They will be making an appointment to get baby James his shots soon.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 1 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p id=\"x-ck12-NjMwMjU4MjIwNDc5OWNjOGU4YWY1N2Y5NGM2OGNjMWU.-hbt\">In this chapter, you learned about some of the same concepts that helped Samantha and Aki make an informed decision. Specifically:<\/p>\n<ul id=\"x-ck12-YjJiMzQyYTM5NjU2OGQyYzlmN2U2YjdkMWIzYTdhOGQ.-yap\">\n<li>Science is a distinctive way of gaining knowledge about the natural world that is based on the use of evidence to logically test ideas. As such, science is\u00a0a\u00a0process,\u00a0as well as\u00a0a body of knowledge.<\/li>\n<li>A scientific theory, such as the germ theory of disease, is the highest level of explanation in science. A theory is a broad explanation for many phenomena that is widely accepted because it is supported by a great deal of evidence.<\/li>\n<li>The scientific\u00a0investigation is the cornerstone of science as a process. A scientific investigation is a systematic approach to answering questions about the physical and natural world. An investigation may be observational or experimental.<\/li>\n<li>A scientific experiment is a type of scientific investigation in which the researcher manipulates variables under controlled conditions to test expected outcomes. Experiments are the gold standard for scientific investigations and can establish causation between variables.<\/li>\n<li>Nonexperimental scientific investigations such as observational studies and modeling may be undertaken when experiments are impractical, unethical, or impossible. Observational studies generally can establish correlation \u2014 but not causation \u2014 between variables.<\/li>\n<li>A pseudoscience, such as astrology, is a field that is presented as scientific but that does not adhere to scientific standards and methods. Other misuses of science include deliberate hoaxes, frauds, and fallacies made by researchers.<\/li>\n<li>Strict guidelines must be followed when using human subjects in scientific research. Among the most important protections is the requirement for informed consent.<\/li>\n<\/ul>\n<p id=\"x-ck12-ZjkwMmVhNTI0YzVjODU2OGEyNjNkZDI4YjAwNGE1MTM.-grg\">Now that you know about the nature and process of science, you can apply these concepts in the next chapter to the study of human biology.<\/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 1 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li id=\"x-ck12-MzhmMWVhNTkyNTM3NzIwMTNjZmQ5YmMwNGYzMmYwNTY.-fvj\">\n<div id=\"h5p-11\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-11\" class=\"h5p-iframe\" data-content-id=\"11\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Scientific Method and &quot;Doing&quot; Science\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Why does a good hypothesis have to be falsifiable?<\/li>\n<li id=\"x-ck12-ZWNiZGI2YTgwM2FlMTkxYmM1NjQ1YjE3YzdhYzc4MzI.-ko2\">Name one scientific law.<\/li>\n<li>Name one scientific theory.<\/li>\n<li>Give an example of a scientific idea that was later discredited.<\/li>\n<li>A statistical measurement called a P-value is often used in science to determine whether or not a difference between two groups is actually significant or simply due to chance. A P-value of 0.03 means that there is a 3% chance that the difference is due to chance alone. Do you think a P-value of 0.03 would indicate that the difference is likely to be significant? Why or why not?<\/li>\n<li>Why is it important that scientists communicate their findings to others? How do they usually do this?<\/li>\n<li>What is a \u201ccontrol group\u201d in science?<\/li>\n<li>In a scientific experiment, why is it important to only change one variable at a time?<\/li>\n<li>Which is the <em style=\"text-align: initial;font-size: 1em\">dependent variable<\/em><span style=\"text-align: initial;font-size: 1em\"> \u2013 the variable that is manipulated or the variable that is being affected by the change?<\/span><\/li>\n<li><span style=\"text-align: initial;font-size: 1em\">You see an ad for a \u201cmiracle supplement\u201d called NQP3 that claims the supplement will reduce belly fat. They say it works by reducing the hormone cortisol and by providing your body with missing unspecified \u201cnutrients\u201d, but they do not cite any peer-reviewed clinical studies. They show photographs of three people who appear slimmer after taking the product. A board-certified plastic surgeon endorses the product on television. Answer the following questions about this product.<\/span><\/li>\n<\/ol>\n<p id=\"x-ck12-ZTkxNDRjODFiZjIwODEzNjc5MjYwMWZmN2U2ZDkyMzk.-o4e\" class=\"x-ck12-indent\" style=\"padding-left: 30px\">a. Do you think that because a doctor endorsed the product, it really works? Explain your answer.<\/p>\n<p id=\"x-ck12-NTgwZmIwM2ExNjcwOGFkM2E5N2RjZDUzMDQwZDkzMWU.-7mz\" class=\"x-ck12-indent\" style=\"padding-left: 30px\">b. What are two signs that these claims could actually be pseudoscience instead of true science?<\/p>\n<p id=\"x-ck12-NTliOGZkOGFlM2YzZjE5NzM2YWEwNmUzYTUxNTEzZjI.-spq\" class=\"x-ck12-indent\" style=\"padding-left: 30px\">c. Do you think the photographs are good evidence that the product works? Why or why not?<\/p>\n<p id=\"x-ck12-Yjc0YTIxZGZkNzYyZTkyYzYwNGNjMTM2ODg5OWRkNmI.-aiy\" class=\"x-ck12-indent\" style=\"padding-left: 30px\">d. If you wanted to do a strong scientific study of whether this supplement does what it claims, what would you do? Be specific about the subjects, data collected, how you would control variables, and how you would analyze the data.<\/p>\n<p id=\"x-ck12-Zjg5MjRhOTIzY2FhZTVmYjhkODFmODQ3YjAzOWMxOGU.-604\" class=\"x-ck12-indent\" style=\"padding-left: 30px\">e. What are some ways that you would ensure that the subjects in your experiment in part d are treated ethically and according to human subjects protections regulations?<\/p>\n<\/div>\n<\/div>\n<h2 id=\"x-ck12-YzhkZDM1NjIyZWY2OTkxNDVlODQ3NzVmZGJkNzkyYmY.-wlj\">Attribution<\/h2>\n<p><strong>Figure 1.8.1<\/strong><\/p>\n<p>[<a href=\"https:\/\/unsplash.com\/photos\/DUmFLtMeAbQ\">Photo of person sitting in front of personal computer<\/a>] by <a href=\"https:\/\/unsplash.com\/@chuklanov\">Avel Chuklanov<\/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<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_3005\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_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_5023_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_5023_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_5023_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_4671\">diarrhea<\/a>.\u00a0Weight\u00a0loss, fever, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_2405\">pathogens<\/a>. Symptoms typically include some combination of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4671\">diarrhea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_5899\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_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_5023_5661\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5661\"><div tabindex=\"-1\"><p>A hormone is a signaling molecule produced by glands in multicellular organisms that target distant organs to regulate physiology and behavior.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_2987\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_2987\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_1132\" aria-describedby=\"caption-attachment-1132\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-1131 size-full\" title=\"Botox, he whispered by Michael Reuter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Botox-joke.jpg\" alt=\"12.7 Botox Joke\" width=\"640\" height=\"225\"><figcaption id=\"caption-attachment-1132\" class=\"wp-caption-text\"><em>Figure 12.7.1 The botox effect.\u00a0<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study Conclusion: Needing to Relax<\/h1>\n<\/div>\n<p>As you learned in the beginning of this chapter, botulinum toxin \u2014 one form of which is sold under the brand name <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4150\">Botox<\/a> \u2014 does much more than smooth out wrinkles. It can be used to treat a number of disorders involving excessive muscle contraction, including cervical dystonia. You also\u00a0learned that cervical dystonia, which Edward suffers from, causes abnormal, involuntary muscle contractions of the neck. This results in jerky movements of the head and neck, and\/or a sustained abnormal tilt to the head. It is often painful and can significantly interfere with a person\u2019s life.<\/p>\n<figure id=\"attachment_1132\" aria-describedby=\"caption-attachment-1132\" style=\"width: 432px\" class=\"wp-caption alignleft\"><img class=\"wp-image-1132\" title=\"botulism by Jason Wilson\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Botulism-by-Jason-Wilson-on-flickr.jpg\" alt=\"12.7 Botulism joke\" width=\"432\" height=\"325\"><figcaption id=\"caption-attachment-1132\" class=\"wp-caption-text\"><em>Figure 12.7.2 These pickles are jokingly labeled \"botulism,\" but <\/em>actual <em>botulism is really no joke.<\/em><\/figcaption><\/figure>\n<p>How could a toxin actually\u00a0<em>help<\/em>\u00a0treat a muscular disorder? The botulinum toxin is produced by the soil bacterium,\u00a0<em>Clostridium botulinum<\/em>, and it is the cause of the potentially deadly disease called botulism. Botulism is often a foodborne illness, commonly caused by foods that are improperly canned. Other forms of botulism are caused by wound infections, or occur when infants consume spores of the bacteria from soil or honey.<\/p>\n<div><\/div>\n<p>Botulism can be life-threatening, because it paralyzes muscles throughout the body, including those involved in breathing. When a very small amount of botulinum toxin is injected carefully into specific muscles by a trained medical professional, however, it can be useful in inhibiting unwanted muscle contractions.<\/p>\n<p>For cosmetic purposes, botulinum toxin injected into the facial muscles relaxes them to reduce the appearance of wrinkles. When used to treat cervical dystonia, it is injected into the muscles of the neck to inhibit excessive muscle contractions. For many patients, this helps relieve the abnormal positioning, movements, and pain associated with the disorder. The effect is temporary, so the injections must be repeated every three to four months to keep the symptoms under control.<\/p>\n<p>How does botulinum toxin inhibit muscle contraction? First, recall how skeletal muscle contraction works. A motor neuron instructs skeletal muscle fibres to contract at a synapse between them called the neuromuscular junction. A nerve impulse called an action potential travels down to the axon terminal of the motor neuron, where it causes the release of the neurotransmitter acetylcholine (ACh) from synaptic vesicles. The ACh travels across the synaptic cleft and binds to ACh receptors on the muscle fibre, signaling the muscle fibre to contract. According to the sliding filament theory, the contraction of the muscle fibre occurs due to the sliding of myosin and actin filaments across each other. This causes the Z discs of the sacromeres to move closer together, shortening the sacromeres and causing the muscle fibre to contract.<\/p>\n<p>If you wanted to inhibit muscle contraction, at what points could you theoretically interfere with this process? Inhibiting the action potential in the motor neuron, the release of ACh, the activity of ACh receptors, or the sliding filament process in the muscle fibre would all theoretically impair this process and inhibit muscle contraction. For example, in the disease myasthenia gravis, the function of the ACh receptors is impaired, causing a lack of sufficient muscle contraction. As you have learned, this results in muscle weakness that can eventually become life-threatening. Botulinum toxin works by inhibiting the release of ACh from the motor neurons, thereby removing the signal instructing the muscles to contract.<\/p>\n<p>Fortunately, Edward\u2019s excessive muscle contractions and associated pain improved significantly thanks to botulinum toxin injections. Although cervical dystonia cannot currently be cured, botulinum toxin injections have improved the quality of life for many patients with this and other disorders involving excessive involuntary muscle contractions.<\/p>\n<p>As you have learned in this chapter, our muscular system allows us to do things like make voluntary movements, digest our food, and pump blood through our bodies. Whether they are in your arm, heart, stomach, or blood vessels, muscle tissue works by contracting. But as you have seen here, too much contraction can be a very bad thing. Fortunately, scientists and physicians have found a way to put a potentially deadly toxin \u2014 and wrinkle-reducing treatment \u2014 to excellent use as a medical treatment for some muscular system disorders.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">Chapter 12 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you learned about the muscular system. Specifically, you learned that:<\/p>\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2907\">muscular system<\/a> consists of all the muscles of the body. There are three types of muscle: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2981\">skeletal muscle<\/a> (which is attached to bones by tendons and enables voluntary body movements), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2568\">cardiac muscle<\/a> (which makes up the walls of the heart and makes it beat) and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscle<\/a> (which is found in the walls of internal organs and other internal structures and controls their movements).<\/li>\n<li>Muscles are organs composed mainly of muscle cells, which may also be called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4156\">muscle fibres<\/a> or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4157\">myocytes<\/a>. Muscle cells are specialized for the function of contracting, which occurs when protein filaments inside the cells slide over one another using energy from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2072\">ATP<\/a>. Muscle tissue is the only type of tissue that has cells with the ability to contract.<\/li>\n<li>Muscles can grow larger, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4159\">hypertrophy<\/a>. This generally occurs through increased use, although hormonal or other influences can also play a role. Muscles can also grow smaller, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4160\">atrophy<\/a>. This may occur through lack of use, starvation, certain diseases, or aging. In both hypertrophy and atrophy, the size \u2014 but not the number \u2014 of muscle fibres changes. The size of muscles is the main determinant of muscle strength.<\/li>\n<li>Skeletal muscles need the stimulus of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3031\">motor neurons<\/a>\u00a0to contract, and to move the body, they need the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2906\">skeletal system<\/a> to act upon.<\/li>\n<li>Skeletal muscle\u00a0is the most common type of muscle tissue in the human body.\u00a0To move bones in opposite directions, skeletal muscles often consist of pairs of muscles that work in opposition to one another to move bones in different directions at <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3949\">joints<\/a>.<\/li>\n<li>Skeletal muscle fibres are bundled together in units called muscle fascicles, which are bundled together to form individual skeletal muscles. Skeletal muscles also have connective tissue supporting and protecting the muscle tissue.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Each skeletal muscle fibre consists of a bundle of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4180\">myofibrils<\/a>, which are bundles of protein filaments. The filaments are arranged in repeating units called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4179\">sarcomeres<\/a>, which are the basic functional units of skeletal muscles. Skeletal muscle tissue is striated, because of the pattern of sarcomeres in its fibres.<\/li>\n<li>Skeletal muscle fibres can be divided into two types, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4184\">slow-twitch<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4185\">fast-twitch<\/a> fibres. Slow-twitch fibres are used mainly in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1796\">aerobic<\/a> endurance activities (such as long-distance running). Fast-twitch fibres are used mainly for non-aerobic, strenuous activities (such as sprinting). Proportions of the two types of fibres vary from muscle to muscle and person to person.<\/li>\n<\/ul>\n<\/li>\n<li>Smooth muscle tissue is found in the walls of internal organs and vessels. When smooth muscles contract, they help the organs and vessels carry out their functions. The pattern of smooth muscle contraction to move substances through body tubes is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>.\u00a0 Contractions of smooth muscles are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3005\">involuntary<\/a> and controlled by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2533\">autonomic nervous system<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2218\">hormones<\/a>, and other substances.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Cells of smooth muscle tissue are not striated because they lack sarcomeres, but the cells contract in the same basic way as striated muscle cells. Unlike striated muscle, smooth muscle can sustain very long-term contractions and maintain its contractile function, even when stretched.<\/li>\n<\/ul>\n<\/li>\n<li>Cardiac muscle tissue is found only in the wall of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2987\">heart<\/a>. When cardiac muscle contracts, the heart beats and pumps blood. Contractions of cardiac muscle are involuntary, like those of smooth muscles. They are controlled by electrical impulses from specialized cardiac cells.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Like skeletal muscle, cardiac muscle is striated because its filaments are arranged in sarcomeres.\u00a0The exact arrangement, however, differs, making cardiac and skeletal muscle tissues look different from one another.<\/li>\n<li>The heart is the muscle that performs the greatest amount of physical work in the course of a lifetime. Its cells contain a great many <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2383\">mitochondria<\/a> to produce ATP for energy and to help the heart resist fatigue.<\/li>\n<\/ul>\n<\/li>\n<li>A muscle contraction is an increase in the tension or a decrease in the length of a muscle. A muscle contraction is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4207\">isometric<\/a> if muscle tension changes, but muscle length remains the same. It is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4208\">isotonic<\/a> if muscle length changes, but muscle tension remains the same.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>A skeletal muscle contraction begins with electrochemical stimulation of a muscle fibre by a motor neuron. This occurs at a chemical synapse called a neuromuscular junction. The neurotransmitter acetylcholine diffuses across the synaptic cleft and binds to receptors on the muscle fibre. This initiates a muscle contraction.<\/li>\n<li>Once stimulated, the protein filaments within the skeletal muscle fibre slide past each other to produce a contraction. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4212\">sliding filament theory<\/a> is the most widely accepted explanation for how this occurs. According to this theory, thick <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4182\">myosin<\/a> filaments repeatedly attach to and pull on thin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4181\">actin<\/a> filaments, thus shortening sarcomeres.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4214\">Crossbridge cycling<\/a> is a cycle of molecular events that underlies the sliding filament theory. Using energy in ATP, myosin heads repeatedly bind with and pull on actin filaments. This moves the actin filaments toward the center of a sarcomere, shortening the sarcomere and causing a muscle contraction.<\/li>\n<li>The ATP needed for a muscle contraction comes first from ATP already available in the cell, and more is generated from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4217\">creatine phosphate<\/a>. These sources are quickly used up. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1945\">Glucose<\/a> and glycogen can be broken down to form ATP and pyruvate. Pyruvate can then be used to produce ATP in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2502\">aerobic respiration<\/a> if oxygen is available, or it can be used in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2163\">anaerobic respiration<\/a> if oxygen is not available.<\/li>\n<\/ul>\n<\/li>\n<li>Physical exercise is defined as any bodily activity that enhances or maintains physical fitness and overall health. Activities such as household chores may even count as physical exercise! Current recommendations for adults are 30 minutes of moderate exercise a day.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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 slow-twitch muscle fibres 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_5023_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 fast-twitch muscle fibres 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_5023_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<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\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_5023_4230\">myokines<\/a>, which promote tissue repair and growth and have anti-inflammatory effects.<\/li>\n<li>Physical exercise can reduce risk factors for cardiovascular disease, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4231\">hypertension<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4243\">excess body weight<\/a>. Physical exercise can also increase factors associated with cardiovascular health, such as mechanical efficiency of 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_5023_4233\">dementia<\/a> and other cognitive problems, perhaps because it increases blood flow or neurotransmitters in the brain, 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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4237\">depression<\/a>, possibly because it increases synthesis of natural <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4239\">euphoriants<\/a>\u00a0in the brain.<\/li>\n<li>Research shows 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 diabetes and obesity.<\/li>\n<\/ul>\n<\/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 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<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4253\">Musculoskeletal disorders<\/a>\u00a0are injuries that occur in muscles or associated tissues (such as tendons) because of biomechanical stresses. The disorders may be caused by sudden exertion, over-exertion, repetitive motions, and similar stresses.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>A <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4255\">muscle strain<\/a> is an injury in which muscle fibres tear as a result of overstretching. First aid for a muscle strain includes the five steps represented by the acronym PRICE (protection, rest, ice, compression, and elevation). Medications for inflammation and pain (such as NSAIDs) may also be used.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4257\">Tendinitis<\/a> is inflammation of a tendon that occurs when it is over-extended or worked too hard without rest. Tendinitis may also be treated with PRICE and NSAIDs.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4258\">Carpal tunnel syndrome<\/a> is a biomechanical problem that occurs in the wrist when the median nerve becomes compressed between carpal bones. It may occur with repetitive use, a tumor, or trauma to the wrist. It may cause pain, numbness, and eventually \u2014 if untreated \u2014 muscle wasting in the thumb and first two fingers of the hand.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4254\">Neuromuscular disorders<\/a>\u00a0are systemic disorders that occur because of problems with the nervous control of muscle contractions, or with the muscle cells themselves.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4260\">Muscular dystrophy<\/a> is a genetic disorder caused by defective proteins in muscle cells. It is characterized by progressive skeletal muscle weakness and death of muscle tissues.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4262\">Myasthenia gravis<\/a> is a genetic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. More muscles are affected, and muscles become increasingly weakened as the disorder progresses. Myasthenia gravis most often occurs because immune system antibodies block acetylcholine receptors on muscle cells, and because of the actual loss of acetylcholine receptors.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4264\">Parkinson\u2019s disease<\/a> is a degenerative disorder of the central nervous system that mainly affects the muscular system and movement. It occurs because of the death of neurons in the midbrain. Characteristic signs of the disorder are muscle tremor, muscle rigidity, slowness of movement, and postural instability. Dementia and depression also often characterize advanced stages of the disease.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>As you saw in this chapter, muscles need oxygen to provide enough ATP for most of their activities. In fact, all of the body\u2019s systems require oxygen, and also need to remove waste products, such as carbon dioxide. In the next chapter, you will learn about how the respiratory system obtains and distributes oxygen throughout the body, as well as\u00a0how it removes\u00a0wastes, such as carbon dioxide.<\/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 12 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-233\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-233\" class=\"h5p-iframe\" data-content-id=\"233\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 12 Review Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What are tendons? Name a muscular system disorder involving tendons<\/li>\n<li>Describe the relationship between muscles, muscle fibres, and fascicles.<br \/>\n<img class=\"alignnone wp-image-1134\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Biceps_PSF.jpg\" alt=\"\" width=\"178\" height=\"223\"><\/li>\n<li>The biceps and triceps muscles are shown above. Answer the following questions about these arm muscles.\n<ol type=\"a\">\n<li>When the biceps contract and become shorter (as in the picture above), what kind of motion does this produce in the arm?<\/li>\n<li>Is the situation described in part (a) more likely to be an isometric or isotonic contraction? Explain your answer.<\/li>\n<li>If the triceps were to then contract, which way would the arm move?<\/li>\n<\/ol>\n<\/li>\n<li>What are Z discs? What happens to them during muscle contraction?<\/li>\n<li>What is the function of mitochondria in muscle cells? Which type of muscle fibre has more mitochondria \u00ad\u2014 slow-twitch or fast-twitch?<\/li>\n<li>What is the difference between primary and secondary Parkinson\u2019s disease?<\/li>\n<li>Why can carpal tunnel syndrome cause muscle weakness in the hands?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 12.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/5409410945\">Botox, he whispered<\/a> by <a class=\"owner-name truncate\" title=\"Go to Michael Reuter's photostream\" href=\"https:\/\/www.flickr.com\/photos\/michaelreuter\/\" data-track=\"attributionNameClick\">Michael Reuter<\/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 12.7.2<\/strong><\/p>\n<p><a style=\"font-size: 1em\" href=\"https:\/\/www.flickr.com\/photos\/hive\/2962297451\">botulism<\/a><span style=\"font-size: 1em\">\u00a0<\/span>by <a class=\"owner-name truncate no-outline\" title=\"Go to jason wilson's photostream\" href=\"https:\/\/www.flickr.com\/photos\/hive\/\" data-track=\"attributionNameClick\">jason wilson<\/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>Reference<\/h2>\n<p class=\"hanging-indent\">Pearson Scott Foresman. (2020, April 14). File:Biceps (PSF).jpg [digital image]. <i>Wikimedia Commons.<\/i>\u00a0https:\/\/commons.wikimedia.org\/w\/index.php?title=File:Biceps_(PSF).jpg&amp;oldid=411251538. [Public Domain (https:\/\/en.wikipedia.org\/wiki\/Public_domain)]<\/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_5023_5783\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5783\"><div tabindex=\"-1\"><p>A double-membrane-bound organelle found in most eukaryotic organisms. Mitochondria convert oxygen and nutrients into adenosine triphosphate (ATP). ATP is the chemical energy \"currency\" of the cell that powers the cell's metabolic 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_5023_4207\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4207\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4452\" aria-describedby=\"caption-attachment-4452\" style=\"width: 321px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4452\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/bodybuilding_PNG24-1.png\" alt=\"14.4.1 Bodybuilding and Veins\" width=\"321\" height=\"500\"><figcaption id=\"caption-attachment-4452\" class=\"wp-caption-text\"><em>Figure 14.4.1 Those are some big veins.....<\/em><\/figcaption><\/figure>\n<div>\n<h1>Bulging Veins<\/h1>\n<\/div>\n<p>Why do bodybuilders have such prominent veins? Bulging\u00a0muscles\u00a0push surface veins closer to the skin.\u00a0Combine\u00a0that with a virtual lack of subcutaneous fat, and you have bulging veins, as well as bulging\u00a0muscles. Veins are one of three major types of blood vessels in the\u00a0cardiovascular system.<\/p>\n<div>\n<h1>Types of Blood Vessels<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3743\">Blood vessels<\/a><\/strong>\u00a0are the part of the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3835\">cardiovascular system<\/a>\u00a0that transports\u00a0blood\u00a0throughout the\u00a0human body. There are three major types of blood vessels. Besides veins, they include arteries and capillaries.<\/p>\n<h2>Arteries<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4385\">Arteries<\/a><\/strong>\u00a0are defined as blood vessels that carry\u00a0blood\u00a0away from the\u00a0heart. Blood flows through arteries largely because it is under pressure from the pumping action of the heart. It should be noted that coronary arteries, which supply heart muscle\u00a0cells\u00a0with blood, travel\u00a0<em>toward<\/em> the heart, but not as part of the blood flow that travels through the chambers of the heart. Most arteries, including coronary arteries, carry oxygenated blood, but there are a few exceptions, most notably the pulmonary artery. This artery carries deoxygenated blood from the heart to the lungs, where it picks up oxygen and releases carbon dioxide. In virtually all other arteries, the hemoglobin in red blood cells is highly saturated with oxygen (95\u2013100 per cent). These arteries distribute oxygenated blood to tissues throughout the body.<\/p>\n<p>The largest artery in the body is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4413\"><strong>aorta<\/strong><\/a>, which is connected to the heart and extends down into the abdomen (see Figure 14.4.2). The aorta has high-pressure, oxygenated blood pumped directly into it from the left ventricle of the heart. The aorta has many branches, and the branches subdivide repeatedly, with the subdivisions growing smaller and smaller in diameter. The smallest arteries are called arterioles.<\/p>\n<figure id=\"attachment_4453\" aria-describedby=\"caption-attachment-4453\" style=\"width: 596px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4453\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Arterial_System_en.svg_-1.png\" alt=\"14.4.2 Arterial System\" width=\"596\" height=\"900\"><figcaption id=\"caption-attachment-4453\" class=\"wp-caption-text\"><em>Figure 14.4.2 This figure shows the heart and the major arteries of the cardiovascular system. The pulmonary veins are included in the diagram because, like arteries, they carry oxygenated blood.<\/em><\/figcaption><\/figure>\n<h2>Veins<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4386\">Veins<\/a><\/strong> are defined as blood vessels that carry blood toward the heart. Blood traveling through veins is not under pressure from the beating heart. It gets help moving along by the squeezing action of skeletal muscles, for example, when you walk or breathe. It is also prevented from flowing backward by valves in the larger veins, as illustrated in Figure 14.4.3. and as seen in the ultrasonography image in Figure 14.4.4.\u00a0 Veins are called capacitance blood vessels, because the majority of the body\u2019s total volume of blood (about 60 per cent) is contained within veins.<\/p>\n<figure id=\"attachment_4465\" aria-describedby=\"caption-attachment-4465\" style=\"width: 759px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4465\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Skeletal_Muscle_Vein_Pump-1.jpg\" alt=\"14.4.3 Venous Valves\" width=\"759\" height=\"664\"><figcaption id=\"caption-attachment-4465\" class=\"wp-caption-text\"><em>Figure 14.4.3 The two flaps that make up a venous valve can open in just one direction, so blood can flow in only one direction through the vein.<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_4466\" aria-describedby=\"caption-attachment-4466\" style=\"width: 560px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4466\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Venous_valve_00013-1.gif\" alt=\"14.4.4 Venous Valve gif\" width=\"560\" height=\"416\"><figcaption id=\"caption-attachment-4466\" class=\"wp-caption-text\"><em>Figure 14.4.4 Here you can see the venous valve opening and closing to allow blood to flow closer to the heart with each contraction of the surrounding skeletal muscle.<\/em><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>Most veins carry deoxygenated blood, but there are a few exceptions, including the four pulmonary veins. These veins carry oxygenated blood from the lungs to the heart, which then pumps the blood to the rest of the body. In virtually all other veins, hemoglobin is relatively unsaturated with oxygen (about 75 per cent).<\/p>\n<figure id=\"attachment_4467\" aria-describedby=\"caption-attachment-4467\" style=\"width: 339px\" class=\"wp-caption alignright\"><img class=\" wp-image-4467\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Superior-and-Inferior-Vena-Cava-from-Freestockphotos.biz-adapted-by-CMiller-Public-Domain-1.png\" alt=\"14.4.5 Superior and Inferior Vena Cava\" width=\"339\" height=\"302\"><figcaption id=\"caption-attachment-4467\" class=\"wp-caption-text\"><em>Figure 14.4.5 The Superior and Inferior Vena Cava are the largest veins in the body. They deliver deoxygenated blood directly to the right atrium.<\/em><\/figcaption><\/figure>\n<p>The two largest veins in the body are the superior <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4410\">vena cava<\/a> \u2014 which carries blood from the upper body directly to the right atrium of the heart \u2014 and the inferior vena cava, which carries blood from the lower body directly to the right atrium (shown in Figure 14.4.5).\u00a0 Like arteries, veins form a complex, branching system of larger and smaller vessels. The smallest veins are called venules. They receive blood from capillaries and transport it to larger veins. Each venule receives blood from multiple capillaries.\u00a0 See the major veins of the human body in Figure 14.4.6.<\/p>\n<figure id=\"attachment_4468\" aria-describedby=\"caption-attachment-4468\" style=\"width: 596px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4468\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Venous_system_en.svg_-1.png\" alt=\"14.4.6 Venous System\" width=\"596\" height=\"900\"><figcaption id=\"caption-attachment-4468\" class=\"wp-caption-text\"><em>Figure 14.4.6 This diagram shows the heart and major veins of the cardiovascular system. The pulmonary arteries are included in the diagram because, like veins, they carry deoxygenated blood.<\/em><\/figcaption><\/figure>\n<h2>Capillaries<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3831\">Capillaries<\/a><\/strong> are the smallest blood vessels in the cardiovascular system. They are so small that only one red blood cell at a time can squeeze through a capillary, and then only if the red blood cell deforms. Capillaries connect arterioles and venules, as shown in Figure 14.4.7. Capillaries generally form a branching network of vessels, called a capillary bed, that provides a large surface area for the exchange of substances between the blood and surrounding tissues.<\/p>\n<figure id=\"attachment_4469\" aria-describedby=\"caption-attachment-4469\" style=\"width: 638px\" class=\"wp-caption alignnone\"><img class=\" wp-image-4469\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-2105_Capillary_Bed-1.jpg\" alt=\"Figure 14.4.6\" width=\"638\" height=\"377\"><figcaption id=\"caption-attachment-4469\" class=\"wp-caption-text\"><em>Figure 14.4.7 Capillaries form beds of tiny blood vessels that exchange substances with the cells of tissues.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Structure of Blood Vessels<\/span><\/p>\n<figure id=\"attachment_4471\" aria-describedby=\"caption-attachment-4471\" style=\"width: 390px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4471\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Artery-1.png\" alt=\"14.4.8 Artery Cross Section\" width=\"390\" height=\"333\"><figcaption id=\"caption-attachment-4471\" class=\"wp-caption-text\"><em>Figure 14.4.8 The lumen is the white space in the center of this cross-sectional slice of an artery. You can see that the walls of the artery have multiple layers.<\/em><\/figcaption><\/figure>\n<p>All blood vessels are basically hollow tubes with an internal space, called a lumen, through which blood flows. The lumen of an artery is shown in cross section in the photomicrograph (Figure 14.4.8). The width of blood vessels varies, but they all have a lumen. The walls of blood vessels differ depending on the type of vessel. In general, arteries and veins are more similar to one another than to capillaries in the structure of their walls.<\/p>\n<h2>Walls of Arteries and Veins<\/h2>\n<p>The walls of both arteries and veins have three layers: the tunica intima, tunica media, and tunica adventitia. You can see the three layers for an artery in the Figure 14.4.9.<\/p>\n<ol>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4473\">tunica intima<\/a><\/strong> is the inner layer of arteries and veins. It is also the thinnest layer, consisting of a single layer of endothelial cells surrounded by a thin layer of connective tissues. It reduces friction between the blood and the inside of the blood vessel walls.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4474\">tunica media<\/a><\/strong> is the middle layer of arteries and veins. In arteries, this is the thickest layer. It consists mainly of elastic fibres and connective tissues. In arteries, this is the thickest layer, because it also contains smooth muscle tissues, which control the diameter of the vessels- as such, the width of the tunic media can be helpful in distinguishing arteries from veins.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4475\">tunica externa<\/a><\/strong>\u00a0(also called tunica adventitia) is the outer layer of arteries and veins. It consists of connective tissue, and also contains nerves. In veins, this is the thickest layer. In general, the tunica externa protects and strengthens vessels, and attaches them to surrounding structures.<\/li>\n<\/ol>\n<figure id=\"attachment_4477\" aria-describedby=\"caption-attachment-4477\" style=\"width: 732px\" class=\"wp-caption alignnone\"><img class=\" wp-image-4477\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0055_ArteryWallStructure-1.png\" alt=\"14.4.8\" width=\"732\" height=\"732\"><figcaption id=\"caption-attachment-4477\" class=\"wp-caption-text\"><em>Figure 14.4.9 A vein has the same three layers as the artery shown here, but the middle layer (tunica media) of a vein is thinner and lacks smooth muscle tissue.<\/em><\/figcaption><\/figure>\n<h2>Capillary Walls<\/h2>\n<p>The walls of capillaries consist of little more than a single layer of epithelial cells. Being just one cell thick, the walls are well-suited for the exchange of substances between the blood inside them and the cells of surrounding tissues. Substances including water, oxygen, glucose, and other nutrients, as well as waste products (such as carbon dioxide), can pass quickly and easily through the extremely thin walls of capillaries.\u00a0 See figure 14.4.9 for a comparison of the structure of arteries, veins and capillaries.<\/p>\n<figure id=\"attachment_4478\" aria-describedby=\"caption-attachment-4478\" style=\"width: 596px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4478\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Artery-Vein-Capillary-Comparison-1.png\" alt=\"14.4.9 Comparison of arteries, veins, capillaries\" width=\"596\" height=\"283\"><figcaption id=\"caption-attachment-4478\" class=\"wp-caption-text\"><em>Figure 14.4.10 There are significant structural differences between arteries, veins and capillaries.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Blood Pressure<\/h1>\n<\/div>\n<p>The blood in arteries is normally under pressure because of the beating of the heart. The pressure is highest when the heart contracts and pumps out blood, and lowest when the heart relaxes and refills with blood. (You can feel this variation in pressure in your wrist or neck when you count your pulse.)\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4480\">Blood pressure<\/a><\/strong> is a measure of the force that blood exerts on the walls of arteries. It is generally measured in millimetres of mercury (mm Hg), and expressed as a double number \u2014 a higher number for systolic pressure when the ventricles contract, and a lower number for diastolic pressure when the ventricles relax. Normal blood pressure is generally defined as less than 120 mm Hg (systolic)\/80 mm Hg (diastolic) when measured in the arm at the level of the heart. It decreases as blood flows farther away from the heart and into smaller arteries.<\/p>\n<p>As arteries grow smaller, there is increasing resistance to blood flow through them, because of the blood's friction against the arterial walls. This resistance restricts blood flow so that less blood reaches smaller, downstream vessels, thus reducing blood pressure before the blood flows into the tiniest vessels, the capillaries. Without this reduction in blood pressure, capillaries would not be able to withstand the pressure of the blood without bursting. By the time blood flows through the veins, it is under very little pressure. The pressure of blood against the walls of veins is always about the same \u2014 normally no more than 10 mm Hg.<\/p>\n<div>\n<h1>Vasoconstriction and Vasodilation<\/h1>\n<\/div>\n<p>Smooth\u00a0muscles\u00a0in the walls of arteries can contract or relax to cause <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3942\">vasoconstriction<\/a> (narrowing of the lumen of blood vessels) or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2756\">vasodilation<\/a> (widening of the lumen of blood vessels). This allows the arteries \u2014 especially the arterioles\u00a0\u2014\u00a0to contract or relax as needed to help regulate <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4480\">blood pressure<\/a>. In this regard, the arterioles act like an adjustable nozzle on a garden hose. When they narrow, the increased\u00a0friction\u00a0with the arterial walls causes less blood to flow downstream from the narrowing, resulting in a drop in blood pressure. These actions are controlled by the autonomic\u00a0nervous system\u00a0in response to pressure-sensitive sensory receptors in the walls of larger arteries.<\/p>\n<p>Arteries can also dilate or constrict to help regulate body\u00a0temperature, by allowing more or less blood to flow from the warm body core to the body\u2019s surface. In addition, vasoconstriction and vasodilation play roles in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3921\">fight-or-flight response<\/a>, under control of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3015\">sympathetic\u00a0nervous system<\/a>. Vasodilation allows more blood to flow to\u00a0skeletal muscles, and vasoconstriction reduces blood flow to digestive organs.<\/p>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<figure id=\"attachment_4481\" aria-describedby=\"caption-attachment-4481\" style=\"width: 391px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4481\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Varicose-veins-1.jpg\" alt=\"14.4.10 Varicose veins\" width=\"391\" height=\"260\"><figcaption id=\"caption-attachment-4481\" class=\"wp-caption-text\"><em>Figure 14.4.11 This man exhibits varicose veins in his right lower calf.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"text-align: initial;font-size: 1em\">The lumpy appearance of this man\u2019s leg (Figure 14.4.10) is caused by varicose veins. Do you have varicose veins? If you do, you may wonder whether they are a sign of a significant health problem. You may also wonder whether you should have them treated, and if so, what treatments are available. As is usually the case, when it comes to your health, knowledge is power.<\/span><\/p>\n<\/div>\n<p>Varicose veins are veins that have become enlarged and twisted, because their valves have become ineffective (see Figure 14.4.11). As a result, blood pools in the veins and stretches them out. Varicose veins occur most frequently in the superficial veins of the legs, but they may also occur in other parts of the body. They are most common in older adults, females, and people who have a family history of the condition. Obesity and pregnancy also increase the risk of developing varicose veins. A job that requires standing for long periods of time, chronic constipation, and long-term alcohol consumption are additional risk factors.<\/p>\n<div>\n<figure id=\"attachment_4482\" aria-describedby=\"caption-attachment-4482\" style=\"width: 476px\" class=\"wp-caption alignright\"><img class=\" wp-image-4482\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Varicose_veins-en.svg_-1.png\" alt=\"14.4.11 Varicose Vein Formation\" width=\"476\" height=\"490\"><figcaption id=\"caption-attachment-4482\" class=\"wp-caption-text\"><em>Figure 14.4.12 This diagram shows how varicose veins form.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Varicose veins usually are not serious.\u00a0For\u00a0many people, they are only a cosmetic issue.\u00a0In severe cases, however, varicose veins may cause pain and other problems.\u00a0The affected leg(s) may feel heavy and achy, especially after long periods of standing. Ankles may become swollen by the end of the day. Minor injuries may bleed more than normal. The skin over the varicosity may become red, dry, and itchy. In very severe cases, skin ulcers may develop.<\/p>\n<p>If you are concerned about varicose veins, call them to the attention of your doctor, who can determine the best course of action for your case. There are many potential treatments for varicose veins. Some of the treatments have potential adverse side effects, and with many of the treatments, varicose veins may return.\u00a0The\u00a0best treatment for a given patient depends in part on the severity of the condition.<\/p>\n<ul>\n<li>If varicose veins are not serious, conservative treatment options may be recommended. These include avoiding standing or sitting for long periods, frequently elevating the legs, and wearing graduated compression stockings.<\/li>\n<li>For more serious cases, less conservative, but non-surgical options may be advised. These include sclerotherapy, in which medicine is injected into the veins to make them shrink. Another non-surgical approach is endovenous thermal ablation. In this type of treatment, laser light, radio-frequency\u00a0energy, or steam is used to\u00a0heat\u00a0the walls of the veins, causing them to shrink and collapse.<\/li>\n<li>For the most serious cases, surgery may be the best option. The most invasive surgery is vein stripping, in which all or part of the main trunk of a vein is tied off and removed from the leg while the patient is under general anesthesia. In a less invasive surgery, called ambulatory phlebectomy, short segments of a vein are removed through tiny incisions under local anesthesia.<\/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\">14.4 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_5023_3743\">Blood vessels<\/a>\u00a0are the part of the cardiovascular system that carries blood throughout the\u00a0human body. They are long, hollow,tube-like structures. There are three major types of blood vessels: arteries, veins, and capillaries.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4385\">Arteries<\/a> are blood vessels that carry blood away from the heart. Most arteries carry oxygenated blood. The largest artery is the aorta, which is connected to the heart and extends into the abdomen. Blood moves through arteries due to pressure from the beating of the heart.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4386\">Veins<\/a> are blood vessels that carry blood toward the heart. Most veins carry deoxygenated blood. The largest veins are the superior vena cava and inferior vena cava. Blood moves through veins by the squeezing action of surrounding skeletal muscles. Valves in veins prevent backflow of blood.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3831\">Capillaries<\/a> are the smallest\u00a0blood vessels. They connect arterioles and venules. They form capillary beds, where substances are exchanged between the blood and surrounding tissues.<\/li>\n<li>The walls of arteries and veins have three layers. The middle layer is thickest in arteries, in which it contains smooth muscle tissue that controls the diameter of the vessels. The outer layer is thickest in veins,\u00a0and consists mainly of connective tissue. The walls of capillaries consist of little more than a single layer of epithelial cells.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4480\">Blood pressure<\/a> is a measure of the force that blood exerts on the walls of arteries. It is expressed as a double number, with the higher number representing systolic pressure when the ventricles contract, and the lower number representing diastolic pressure when the ventricles relax. Normal blood pressure is generally defined as a pressure of less than 120\/80 mm Hg.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3942\">Vasoconstriction<\/a> (narrowing) and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2756\">vasodilation<\/a> (widening) of arteries can occur to help regulate blood pressure or body temperature, or change blood flow as part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3921\">fight-or-flight response<\/a>.<\/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\">14.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What are blood vessels? Name the three major types of blood vessels.<\/li>\n<li>\n<div id=\"h5p-397\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-397\" class=\"h5p-iframe\" data-content-id=\"397\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"14.4 Blood Vessels Flashcards\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Compare and contrast how blood moves through arteries and veins.<\/li>\n<li>What are capillaries, and what is their function?<\/li>\n<li>Does the blood in most veins have any oxygen at all? Explain your answer.<\/li>\n<li>Explain why it is important that the walls of capillaries are very thin.<\/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\">14.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/Ab9OZsDECZw<\/p>\n<p style=\"text-align: center\">How blood pressure works - Wilfred Manzano, TED-Ed, 2015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=9Wf8bLXVwFI<\/p>\n<p style=\"text-align: center\">What are Varicose Veins? Cleveland Clinic, 2019.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=hnjMdXSyA5o<\/p>\n<p style=\"text-align: center\">Arteries vs Veins ( Circulatory System ), MooMooMath and Science, 2018.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 14.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/pngimg.com\/download\/55276\" rel=\"cc:attributionURL\">bodybuilding_PNG24<\/a> from <a href=\"http:\/\/pngimg.com\">pngimg.com<\/a> is used under a\u00a0<a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\" rel=\"license\">CC BY-NC <\/a><a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\" target=\"_blank\" rel=\"license noopener noreferrer\">4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/) license.<\/p>\n<p><strong>Figure 14.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Arterial_System_en.svg\" rel=\"cc:attributionURL\">Arterial_System_en.svg<\/a> by Mariana Ruiz Villarreal [<a title=\"User:LadyofHats\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:LadyofHats\">LadyofHats]<\/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 14.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2114_Skeletal_Muscle_Vein_Pump.jpg\" rel=\"cc:attributionURL\">Skeletal_Muscle_Vein_Pump<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/20-2-blood-flow-blood-pressure-and-resistance\">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 14.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Venous_valve_00013.gif\" rel=\"cc:attributionURL\">Venous_valve_00013<\/a> by <a title=\"User:Nevit\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Nevit\">Nevit Dilmen<\/a> 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.<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\"><br \/>\nFigure 14.4.5<\/strong><\/p>\n<p><a href=\"http:\/\/www.freestockphotos.biz\/stockphoto\/14157\" rel=\"cc:attributionURL\">Superior and Inferior Vena Cava<\/a> by <a href=\"http:\/\/www.openclipart.org\/user-detail\/ArtFavor\" rel=\"nofollow\">ArtFavor<\/a> (acquired from\u00a0<a href=\"http:\/\/www.freestockphotos.biz\/photos.php?c=all&amp;o=popular&amp;s=0&amp;lic=all&amp;a=18&amp;set=all\">OCAL)<\/a> from <a href=\"http:\/\/Freestockphotos.biz\" rel=\"cc:attributionURL\">Freestockphotos.biz<\/a>, is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\">CC0 1.0<\/a> Universal public domain dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/). Work adapted by Christine Miller.<\/p>\n<p><strong>Figure 14.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Venous_system_en.svg\" rel=\"cc:attributionURL\">Venous_system_en.svg<\/a> by Mariana Ruiz Villarreal [<a title=\"User:LadyofHats\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:LadyofHats\">LadyofHats]<\/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 14.4.7<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:2105_Capillary_Bed.jpg\" rel=\"cc:attributionURL\">1024px-2105_Capillary_Bed<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/20-1-structure-and-function-of-blood-vessels\">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 14.4.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Artery.png\" rel=\"cc:attributionURL\">Artery<\/a> by <a class=\"new\" title=\"User:Lord of Konrad (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Lord_of_Konrad&amp;action=edit&amp;redlink=1\">Lord of Konrad<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\">CC0 1.0<\/a> Universal public domain dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/).<\/p>\n<p><strong>Figure 14.4.9<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0055_ArteryWallStructure.png\" rel=\"cc:attributionURL\">Blausen_0055_ArteryWallStructure<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> <span style=\"text-align: initial;font-size: 1em\">(https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/p>\n<p><strong>Figure 14.4.10<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Artery_Vein_Capillary_Comparison.png\" rel=\"cc:attributionURL\">Artery Vein Capillary Comparison<\/a> by <a title=\"User:Christinelmiller\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Christinelmiller\">Christinelmiller<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\" rel=\"license\">CC BY-SA 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/4.0) license.<\/p>\n<p><strong>Figure 14.4.11<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Varicose-veins.jpg\" rel=\"cc:attributionURL\">Varicose-veins<\/a> by <a class=\"extiw\" title=\"wikipedia:User:Jackerhack\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Jackerhack\">Jackerhack<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"wikipedia:\" href=\"https:\/\/en.wikipedia.org\/wiki\/\">English Wikipedia<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/2.5\" rel=\"license\">CC BY-SA 2.5<\/a> (https:\/\/creativecommons.org\/licenses\/by-sa\/2.5) license.<\/p>\n<p><strong>Figure 14.4.12<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Varicose_veins-en.svg\" rel=\"cc:attributionURL\">Varicose_veins-en.svg<\/a> by <a title=\"User:Jmarchn\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Jmarchn\">Jmarchn<\/a> 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. [Work modified from <a title=\"File:Varicose veins.jpg\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Varicose_veins.jpg\">Varicose veins.jpg<\/a> on Wikimedia Commons from <a href=\"https:\/\/www.nhlbi.nih.gov\/health-topics\/varicose-veins\">National Heart Lung and Blood Institute (NIH)]<\/a><\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1597098332397\" data-highlight-id=\"f612d91e-5631-4e48-9e62-a7146e5fdc70\" data-highlighted=\"true\"><span class=\"search-highlight text focus\" data-timestamp=\"1597097424850\" data-highlight-id=\"4390df96-8cec-49b4-b055-d4e046cfb136\" 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). <\/span>Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text\" data-timestamp=\"1597098332397\" data-highlight-id=\"f612d91e-5631-4e48-9e62-a7146e5fdc70\" data-highlighted=\"true\">20.6<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"83556\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1597098332397\" data-highlight-id=\"f612d91e-5631-4e48-9e62-a7146e5fdc70\" data-highlighted=\"true\">Capillary bed <span id=\"40312\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597097424850\" data-highlight-id=\"4390df96-8cec-49b4-b055-d4e046cfb136\" data-highlighted=\"true\">[digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 20.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/20-1-structure-and-function-of-blood-vessels<\/span><\/span><\/span><\/span><\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text focus\" data-timestamp=\"1597097424850\" data-highlight-id=\"4390df96-8cec-49b4-b055-d4e046cfb136\" 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 <\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text focus\" data-timestamp=\"1597097424850\" data-highlight-id=\"4390df96-8cec-49b4-b055-d4e046cfb136\" data-highlighted=\"true\">20.15<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"40312\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text focus\" data-timestamp=\"1597097424850\" data-highlight-id=\"4390df96-8cec-49b4-b055-d4e046cfb136\" data-highlighted=\"true\">Skeletal muscle pump [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 20.2). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/20-2-blood-flow-blood-pressure-and-resistance<\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">Cleveland Clinic. (2019, December 30). What are varicose veins? YouTube. https:\/\/www.youtube.com\/watch?v=9Wf8bLXVwFI&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">MooMooMath and Science. (2018, April 5). Arteries vs veins ( Circulatory System ). YouTube. https:\/\/www.youtube.com\/watch?v=hnjMdXSyA5o&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, July 23). How blood pressure works - Wilfred Manzano. YouTube. https:\/\/www.youtube.com\/watch?v=Ab9OZsDECZw&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_5023_4208\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4208\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4487\" aria-describedby=\"caption-attachment-4487\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4487\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/vampire_PNG32-1.png\" alt=\"14.5.1\" width=\"400\" height=\"316\"><figcaption id=\"caption-attachment-4487\" class=\"wp-caption-text\"><em>Figure 14.5.1 \"I want to suck your blood.\"<\/em><\/figcaption><\/figure>\n<div>\n<h1>Vampires<\/h1>\n<\/div>\n<p>From Bram Stoker\u2019s famous novel about Count Dracula, to films such as <em>Van Helsing<\/em> and the <em>Twilight<\/em> Saga<em>,<\/em> fantasies featuring vampires (like the one in Figure 14.5.1) have been popular for decades. Vampires, in fact, are found in centuries-old myths from many cultures. In such myths, vampires are generally described as creatures that drink blood \u2014 preferably of the human variety \u2014 for sustenance. Dracula, for example, is based on Eastern European folklore about a human who attains immortality (and eternal damnation) by drinking the blood of others.<\/p>\n<div>\n<h1>What Is Blood?<\/h1>\n<\/div>\n<figure id=\"attachment_4489\" aria-describedby=\"caption-attachment-4489\" style=\"width: 397px\" class=\"wp-caption alignleft\"><img class=\"wp-image-4489 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blood-centrifugation-scheme-1.png\" alt=\"14.5.2 Components of Blood\" width=\"397\" height=\"530\"><figcaption id=\"caption-attachment-4489\" class=\"wp-caption-text\">Figure 14.5.2 If blood is centrifuged (spun at high speed), it separates into its major components based on density, as shown here: plasma, leukocytes (white blood cells) and platelets, and erythrocytes (red blood cells). All blood normally contains these components in about the same proportions.<\/figcaption><\/figure>\n<p>The average adult body contains between 4.7 and 5.7 litres of blood. More than half of that amount is fluid. Most of the rest of that amount consists of blood cells. The relative amounts of the various components in blood are illustrated in Figure 14.5.2. The components are also described in detail below.<\/p>\n<div>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2702\"><strong>Blood<\/strong><\/a><span style=\"text-align: initial;font-size: 1em\">\u00a0is a fluid connective tissue that circulates throughout the body through blood vessels of the cardiovascular system. What makes blood so special that it features in widespread myths? Although blood accounts for less than 10% of human body weight, it is quite literally the elixir of life. As blood travels through the vessels of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3835\">cardiovascular system<\/a>, it delivers vital substances (such as nutrients and oxygen) to all of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3573\">cells<\/a>, and carries away their metabolic wastes. It is no exaggeration to say that without blood, cells could not survive. Indeed, without the oxygen carried in blood, cells of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3823\">brain<\/a> start to die within a matter of minutes.<\/span><\/p>\n<h1>Functions of Blood<\/h1>\n<\/div>\n<p>Blood performs many important functions in the body. Major functions of blood include:<\/p>\n<ul>\n<li>Supplying tissues with oxygen, which is needed by all cells for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3785\">aerobic cellular respiration<\/a>.<\/li>\n<li>Supplying cells with nutrients, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3359\">glucose<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3615\">amino acids<\/a>, and fatty acids.<\/li>\n<li>Removing metabolic wastes from cells, including carbon dioxide, urea, and lactic acid.<\/li>\n<li>Helping to defend the body from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">pathogens<\/a> and other foreign substances.<\/li>\n<li>Forming clots to seal broken blood vessels and stop bleeding.<\/li>\n<li>Transporting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3569\">hormones<\/a> and other messenger molecules.<\/li>\n<li>Regulating the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4330\">pH<\/a> of the body, which must be kept within a narrow range (7.35 to 7.45).<\/li>\n<li>Helping regulate body temperature (through <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3942\">vasoconstriction<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2756\">vasodilation<\/a>).<\/li>\n<\/ul>\n<div>\n<h1>Blood\u00a0Plasma<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4395\">Plasma<\/a><\/strong> is the liquid component of human blood. It makes up about 55% of blood by volume. It is about 92% water, and contains many dissolved substances. Most of these substances are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3721\">protein<span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">, but plasma also contains trace amounts of glucose, mineral ions, hormones, carbon dioxide, and other substances. In addition, plasma contains blood cells. When the cells are removed from plasma, as in Figure 14.5.2 above, the remaining liquid is clear but yellow in colour.<\/span><\/p>\n<div>\n<h1>Blood Cells<\/h1>\n<\/div>\n<p>The cells in blood include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4398\">erythrocytes<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">leukocytes<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4399\">thrombocytes<\/a>. These different types of blood cells are shown in the photomicrograph (Figure 14.5.3) and described in the sections that follow.<\/p>\n<figure id=\"attachment_4490\" aria-describedby=\"caption-attachment-4490\" style=\"width: 402px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4490\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/SEM_blood_cells-1.jpg\" alt=\"14.5.3 SEM Blood Cells\" width=\"402\" height=\"500\"><figcaption id=\"caption-attachment-4490\" class=\"wp-caption-text\"><em>Figure 14.5.3 Highly magnified blood cells in this image include doughnut-shaped red blood cells, rough-surfaced white blood cells, and small disc-shaped platelets.<\/em><\/figcaption><\/figure>\n<h2>Erythrocytes<\/h2>\n<p>The most numerous cells in blood are\u00a0red blood cells<strong>,<\/strong>\u00a0also called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4398\">erythrocyte<\/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\">. One microlitre of blood contains between 4.2 and 6.1 million red blood cells, and red blood cells make up about 25% of all the cells in the human body. The cytoplasm of a mature erythrocyte is almost completely filled with hemoglobin, the iron-containing protein that binds with oxygen and gives the cell its red colour. In order to provide maximum space for hemoglobin, mature erythrocytes lack a cell <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3705\">nucleus<\/a> and most <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3465\">organelle<\/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\">. They are little more than sacks of hemoglobin.<\/span><\/p>\n<p>Erythrocytes also carry proteins called antigens that determine blood type. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2703\">Blood type<\/a> is a genetic characteristic. The best known human blood type systems are the ABO and Rhesus systems.<\/p>\n<ul>\n<li>In the ABO system, there are two common antigens, called antigen A and antigen B. There are four ABO blood types, A (only A antigen), B (only B antigen), AB (both A and B antigens), and O (neither A nor B antigen). The ABO antigens are illustrated in Figure 14.5.4.<\/li>\n<li>In the Rhesus system, there is just one common antigen. A person may either have the antigen (Rh+) or lack the antigen (Rh-).<\/li>\n<\/ul>\n<figure id=\"attachment_4491\" aria-describedby=\"caption-attachment-4491\" style=\"width: 856px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4491\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/ABO_blood_type.svg_-1-2.png\" alt=\"14.5.4 ABO Blood Group\" width=\"856\" height=\"550\"><figcaption id=\"caption-attachment-4491\" class=\"wp-caption-text\"><em>Figure 14.5.4 Each of the ABO blood types is characterized by different glycoproteins on red blood cells.<\/em><\/figcaption><\/figure>\n<p>Blood type\u00a0is important for medical reasons. A person who needs a blood transfusion must receive blood of a compatible type. Blood that is compatible lacks antigens that the patient's own blood also lacks. For example, for a person with type A blood (no B antigen), compatible types include any type of blood that lacks the B antigen. This would include type A blood or type O blood, but not type AB or type B blood. If incompatible blood is transfused, it may cause a potentially life-threatening reaction in the patient\u2019s blood.<\/p>\n<h2>Leukocytes<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">Leukocyte<\/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\">\u00a0(also called white blood cells)<\/span><span style=\"text-align: initial;font-size: 1em\"> are cells in blood that defend the body against invading microorganisms and other threats. There are far fewer leukocytes than red blood cells in blood. There are normally only about 1,000 to 11,000 white blood cells per microlitre of blood. Unlike erythrocytes, leukocytes have a nucleus. White blood cells are part of the body\u2019s immune system. They destroy and remove old or abnormal cells and cellular debris, as well as attack pathogens and foreign substances. There are five main types of white blood cells, which are described in Table 14.5.1: neutrophils, eosinophils, basophils, lymphocytes, and monocytes. The five types differ in their specific immune functions.<\/span><\/p>\n<table class=\"grid\" style=\"width: 100%;height: 159px\">\n<caption>Table 14.5.1: Major Types of White Blood Cells<\/caption>\n<tbody>\n<tr style=\"height: 59px\">\n<th scope=\"col\">Type of Leukocyte<\/th>\n<th scope=\"col\">Per cent of All Leukocytes<\/th>\n<th scope=\"col\">Main Function(s)<\/th>\n<\/tr>\n<tr style=\"height: 14px\">\n<td>Neutrophil<\/td>\n<td>62%<\/td>\n<td>Phagocytize (engulf and destroy) bacteria and fungi in blood.<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td>Eosinophil<\/td>\n<td>\u00a0 2%<\/td>\n<td>Attack and kill large parasites; carry out allergic responses.<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td>Basophil<\/td>\n<td>\u00a0less than 1%<\/td>\n<td>Release histamines in inflammatory responses.<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<td>Lymphocyte<\/td>\n<td>30%<\/td>\n<td>Attack and destroy virus-infected and tumor cells; create lasting immunity to specific pathogens.<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td>Monocyte<\/td>\n<td>\u00a0 5%<\/td>\n<td>Phagocytize pathogens and debris in tissues.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Thrombocytes<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4399\">Thrombocyte<\/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\"> also called platelets, are actually cell fragments. Like erythrocytes, they lack a nucleus and are more numerous than white blood cells. There are about 150 thousand to 400 thousand thrombocytes per microlitre of blood.<\/span><\/p>\n<p>The main function of thrombocytes is blood clotting, or <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4492\">coagulation<\/a>.<\/strong>\u00a0This is the process by which blood changes from a\u00a0liquid\u00a0to a gel, forming a plug in a damaged blood vessel. If blood clotting is successful, it results in\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4493\">hemostasis<\/a><\/strong>, which is the cessation of blood loss from the damaged vessel. A blood clot consists of both platelets and proteins, especially the protein fibrin. You can see a scanning electron microscope photomicrograph of a blood clot in Figure 14.5.5.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_4494\" aria-describedby=\"caption-attachment-4494\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4494\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blood_clot_in_scanning_electron_microscopy-1.jpg\" alt=\"14.5.5 Blood Clot\" width=\"400\" height=\"271\"><figcaption id=\"caption-attachment-4494\" class=\"wp-caption-text\"><em>Figure 14.5.5 Erythrocytes become trapped in a coagulating clot so they cannot escape through a break in a blood vessel.<\/em><\/figcaption><\/figure>\n<figure id=\"attachment_4496\" aria-describedby=\"caption-attachment-4496\" style=\"width: 311px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4496\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0740_Platelets-1.png\" alt=\"14.5.6 Activated Thrombocytes\" width=\"311\" height=\"311\"><figcaption id=\"caption-attachment-4496\" class=\"wp-caption-text\"><em>Figure 14.5.6 The shape of platelets (thrombocytes) after they are activated helps them to stick together and form a plug for a damaged blood vessel.<\/em><\/figcaption><\/figure>\n<p>Coagulation begins almost instantly after an injury occurs to the endothelium of a blood vessel. Thrombocytes become activated and change their shape from spherical to star-shaped, as shown in Figure 14.5.6. This helps them aggregate with one another (stick together) at the site of injury to start forming a plug in the vessel wall. Activated thrombocytes also release substances into the blood that activate additional thrombocytes and start a sequence of reactions leading to fibrin formation. Strands of fibrin crisscross the platelet plug and strengthen it, much as rebar strengthens concrete.<\/p>\n<figure id=\"attachment_4651\" aria-describedby=\"caption-attachment-4651\" style=\"width: 675px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4651\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Platelet_Party_900x-1.png\" alt=\"Platelet Party\" width=\"675\" height=\"821\"><figcaption id=\"caption-attachment-4651\" class=\"wp-caption-text\"><em>Figure 14.5.7 Image by Nick Seluk\/ <a href=\"http:\/\/theAwkwardYeti.com\">theAwkwardYeti.com<\/a>. (c) Used with permission.<\/em><\/figcaption><\/figure>\n<h2>Formation and Degradation of Blood Cells<\/h2>\n<p>Blood is considered a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2815\">connective tissue<\/a>, because blood cells form inside\u00a0bones. All three types of blood cells are made in red marrow within the medullary cavity of bones in a process called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3961\">hematopoiesis<\/a><\/strong>. Formation of blood cells occurs by the proliferation of stem cells in the marrow. These stem cells are self-renewing \u2014 when they divide, some of the daughter cells remain stem cells, so the pool of stem cells is not used up. Other daughter cells follow various pathways to differentiate into the variety of blood cell types. Once the cells have differentiated, they cannot divide to form copies of themselves.<\/p>\n<p>Eventually, blood cells die and must be replaced through the formation of new blood cells from proliferating stem cells. After blood cells die, the dead cells are phagocytized (engulfed and destroyed) by white blood cells, and removed from the\u00a0circulation. This process most often takes place in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4497\">spleen<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2989\">liver<\/a>.<\/p>\n<div>\n<h1>Blood Disorders<\/h1>\n<\/div>\n<p>Many human disorders primarily affect the blood. They include cancers,\u00a0genetic disorders, poisoning by toxins, infections, and nutritional deficiencies.<\/p>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4498\">Leukemia<\/a><\/strong> is a group of cancers of the blood-forming tissues in the bone marrow. It is the most common type of cancer in children, although most cases occur in adults. Leukemia is generally characterized by large numbers of abnormal leukocytes. Symptoms may include excessive bleeding and bruising, fatigue, fever, and an increased risk of infections. Leukemia is thought to be caused by a combination of genetic and environmental factors.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4499\">Hemophilia<\/a><\/strong>\u00a0refers to any of several\u00a0genetic disorders\u00a0that cause dysfunction in the blood clotting process. People with hemophilia are prone to potentially uncontrollable bleeding, even with otherwise inconsequential injuries. They also commonly suffer bleeding into the spaces between\u00a0joints, which can cause crippling.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4500\">Carbon monoxide poisoning<\/a><\/strong> occurs when inhaled carbon monoxide (in fumes from a faulty home furnace or car exhaust, for example) binds irreversibly to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3556\">hemoglobin<\/a> in erythrocytes. As a result, oxygen cannot bind to the red blood cells for transport throughout the body, and this can quickly lead to suffocation. Carbon monoxide is extremely dangerous, because it is colourless and odorless, so it cannot be detected in the air by human senses.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4501\">HIV<\/a><\/strong> is a virus that infects certain types of leukocytes and interferes with the body\u2019s ability to defend itself from pathogens and other causes of illness. HIV infection may eventually lead to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3523\">AIDS<\/a> (acquired immunodeficiency syndrome). AIDS is characterized by rare infections and cancers that people with a healthy immune system almost never acquire.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3449\">Anemia<\/a><\/strong> is a disorder in which the blood has an inadequate volume of erythrocytes, reducing the amount of oxygen that the blood can carry, and potentially causing weakness and fatigue. These and other signs and symptoms of anemia are shown in Figure 14.5.8. Anemia has many possible causes, including excessive bleeding, inherited disorders (such as sickle cell hemoglobin), or nutritional deficiencies (iron, folate, or B12). Severe anemia may require transfusions of donated blood.<\/li>\n<\/ul>\n<figure id=\"attachment_4502\" aria-describedby=\"caption-attachment-4502\" style=\"width: 623px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4502\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Symptoms_of_anemia.svg_-1.png\" alt=\"14.5.7 Symptoms of Anemia\" width=\"623\" height=\"587\"><figcaption id=\"caption-attachment-4502\" class=\"wp-caption-text\"><em>Figure 14.5.8 Anemia has wide-ranging effects on the human body because oxygen is essential for normal functioning of cells in every organ system.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Feature: Myth vs. Reality<\/h1>\n<\/div>\n<p>Donating blood saves lives. In fact, with each blood donation, as many as <em>three<\/em> lives may be saved. According to Government Canada, up to 52% of Canadians have reported that they or a family member have needed blood or blood products at some point in their lifetime. Many donors agree that the\u00a0feeling that comes from knowing you have saved lives is well worth the short amount of time it takes to make a blood donation. Nonetheless, only a minority of potential donors actually donate blood. There are many myths about blood donation that may help explain the small percentage of donors. Knowing the facts may reaffirm your decision to donate if you are already a donor \u2014 and if you aren\u2019t a donor already, getting the facts may help you decide to become one.<\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%;height: 347px\" border=\"0\">\n<tbody>\n<tr>\n<th scope=\"col\"><span style=\"color: #ff0000\">Myth<\/span><\/th>\n<th scope=\"col\"><span style=\"color: #008000\">Reality<\/span><\/th>\n<\/tr>\n<tr style=\"height: 47px\">\n<td>\"Your blood might become contaminated with an infection during the donation.\"<\/td>\n<td>There is no risk of contamination because only single-use, disposable catheters, tubing, and other equipment are used to collect blood for a donation.<\/td>\n<\/tr>\n<tr style=\"height: 31px\">\n<td>\"You are too old (or too young) to donate blood.\"<\/td>\n<td>There is no upper age limit on donating blood, as long as you are healthy. The minimum age\u00a0is 16 years.<\/td>\n<\/tr>\n<tr style=\"height: 47px\">\n<td>\"You can\u2019t donate blood if you have high blood pressure.\"<\/td>\n<td>As long as your\u00a0blood pressure\u00a0is below 180\/100 at the time of donation, you can give blood. Even if you take blood pressure medication to keep your blood pressure below this level, you can donate.<\/td>\n<\/tr>\n<tr style=\"height: 31px\">\n<td>\"You can\u2019t give blood if you have high cholesterol.\"<\/td>\n<td>Having high cholesterol does not affect your ability to donate blood. Taking cholesterol-lowering medication also does not disqualify you.<\/td>\n<\/tr>\n<tr style=\"height: 31px\">\n<td>\"You can\u2019t donate blood if you have had a flu shot.\"<\/td>\n<td>Having a flu shot has no effect on your ability to donate blood. You can even donate on the same day that you receive a flu shot.<\/td>\n<\/tr>\n<tr style=\"height: 31px\">\n<td>\"You can\u2019t donate blood if you take medication.\"<\/td>\n<td>As long as you are healthy, in most cases, taking medication does not preclude you from donating blood.<\/td>\n<\/tr>\n<tr style=\"height: 31px\">\n<td>\"Your blood isn\u2019t needed if it\u2019s a common blood type.\"<\/td>\n<td>All types of blood are in constant demand.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">14.5 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_5023_2702\">Blood<\/a> is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4402\">fluid connective tissue<\/a> that circulates throughout the body in the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3835\">cardiovascular system<\/a>. Blood supplies tissues with oxygen and\u00a0nutrients\u00a0and removes their metabolic wastes. Blood helps defend the body from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">pathogens<\/a>\u00a0and other threats, transports <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3569\">hormones<\/a> and other substances, and helps keep the body\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4330\">pH<\/a> and temperature in homeostasis.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4395\">Plasma<\/a> is the liquid component of blood, and it makes up more than half of blood by volume. It consists of water and many dissolved substances. It also contains blood cells, including erythrocytes, leukocytes and thrombocytes.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4398\">Erythrocytes<\/a>, (also known as red blood cells) are the most numerous cells in blood. They consist mostly of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3556\">hemoglobin<\/a>, which carries oxygen. Erythrocytes also carry <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">antigens<\/a>\u00a0that determine <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2703\">blood type<\/a>.<\/li>\n<li>Leukocytes (also referred to as white blood cells) are less numerous than erythrocytes and are part of the body\u2019s immune system. There are several different types of leukocytes that differ in their specific immune functions. They protect the body from abnormal cells, microorganisms, and other harmful substances.<\/li>\n<li>Thrombocytes (also called platelets) are cell fragments that play important roles in blood clotting, or coagulation. They stick together at breaks in blood vessels to form a clot and stimulate the production of fibrin, which strengthens the clot.<\/li>\n<li>All blood cells form by proliferation of stem cells in red bone marrow in a process called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3961\">hematopoiesis<\/a>. When blood cells die, they are phagocytized by leukocytes and removed from the circulation.<\/li>\n<li>Disorders of the blood include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4498\">leukemia<\/a>, which is\u00a0cancer\u00a0of the bone-forming cells; <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4499\">hemophilia<\/a>, which is any of several genetic blood-clotting disorders; <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4500\">carbon monoxide poisoning<\/a>, which prevents erythrocytes from binding with oxygen and causes suffocation; <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4501\">HIV<\/a> infection, which destroys certain types of leukocytes and can cause <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3523\">AIDS<\/a>; and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3449\">anemia<\/a>, in which there are not enough erythrocytes to carry adequate oxygen to body tissues.<\/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\">14.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is blood? Why is blood considered a connective tissue?<\/li>\n<li>Identify four physiological roles of blood in the body.<\/li>\n<li>Describe plasma and its components.<\/li>\n<li>\n<div id=\"h5p-398\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-398\" class=\"h5p-iframe\" data-content-id=\"398\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"14.5 Quiz\"><\/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\">14.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/e-5wqwp64MM<\/p>\n<p style=\"text-align: center\">Joe Landolina: This gel can make you stop bleeding instantly, TED, 2014.<\/p>\n<p>https:\/\/youtu.be\/hgp8LtwFSBA<\/p>\n<p style=\"text-align: center\">Can Synthetic Blood Help The World's Blood Shortage? Science Plus, 2016.<\/p>\n<p>https:\/\/youtu.be\/1Qfmkd6C8u8<\/p>\n<p style=\"text-align: center\">How bones make blood - Melody Smith, TED-Ed, 2020.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 14.5.1<\/strong><\/p>\n<p><a href=\"http:\/\/pngimg.com\/download\/35873\" rel=\"cc:attributionURL\">vampire_PNG32<\/a> from <a href=\"http:\/\/pngimg.com\">pngimg.com<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\" rel=\"license\">CC BY-NC 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/) license.<\/p>\n<p><strong>Figure 14.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blood-centrifugation-scheme.png\" rel=\"cc:attributionURL\">Blood-centrifugation-scheme<\/a> by <a class=\"extiw\" title=\"wikipedia:User:KnuteKnudsen\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:KnuteKnudsen\">KnuteKnudsen<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"wikipedia:\" href=\"https:\/\/en.wikipedia.org\/wiki\/\">English Wikipedia<\/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 14.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:SEM_blood_cells.jpg\" rel=\"cc:attributionURL\">SEM_blood_cells<\/a> by Bruce Wetzel and Harry Schaefer (Photographers)\/ <a href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=2129\">NCI AV-8202-3656<\/a> 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><strong>Figure 14.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:ABO_blood_type.svg\" rel=\"cc:attributionURL\">ABO_blood_type.svg<\/a> by <a class=\"new\" title=\"User:InvictaHOG (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:InvictaHOG&amp;action=edit&amp;redlink=1\">InvictaHOG<\/a> on Wikimedia Commons is 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><strong>Figure 14.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blood_clot_in_scanning_electron_microscopy.jpg\" rel=\"cc:attributionURL\">Blood_clot_in_scanning_electron_microscopy<\/a> by Janice Carr from CDC\/ Public Health Image LIbrary <a href=\"https:\/\/phil.cdc.gov\/Details.aspx?pid=7308\">(PHIL) ID #7308<\/a> 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><strong>Figure 14.5.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0740_Platelets.png\" rel=\"cc:attributionURL\">Blausen_0740_Platelets<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> <span style=\"text-align: initial;font-size: 1em\">on Wikimedia Commons is used under a <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/p>\n<p><strong><br \/>\nFigure 14.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/theawkwardstore.com\/products\/platelet-party-id-badge-reel\" rel=\"cc:attributionURL\">Platelet_Party_900x<\/a>\u00a0by Awkward Yeti (used with permission of the author) \u00a9\u00a0<a href=\"https:\/\/choosealicense.com\/no-license\/\" rel=\"license\">All Rights Reserved<\/a><\/p>\n<p><strong>Figure 14.5.8<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Symptoms_of_anemia.svg\" rel=\"cc:attributionURL\">Symptoms_of_anemia.svg<\/a> by <a class=\"extiw\" title=\"en:User:Mikael H\u00e4ggstr\u00f6m\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:Mikael_H%C3%A4ggstr%C3%B6m\">Mikael H\u00e4ggstr\u00f6m<\/a> 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><span style=\"font-size: 1.424em;font-weight: bold\"><br \/>\nReferences<\/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\">Blood, organ and tissue donation. (2020, April 28). Government of Canada. https:\/\/www.canada.ca\/en\/public-health\/services\/healthy-living\/blood-organ-tissue-donation.html#a3<\/p>\n<p class=\"hanging-indent\">Canadian Blood Services. (n.d.). There is an immediate need for blood as demand is rising. https:\/\/www.blood.ca<\/p>\n<p class=\"hanging-indent\"><span style=\"text-align: initial;font-size: 1em\">Science Plus. (2016, March 2). Can synthetic blood help the world's blood shortage? <\/span><span style=\"text-align: initial;font-size: 1em\">https:\/\/www.youtube.com\/watch?v=hgp8LtwFSBA&amp;feature=youtu.be<\/span><\/p>\n<p class=\"hanging-indent\">TED. (2014, November 20). Joe Landolina: This gel can make you stop bleeding instantly. YouTube. https:\/\/www.youtube.com\/watch?v=e-5wqwp64MM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2020, January 27). How bones make blood - Melody Smith. YouTube. https:\/\/www.youtube.com\/watch?v=1Qfmkd6C8u8&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_5023_4212\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4212\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4547\" aria-describedby=\"caption-attachment-4547\" style=\"width: 415px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4547\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Ice-Cream-by-mark-cruz-Ov0u44CyGdM-unsplash-scaled-e1606264432394-1.jpg\" alt=\"The hands of 3 friends, each holding an ice cream cone.\" width=\"415\" height=\"500\"><figcaption id=\"caption-attachment-4547\" class=\"wp-caption-text\"><em>Figure 15.2.1 We all scream for ice cream!<\/em><\/figcaption><\/figure>\n<div>\n<h1>We All Scream for Ice Cream<\/h1>\n<\/div>\n<p>If you\u2019re an ice cream lover, then just the sight of this yummy ice cream cone may make your mouth\u00a0water. The \u201cwater\u201d in your mouth is actually saliva, a fluid released by glands that are part of the digestive system. Saliva contains digestive\u00a0enzymes, among other substances important for digestion. When your mouth waters at the sight of a tasty treat, it\u2019s a sign that your digestive system is preparing to digest food.<\/p>\n<div>\n<h1>What Is the Digestive System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3877\">digestive system<\/a><\/strong> consists of organs that break down food, absorb its nutrients, and expel any remaining waste. Organs of the digestive system are shown in <em>Figure 15.2.2.<\/em>\u00a0Most of these organs make up the gastrointestinal (GI) tract, through which food actually passes. The rest of the organs of the digestive system are called accessory organs. These organs secrete enzymes and other substances into the GI tract, but food does not actually pass through them.<\/p>\n<figure id=\"attachment_4548\" aria-describedby=\"caption-attachment-4548\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4548\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0316_DigestiveSystem-1.png\" alt=\"15.2.2\" width=\"400\" height=\"400\"><figcaption id=\"caption-attachment-4548\" class=\"wp-caption-text\"><em>Figure 15.2.2 The components of the digestive system include the gastrointestinal tract and accessory organs of digestion. Find the organs of the digestive system in this diagram as you read about them below.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Functions of the Digestive System<\/span><\/p>\n<\/div>\n<p>The digestive system has three main functions relating to food: digestion of food, absorption of\u00a0nutrients\u00a0from food, and elimination of\u00a0solid\u00a0food waste.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4549\">Digestion<\/a><\/strong>\u00a0is the process of breaking down food into components the body can absorb. It consists of two types of processes: mechanical digestion and chemical digestion.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">Mechanical digestion<\/a><\/strong>\u00a0is the physical breakdown of chunks of food into smaller pieces, and it takes place mainly in the mouth and stomach.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">Chemical digestion<\/a><\/strong>\u00a0is the chemical breakdown of large, complex food molecules into smaller, simpler nutrient molecules that can be absorbed by body fluids (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2702\">blood<\/a>\u00a0or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4552\">lymph<\/a>). This type of digestion begins in the mouth and continues in the stomach, but occurs mainly in the\u00a0small intestine.<\/p>\n<p>After food is digested, the resulting\u00a0nutrients\u00a0are absorbed.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4553\">Absorption<\/a><\/strong>\u00a0is the process in which substances pass into the bloodstream or lymph system to circulate throughout the body. Absorption of nutrients occurs mainly in the\u00a0small intestine. Any remaining matter from food that is not digested and absorbed passes out of the body through the anus in the process of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4554\"><strong>elimination<\/strong><\/a>.<\/p>\n<div id=\"h5p-402\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-402\" class=\"h5p-iframe\" data-content-id=\"402\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.2 Functions of the Digestive System\"><\/iframe><\/div>\n<\/div>\n<div>\n<h1>Gastrointestinal Tract<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4555\">gastrointestinal (GI) tract<\/a><\/strong> is basically a long, continuous tube that connects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a> with the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4556\">anus<\/a>. If it were fully extended, it would be about nine metres long in adults. It includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4296\">pharynx<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4560\">large<\/a> intestines. Food enters the mouth, and then passes through the other organs of the GI tract, where it is digested and\/or absorbed. Finally, any remaining food waste leaves the body through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4556\">anus<\/a> at the end of the large intestine. It takes up to 50 hours for food or food waste to make the complete trip through the GI tract.<\/p>\n<h2>Tissues of the GI Tract<\/h2>\n<p>The walls of the organs of the GI tract consist of four different tissue layers, which are illustrated in Figure 15.2.3: mucosa, submucosa, muscularis externa, and serosa.<\/p>\n<ol>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4561\">mucosa<\/a><\/strong>\u00a0is the innermost layer surrounding the lumen (open space within the organs of the GI tract). This layer consists mainly of epithelium with the capacity to secrete and absorb substances.\u00a0The epithelium can secret digestive\u00a0enzymes\u00a0and mucus, and it can absorb nutrients and\u00a0water.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4562\">submucosa<\/a><\/strong> layer consists of connective tissue that contains\u00a0blood and lymph vessels, as well as nerves. The vessels are needed to absorb and carry away nutrients after food is digested, and nerves help control the\u00a0muscles\u00a0of the GI tract organs.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4563\">muscularis externa<\/a><\/strong>\u00a0layer contains two types of smooth muscle: longitudinal muscle and circular muscle. Longitudinal muscle runs the length of the GI tract organs, and circular muscle encircles the organs. Both types of\u00a0muscles\u00a0contract to keep food moving through the tract by the process of peristalsis, which is described below.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4564\">serosa<\/a><\/strong>\u00a0layer is the outermost layer of the walls of GI tract organs. This is a thin layer that consists of connective tissue and separates the organs from surrounding cavities and tissues.<\/li>\n<\/ol>\n<table style=\"border-collapse: collapse;width: 76.413%\" border=\"0\">\n<tbody>\n<tr>\n<td style=\"width: 40.6725%\">\n<figure id=\"attachment_4566\" aria-describedby=\"caption-attachment-4566\" style=\"width: 502px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4566\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Intestinal_layers-1.png\" alt=\"15.2.3\" width=\"502\" height=\"251\"><figcaption id=\"caption-attachment-4566\" class=\"wp-caption-text\"><em>Figure 15.2.3 This cross-sectional diagram of the wall of a typical GI tract organ shows the layers that comprise it.<\/em><\/figcaption><\/figure>\n<\/td>\n<td style=\"width: 35.7786%\">\n<figure id=\"attachment_4567\" aria-describedby=\"caption-attachment-4567\" style=\"width: 259px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4567\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Normal_gastric_mucosa_intermed_mag-1.jpg\" alt=\"15.2.4 GI Cross section histology\" width=\"259\" height=\"388\"><figcaption id=\"caption-attachment-4567\" class=\"wp-caption-text\"><em>Figure 15.2.4 Can you match the layers in this pictomicrograph to the diagram on the left?<\/em><\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 style=\"margin-top: 2.14286em;margin-bottom: 1.42857em;line-height: 1.28571em\">Peristalisis in the GI Tract<\/h2>\n<p>The muscles in the walls of GI tract organs enable peristalsis, which is illustrated in Figure 15.2.5. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">Peristalsis<\/a><\/strong>\u00a0is a continuous sequence of involuntary\u00a0muscle contraction\u00a0and relaxation that moves rapidly along an organ like a wave, similar to the way a wave moves through a spring toy. Peristalsis in organs of the GI tract propels food through the tract.<\/p>\n<figure id=\"attachment_4569\" aria-describedby=\"caption-attachment-4569\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4569\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/f-d_336ab46447bfb7c6da55d47fc12cc19783994991cbee6cd347338bd1IMAGE_THUMB_POSTCARD_TINYIMAGE_THUMB_POSTCARD_TINY-1.png\" alt=\"15.2.5\" width=\"500\" height=\"259\"><figcaption id=\"caption-attachment-4569\" class=\"wp-caption-text\"><em>Figure 15.2.5 Peristalsis pushes food through the GI tract.<\/em><\/figcaption><\/figure>\n<p>Watch the video \"What is peristalsis?\" by Mister Science to see peristalsis in action:<\/p>\n<p>https:\/\/youtu.be\/kVjeNZA5pi4<\/p>\n<p style=\"text-align: center\">What is peristalsis?, Mister Science, 2018.<\/p>\n<h2>Immune Function of the GI Tract<\/h2>\n<p>The GI tract plays an important role in protecting the body from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">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\">. The surface area of the GI tract is estimated to be about 32 square metres (105 square feet), or about half the area of a badminton court. This is more than three times the area of the exposed skin of the body, and it provides a lot of area for pathogens to invade the tissues of the body. The innermost mucosal layer of the walls of the GI tract provides a barrier to pathogens so they are less likely to enter the blood or lymph circulations. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4571\">mucus<\/a> produced by the mucosal layer, for example, contains <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a> that mark many pathogenic microorganisms for destruction. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3665\">Enzyme<\/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\">\u00a0in some of the secretions of the GI tract also destroy pathogens. In addition, stomach acids have a very low <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4330\">pH<\/a> that is fatal for many microorganisms that enter the stomach.<\/span><\/p>\n<h2>Divisions of the GI Tract<\/h2>\n<p>The GI tract is often divided into an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4574\">upper GI tract<\/a> and a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4575\">lower GI tract<\/a>. For medical purposes, the upper GI tract is typically considered to include all the organs from the mouth through the first part of the\u00a0small intestine, called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4576\">duodenum<\/a>. For our instructional purposes, it makes more sense to include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a> through the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a> in the upper GI tract, and all of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a> \u2014 as well as the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4560\">large intestine<\/a>\u00a0\u2014 in the lower GI tract.<\/p>\n<h3>Upper GI Tract<\/h3>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a> is the first digestive organ that food enters. The sight, smell, or taste of food stimulates the release of digestive enzymes and other secretions by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4577\">salivary gland<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\">\u00a0inside the mouth. The major salivary gland\u00a0enzyme\u00a0is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4578\">amylase<\/a>. It begins the chemical digestion of\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3563\">carbohydrates<\/a>\u00a0by breaking down <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3367\">starch<\/span><span style=\"font-size: 1em\">es<\/span><span style=\"font-size: 1em;text-align: initial\"><\/a><\/span><span style=\"font-size: 1em;text-align: initial\">\u00a0into <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_316\">sugar<\/a>. The mouth also begins the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">mechanical digestion<\/a> of food. When you chew, your teeth break, crush, and grind food into increasingly smaller pieces. Your tongue helps mix the food with saliva and also helps you swallow.<\/span><\/p>\n<p>A lump of swallowed food is called a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4579\">bolus<\/a>.<\/strong>\u00a0The bolus passes from the mouth into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4296\">pharynx<\/a>, and from the pharynx into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a>. The esophagus is a long, narrow tube that carries food from the pharynx to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a>. It has no other digestive functions. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">Peristalsis<\/a> starts at the top of the esophagus when food is swallowed and continues down the esophagus in a single wave, pushing the bolus of food ahead of it.<\/p>\n<p>From the esophagus, food passes into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a>, where both <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">mechanical<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">chemical digestion<\/a> continue. The muscular walls of the stomach churn and mix the food, thus completing mechanical digestion, as well as mixing the food with digestive fluids secreted by the stomach. One of these fluids is hydrochloric acid (HCl). In addition to killing pathogens in food, it gives the stomach the low pH needed by digestive enzymes that work in the stomach. One of these enzymes is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4581\">pepsin<\/a>, which chemically digests proteins. The stomach stores the partially digested food until the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a> is ready to receive it. Food that enters the small intestine from the stomach is in the form of a thick slurry (semi-liquid) called <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4582\">chyme<\/a>.<\/strong><\/p>\n<h3>Lower GI Tract<\/h3>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a> is a narrow, but very long tubular organ. It may be almost seven metres long in adults. It is the site of most <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">chemical digestion<\/a> and virtually all absorption of nutrients. Many digestive <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3665\">enzyme<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\">\u00a0are active in the small intestine, some of which are produced by the small intestine itself, and some of which are produced by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3197\">pancreas<\/a>, an accessory organ of the digestive system. Much of the inner lining of the small intestine is covered by tiny finger-like projections called <\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4543\">villi<\/a>,<\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0each of which is covered by even tinier projections called\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4583\">microvilli<\/a>.<\/strong><span style=\"text-align: initial;font-size: 1em\"> These projections, shown in the drawing below (Figure 15.2.6), greatly increase the surface area through which nutrients can be absorbed from the small intestine.<\/span><\/p>\n<div>\n<figure id=\"attachment_4584\" aria-describedby=\"caption-attachment-4584\" style=\"width: 800px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4584\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Villi__microvilli_of_small_intestine.svg_-1.png\" alt=\"14.2.6\" width=\"800\" height=\"600\"><figcaption id=\"caption-attachment-4584\" class=\"wp-caption-text\"><em>Figure 15.2.6 Each tiny projection (villus) of the lining of the small intestine is also covered with tiny projections (microvilli).<\/em><\/figcaption><\/figure>\n<\/div>\n<p>From the small intestine, any remaining nutrients and food waste pass into the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4560\">large intestine<\/a>. The large intestine is another tubular organ, but it is wider and shorter than the small intestine. It connects the small intestine and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4556\">anus<\/a>. Waste that enters the large intestine is in a\u00a0liquid\u00a0state. As it passes through the large intestine, excess\u00a0water\u00a0is absorbed from it. The remaining\u00a0solid\u00a0waste \u2014 called feces \u2014 is eventually eliminated from the body through the anus.<\/p>\n<div>\n<h1>Accessory Organs of the Digestive System<\/h1>\n<\/div>\n<figure id=\"attachment_4585\" aria-describedby=\"caption-attachment-4585\" style=\"width: 178px\" class=\"wp-caption alignright\"><img class=\" wp-image-4585\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0428_Gallbladder-Liver-Pancreas_Location-2.png\" alt=\"15.2.7 Accessory Organs of the Digestive System\" width=\"178\" height=\"356\"><figcaption id=\"caption-attachment-4585\" class=\"wp-caption-text\"><em>Figure 15.2.7 This diagram shows the locations of the accessory organs of digestion: the liver, gallbladder, and pancreas.<\/em><\/figcaption><\/figure>\n<p>Accessory organs of the digestive system are not part of the GI tract, so they are not sites where digestion or absorption take place. Instead, these organs secrete or store substances needed for the chemical digestion of food. The accessory organs include the liver, gallbladder, and pancreas. They are shown in Figure 15.2.7 and described in the text that follows.<\/p>\n<ul>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2989\">liver<\/a><\/strong>\u00a0is an organ\u00a0with\u00a0multitude of functions. Its main digestive function is producing and secreting a fluid called bile, which reaches the small intestine through a duct. Bile breaks down large globules of\u00a0lipids\u00a0into smaller ones that are easier for enzymes to chemically digest. Bile is also needed to reduce the acidity of food entering the small intestine from the highly acidic stomach, because enzymes in the small intestine require a less acidic environment in order to work.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4586\">gallbladder<\/a><\/strong>\u00a0is a small sac below the liver that stores some of the bile from the liver. The gallbladder also concentrates the bile by removing some of the water from it. It then secretes the concentrated bile into the small intestine as needed for fat digestion following a meal.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3197\">pancreas<\/a><\/strong>\u00a0secretes many digestive enzymes, and releases them into the small intestine for the chemical digestion of\u00a0carbohydrates,\u00a0proteins, and\u00a0lipids. The pancreas also helps lessen the acidity of the small intestine by secreting bicarbonate, a basic substance that neutralizes\u00a0acid.<\/li>\n<\/ul>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.2 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_5023_3877\">digestive system<\/a> consists of organs that break down food, absorb its nutrients, and expel any remaining food waste.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4549\">Digestion<\/a> is the process of breaking down food into components that the body can absorb. It includes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">mechanical digestion<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">chemical digestion<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4553\">Absorption<\/a> is the process of taking up nutrients from food by body fluids for\u00a0circulation\u00a0to the rest of the body. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4554\">Elimination<\/a> is the process of excreting any remaining food waste after\u00a0digestion and absorption\u00a0are finished<em>.<\/em><\/li>\n<li>Most digestive organs form a long, continuous tube called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4555\">gastrointestinal (GI) tract<\/a>. It starts at the mouth, which is followed by the pharynx, esophagus, stomach, small intestine, and large intestine. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4574\">upper GI tract<\/a> consists of the mouth through the stomach, while the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4575\">lower GI tract<\/a> consists of the small and large intestines.<\/li>\n<li>Digestion and\/or absorption take place in most of the organs of the GI tract. Organs of the GI tract have walls that consist of several tissue layers that enable them to carry out these functions.\u00a0The inner <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4561\">mucosa<\/a> has\u00a0cells\u00a0that secrete digestive enzymes and other digestive substances, as well as cells that absorb nutrients. The muscle layer of the organs enables them to contract and relax in waves of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a> to move food through the GI tract.<\/li>\n<li>Three digestive organs \u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2989\">liver<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4586\">gallbladder<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3197\">pancreas<\/a> \u2014 are\u00a0accessory organs of digestion. They secrete substances needed for chemical digestion into the small intestine.<\/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\">15.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the digestive system?<\/li>\n<li>What are the three main functions of the digestive system? Define each function.<\/li>\n<li>\n<div id=\"h5p-403\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-403\" class=\"h5p-iframe\" data-content-id=\"403\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.2 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Relate the tissues in the walls of GI tract organs to the functions the organs perform.<\/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\">15.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/Og5xAdC8EUI<\/p>\n<p style=\"text-align: center\">How your digestive system works - Emma Bryce, TED-Ed, 2017.<\/p>\n<p>https:\/\/youtu.be\/YVfyYrEmzgM<\/p>\n<p style=\"text-align: center\">How does your body know you're full? - Hilary Coller, TED-Ed, 2017.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.2.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/Ov0u44CyGdM\" rel=\"cc:attributionURL\">Ice Cream<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@mark_crz\">Mark Cruz<\/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 15.2.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0316_DigestiveSystem.png\" rel=\"cc:attributionURL\">Blausen_0316_DigestiveSystem<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 15.2.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Intestinal_layers.png\" rel=\"cc:attributionURL\">Intestinal_layers<\/a> by <a class=\"new\" title=\"User:Boumphreyfr (page does not exist)\" href=\"https:\/\/commons.wikimedia.org\/w\/index.php?title=User:Boumphreyfr&amp;action=edit&amp;redlink=1\">Boumphreyfr<\/a> 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.<\/p>\n<p><strong>Figure 15.2.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Normal_gastric_mucosa_intermed_mag.jpg\" rel=\"cc:attributionURL\">512px-Normal_gastric_mucosa_intermed_mag<\/a> by Nephron 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.<\/p>\n<p><strong>Figure 15.2.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/17.2\/\" rel=\"cc:attributionURL\">Peristalsis pushes food through the GI tract<\/a> by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/17.2\/\">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=2.235351745.1988667202.1598996862-1392032960.1592870652\">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<p><strong>Figure 15.2.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Villi_%26_microvilli_of_small_intestine.svg\" rel=\"cc:attributionURL\">Villi_&amp;_microvilli_of_small_intestine.svg<\/a> by <a title=\"User:BallenaBlanca\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BallenaBlanca\">BallenaBlanca<\/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 style=\"text-align: initial;font-size: 1em\">Figure 15.2.7<\/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>\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<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\">Brainard, J\/ CK-12 Foundation. (2016). Figure 4 Peristalsis pushes food through the GI tract. [digital image]. In <em>CK-12 College Human Biology<\/em> (Section 17.2) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/17.2\/<\/p>\n<p class=\"hanging-indent\">Mister Science. (2018). What is peristalsis? YouTube. https:\/\/www.youtube.com\/channel\/UCxTlkZfjArUobBAeVwzJjYg\/videos<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, November 13). How does your body know you're full? - Hilary Coller. YouTube. https:\/\/www.youtube.com\/watch?v=YVfyYrEmzgM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, December 14). How your digestive system works - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=Og5xAdC8EUI&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_5023_4182\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4182\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3535\" aria-describedby=\"caption-attachment-3535\" style=\"width: 350px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3535\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Sunburn-1.jpg\" alt=\"10.3.1\" width=\"350\" height=\"452\"><figcaption id=\"caption-attachment-3535\" class=\"wp-caption-text\"><em>Figure 10.3.1 Feel the burn!<\/em><\/figcaption><\/figure>\n<h1>Feel the Burn<\/h1>\n<p>The person in Figure 10.3.1 is no doubt feeling the burn \u2014 sunburn, that is. <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3536\">Sunburn<\/a><\/strong>\u00a0occurs when the outer layer of the skin is damaged by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3537\">UV light<\/a> from the\u00a0sun\u00a0or tanning lamps. Some people deliberately allow UV light to burn their skin, because after the redness subsides, they are left with a tan. A tan may look healthy, but it is actually a sign of skin damage. People who experience one or more serious sunburns are significantly more likely to develop\u00a0skin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a>. Natural pigment molecules in the skin help protect it from UV light damage. These pigment molecules are found in the layer of the skin called the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3899\">epidermis<\/a>.<\/p>\n<div>\n<h1>What is the\u00a0Epidermis?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3899\">epidermis<\/a><\/strong>\u00a0is the outer of the two main layers of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>. The inner layer\u00a0is\u00a0the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3875\">dermis<\/a>. It averages about 0.10 mm thick, and is much thinner than the dermis. The epidermis is thinnest on the eyelids (0.05 mm) and thickest on the palms of the hands and soles of the feet (1.50 mm). The epidermis covers almost the entire body surface. It is continuous with \u2014 but structurally distinct from \u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3538\">mucous membranes<\/a>\u00a0that line the mouth, anus, urethra, and vagina.<\/p>\n<div>\n<h1>Structure of the Epidermis<\/h1>\n<\/div>\n<p>There are no blood vessels and very few nerve cells in the epidermis. Without blood to bring epidermal cells oxygen and nutrients, the cells must absorb oxygen directly from the air and obtain nutrients via <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1655\">diffusion<\/a> of fluids from the dermis below. However, as thin as it is, the epidermis still has a complex structure. It has a variety of cell types and multiple layers.<\/p>\n<h2>Cells\u00a0of the Epidermis<\/h2>\n<p>There are several different types of\u00a0cells\u00a0in the epidermis. All of the cells are necessary for the important functions of the epidermis.<\/p>\n<ul>\n<li>The epidermis consists mainly of stacks of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>-producing epithelial cells called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a><\/strong>. These cells make up at least 90 per cent of the epidermis. Near the top of the epidermis, these cells are also called squamous cells.<\/li>\n<li>Another eight per cent of epidermal cells are <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3526\">melanocytes<\/a><\/strong>. These cells produce the pigment melanin that protects the\u00a0dermis\u00a0from UV light.<\/li>\n<li>About one per cent of epidermal cells are <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3540\">Langerhans cells<\/a><\/strong>. These are immune system cells that detect and fight pathogens entering the skin.<\/li>\n<li>Less than one per cent of epidermal cells are <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3527\">Merkel cells<\/a><\/strong>, which respond to light touch and connect to nerve endings in the dermis.<\/li>\n<\/ul>\n<h2>Layers of the Epidermis<\/h2>\n<p>The epidermis in most parts of the body consists of four distinct layers. A fifth layer occurs in the palms of the hands and soles of the feet, where the epidermis is thicker than in the rest of the body. The layers of the epidermis are shown in Figure 10.3.2, and described in the following text.<\/p>\n<figure id=\"attachment_3541\" aria-describedby=\"caption-attachment-3541\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-3541\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0353_Epidermis-1.png\" alt=\"Diagram of the Epidermis\" width=\"1024\" height=\"1024\"><figcaption id=\"caption-attachment-3541\" class=\"wp-caption-text\"><em>Figure 10.3.2 The epidermis has multiple layers, and structures (such as hairs from the dermis below it) pass through them. This diagram illustrates the five layers that exist on the palms and soles of the feet.<\/em><\/figcaption><\/figure>\n<h3>Stratum Basale<\/h3>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3542\">stratum basale<\/a><\/strong>\u00a0is the innermost (or deepest) layer of the epidermis. It is separated from the dermis by a membrane called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3815\">basement membrane<\/a><\/strong>. The stratum basale contains stem cells \u2014 called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3811\">basal cells<\/a><\/strong>\u00a0\u2014 which divide to form all the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a> of the epidermis. When keratinocytes first form, they are cube-shaped and contain almost no keratin. As more keratinocytes are produced, previously formed cells are pushed up through the stratum basale. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3545\">Melanocytes<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3527\">Merkel cells<\/a>\u00a0are also found in the stratum basale. The Merkel cells are especially numerous in touch-sensitive areas, such as the fingertips and lips.<\/p>\n<h3>Stratum Spinosum<\/h3>\n<p>Just above the stratum basale is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3546\">stratum spinosum<\/a><\/strong>. This is the\u00a0thickest\u00a0of the four epidermal layers. The keratinocytes in this layer have begun to accumulate keratin, and they have become tougher and flatter. Spiny cellular projections form between the keratinocytes and hold them together. In addition to keratinocytes, the stratum spinosum contains the immunologically active <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3540\">Langerhans cells<\/a>.<\/p>\n<h3>Stratum Granulosum<\/h3>\n<p>The next layer above the stratum spinosum is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3547\">stratum granulosum<\/a><\/strong>. In this layer, keratinocytes have become nearly filled with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>, giving their cytoplasm a granular appearance.\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3559\">Lipids<\/a>\u00a0are released by keratinocytes in this layer to form a\u00a0lipid\u00a0barrier in the epidermis. Cells in this layer have also started to die, because they are becoming too far removed from\u00a0blood vessels\u00a0in the dermis to receive\u00a0nutrients. Each dying cell digests its own\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3705\">nucleus<\/a>\u00a0and\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3465\">organelles<\/a>, leaving behind only a tough, keratin-filled shell.<\/p>\n<h3>Stratum Lucidum<\/h3>\n<p>Only on the palms of the hands and soles of the feet, the next layer above the stratum granulosum is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3548\">stratum lucidum<\/a><\/strong>. This is a layer consisting of stacks of translucent, dead keratinocytes that provide extra protection to the underlying layers.<\/p>\n<h3>Stratum Corneum<\/h3>\n<p>The uppermost layer of the epidermis everywhere on the body is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3549\">stratum corneum<\/a><\/strong>. This layer is made of flat, hard, tightly packed dead keratinocytes that form a waterproof keratin barrier to protect the underlying layers of the epidermis. Dead cells from this layer are constantly shed from the surface of the body. The shed cells are continually replaced by cells moving up from lower layers of the epidermis. It takes a period of about 48 days for newly formed keratinocytes in the stratum basale to make their way to the top of the stratum corneum to replace shed cells.<\/p>\n<div>\n<h1>Functions of the Epidermis<\/h1>\n<\/div>\n<p>The epidermis has several crucial functions in the body. These functions include protection,\u00a0water\u00a0retention, and vitamin D synthesis.<\/p>\n<h2>Protective Functions<\/h2>\n<p>The epidermis provides protection to underlying tissues from physical damage, pathogens, and UV light.<\/p>\n<h3>Protection from Physical Damage<\/h3>\n<p>Most of the physical protection of the epidermis is provided by its tough outer layer, the stratum corneum. Because of this layer, minor scrapes and scratches generally do not cause significant damage to the skin or underlying tissues. Sharp objects and rough surfaces have difficulty penetrating or removing the tough, dead, keratin-filled cells of the stratum corneum. If cells in this layer are pierced or scraped off, they are quickly replaced by new cells moving up to the surface from lower skin layers.<\/p>\n<h3>Protection from Pathogens<\/h3>\n<figure id=\"attachment_3550\" aria-describedby=\"caption-attachment-3550\" style=\"width: 337px\" class=\"wp-caption alignright\"><img class=\" wp-image-3550\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Scraped-knee-by-Alpha-on-flickr-1.jpg\" alt=\"Skin: Protection from Pathogens\" width=\"337\" height=\"253\"><figcaption id=\"caption-attachment-3550\" class=\"wp-caption-text\"><em>Figure 10.3.3 This scrape on the knee provides an opportunity for bacteria to enter the body through the broken skin.<\/em><\/figcaption><\/figure>\n<p>When pathogens such as viruses and bacteria try to enter the body, it is virtually impossible for them to enter through intact epidermal layers. Generally, pathogens can enter the skin only if the epidermis has been breached, for example by a cut, puncture, or scrape (like the one pictured in Figure 10.3.3). That\u2019s why it is important to clean and cover even a <em>minor<\/em> wound in the epidermis. This helps ensure that pathogens do not use the wound to enter the body. Protection from pathogens is also provided by conditions at or near the skin surface. These include relatively high acidity (pH\u00a0of about 5.0), low amounts of\u00a0water, the presence of antimicrobial substances produced by epidermal cells, and\u00a0competition\u00a0with non-pathogenic microorganisms that normally live on the epidermis.<\/p>\n<p>&nbsp;<\/p>\n<h3>Protection from UV Light<\/h3>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3537\">UV light<\/a>\u00a0that penetrates the epidermis can damage epidermal cells. In particular, it can cause\u00a0mutations\u00a0in\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a>\u00a0that lead to the\u00a0development\u00a0of\u00a0skin <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a>, in which epidermal cells grow out of control. UV light can also destroy vitamin B9 (in forms such as folate or folic acid), which is needed for good health and successful\u00a0reproduction. In a person with light skin, just an hour of exposure to intense sunlight can reduce the body\u2019s vitamin B9 level by <em>50 per cent.<\/em><\/p>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3526\">Melanocyte<\/a>s in the stratum basale of the epidermis contain small\u00a0organelles\u00a0called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3759\">melanosomes<\/a><\/strong>, which produce, store, and transport the dark brown pigment <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3753\">melanin<\/a>. As melanosomes become full of melanin, they move into thin extensions of the melanocytes. From there, the melanosomes are transferred to <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a>\u00a0in the epidermis, where they absorb UV light that strikes the skin. This prevents the light from penetrating deeper into the skin, where it can cause damage. The more melanin there is in the skin, the more UV light can be absorbed.<\/p>\n<h2>Water\u00a0Retention<\/h2>\n<p>Skin's ability\u00a0to hold water and not lose it to the surrounding environment is due mainly to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3549\">stratum corneum<\/a>.\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3559\">Lipids<\/a>\u00a0arranged in an organized way among the cells of the stratum corneum form a barrier to water loss from the epidermis. This is critical for maintaining healthy skin and preserving proper water balance in the body.<\/p>\n<p>Although the skin is impermeable to water, it is not impermeable to\u00a0<em>all <\/em>substances. Instead, the skin is\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3767\"><em>selectively<\/em>\u00a0permeable<\/a>, allowing certain fat-soluble substances to pass through the epidermis. The selective permeability of the epidermis is both a benefit and a risk.<\/p>\n<ul>\n<li>Selective permeability allows certain medications to enter the bloodstream through the capillaries in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3875\">dermis<\/a>. This is the basis of medications that are delivered using topical ointments, or patches (see Figure 10.3.4) that are applied to the skin. These include steroid hormones, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a> (for hormone replacement therapy), scopolamine (for motion sickness), nitroglycerin (for heart problems), and nicotine (for people trying to quit smoking).<\/li>\n<li>Selective permeability of the epidermis also allows certain harmful substances to enter the body through the skin. Examples include the heavy metal lead, as well as many pesticides.<\/li>\n<\/ul>\n<figure id=\"attachment_3554\" aria-describedby=\"caption-attachment-3554\" style=\"width: 394px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-3554\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Nicoderm-1.jpg\" alt=\"Skin - selectively permeable\" width=\"394\" height=\"262\"><figcaption id=\"caption-attachment-3554\" class=\"wp-caption-text\"><em>Figure 10.3.4 This skin patch delivers small amounts of nicotine through the skin of a person in a smoking cessation program.<\/em><\/figcaption><\/figure>\n<h3>Vitamin D Synthesis<\/h3>\n<p>Vitamin D is a nutrient that is needed in the human body for the absorption of calcium from food. Molecules of a lipid compound named 7-dehydrocholesterol are precursors of vitamin D. These molecules are present in the stratum basale and stratum spinosum layers of the epidermis. When UV light strikes the molecules, it changes them to vitamin D3. In the kidneys, vitamin D3 is converted to calcitriol, which is the form of vitamin D that is active in the body.<\/p>\n<div>\n<h1>What Gives Skin Its Colour?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3753\">Melanin<\/a><\/strong> in the epidermis is the main substance that determines the colour of human skin. It explains most of the variation in skin colour in people around the world. Two other substances also contribute to skin colour, however, especially in light-skinned people: carotene and hemoglobin.<\/p>\n<ul>\n<li>The pigment\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3749\">carotene<\/a><\/strong>\u00a0is present in the epidermis and gives skin a yellowish tint, especially in skin with low levels of melanin.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3556\">Hemoglobin<\/a><\/strong> is a red pigment found in red\u00a0blood\u00a0cells. It is visible through skin as a pinkish tint, mainly in skin with low levels of melanin. The pink colour is most visible when capillaries in the underlying dermis dilate, allowing greater blood flow near the surface.<\/li>\n<\/ul>\n<p>Hear what Bill Nye has to say about the subject of skin colour in the video <a href=\"https:\/\/youtu.be\/zOkj5jgC4sM\">here<\/a>.<\/p>\n<div>\n<h1>Bacteria\u00a0on Skin<\/h1>\n<\/div>\n<figure id=\"attachment_3557\" aria-describedby=\"caption-attachment-3557\" style=\"width: 251px\" class=\"wp-caption alignleft\"><img class=\" wp-image-3557\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Staphylococcus-aureus-bacteria-by-Microbe-World-on-flickr-1.jpg\" alt=\"Skin - protects against bacteria\" width=\"251\" height=\"170\"><figcaption id=\"caption-attachment-3557\" class=\"wp-caption-text\"><em>Figure 10.3.5 The bacterium Staphylococcus epidermidis is a common microorganism living on healthy human skin.<\/em><\/figcaption><\/figure>\n<p>The surface of the human skin normally provides a home to countless numbers of bacteria. Just one square inch of skin normally has an average of about 50 million bacteria. These generally harmless bacteria represent roughly one thousand bacterial species (including the one in Figure 10.3.5) from 19 different bacterial phyla. Typical variations in the moistness and oiliness of the skin produce a variety of rich and diverse habitats for these microorganisms. For example, the skin in the armpits is warm and moist and often hairy, whereas the skin on the forearms is smooth and dry. These two areas of the human body are as diverse to microorganisms as rainforests and deserts are to larger organisms. The density of bacterial populations on the skin depends largely on the region of the skin and its ecological characteristics. For example, oily surfaces, such as the face, may contain over 500 million bacteria per square inch. Despite the huge number of individual microorganisms living on the skin, their total volume is only about the size of a pea.<\/p>\n<p>In general, the normal microorganisms living on the skin keep one another in check, and thereby play an important role in keeping the skin healthy.\u00a0If the balance of microorganisms is disturbed, however, there may be an overgrowth of certain\u00a0species, and this may result in an infection. For example, when a patient is prescribed antibiotics, it may kill off normal bacteria and allow an overgrowth of single-celled yeast. Even if skin is disinfected, no amount of cleaning can remove all of the microorganisms it contains. Disinfected areas are also quickly recolonized by bacteria residing in deeper areas (such as\u00a0hair\u00a0follicles) and in adjacent areas of the skin.<\/p>\n<div>\n<h1>Feature: Myth vs. Reality<\/h1>\n<\/div>\n<p>Because of the negative health effects of excessive UV light exposure, it is important to know the facts about protecting the skin from UV light.<\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 84.1914%;height: 84px\" border=\"0\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\">\n<h2><span style=\"color: #ff0000\">Myth<\/span><\/h2>\n<\/td>\n<td style=\"width: 55.0036%;height: 14px\">\n<h2><span style=\"color: #339966\">Reality<\/span><\/h2>\n<\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\"><em>\"Sunblock and sunscreen are just different names for the same type of product. They both work the same way and are equally effective.\"<\/em><\/td>\n<td style=\"width: 55.0036%;height: 14px\"><strong><span style=\"font-size: 16px\">Sunscreens and sunblocks are different types of products that protect the skin from UV light in different ways. They are not equally effective. Sunblocks are opaque, so they do not let light pass through. They prevent most of the rays of UV light from penetrating to the skin surface. Sunblocks are generally stronger and more effective than sunscreens. Sunblocks also do not need to be reapplied as often as sunscreens. Sunscreens, in contrast, are transparent once they are applied the skin. Although they can prevent most UV light from penetrating the skin when first applied, the active ingredients in sunscreens tend to break down when exposed to UV light. Sunscreens, therefore, must be reapplied often to remain effective.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\"><em><span style=\"font-size: 16px\">\"The skin needs to be protected from UV light only on sunny days. When the sky is cloudy, UV light cannot penetrate to the ground and harm the skin.\"<\/span><\/em><\/td>\n<td style=\"width: 55.0036%;height: 14px\"><strong><span style=\"font-size: 16px\">Even on cloudy days, a significant amount of UV radiation penetrates the atmosphere to strike Earth\u2019s surface. Therefore, using sunscreens or sunblocks to protect exposed skin is important even when there are\u00a0clouds\u00a0in the sky.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\"><em><span style=\"font-size: 16px\">\"People who have dark skin, such as African Americans, do not need to worry about skin damage from UV light.\"<\/span><\/em><\/td>\n<td style=\"width: 55.0036%;height: 14px\"><strong><span style=\"font-size: 16px\">No matter what colour skin you have, your skin can be damaged by too much exposure to UV light. Therefore, even dark-skinned people should use sunscreens or sunblocks to protect exposed skin from UV light.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\"><em><span style=\"font-size: 16px\">\"Sunscreens with an SPF (sun protection factor) of 15 are adequate to fully protect the skin from UV light.\"<\/span><\/em><\/td>\n<td style=\"width: 55.0036%;height: 14px\"><strong><span style=\"font-size: 16px\">Most dermatologists recommend using sunscreens with an SPF of at least 35 for adequate protection from UV light. They also recommend applying sunscreens at least 20 minutes before\u00a0sun\u00a0exposure and reapplying sunscreens often, especially if you are sweating or spending time in the water.<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 29.1878%;height: 14px\"><em><span style=\"font-size: 16px\">\"Using tanning beds is safer than tanning outside in natural sunlight.\"<\/span><\/em><\/td>\n<td style=\"width: 55.0036%;height: 14px\"><strong><span style=\"font-size: 16px\">The light in tanning beds is UV light, and it can do the same damage to the skin as the natural UV light in sunlight. This is evidenced by the fact that people who regularly use tanning beds have significantly higher rates of\u00a0skin cancer\u00a0than people who do not. It is also the reason that the use of tanning beds is prohibited in many places in people who are under the age of 18, just as youth are prohibited from using harmful substances, such as tobacco and alcohol.<\/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\">10.3 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_5023_3899\">epidermis<\/a> is the outer of the two main layers of the skin. It is very thin, but has a complex structure.<\/li>\n<li>Cell types in the epidermis include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a> that produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a> and make up 90 per cent of epidermal cells, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3526\">melanocytes<\/a> that produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3753\">melanin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3540\">Langerhans cells<\/a> that fight <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">pathogens<\/a> in the skin, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3527\">Merkel cells<\/a> that respond to light touch.<\/li>\n<li>The epidermis in most parts of the body consists of four distinct layers. A fifth layer occurs only in the epidermis of the palms of the hands and soles of the feet.<\/li>\n<li>The innermost layer of the epidermis is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3542\">stratum basale<\/a>, which contains stem cells that divide to form new keratinocytes. The next layer is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3546\">stratum spinosum<\/a>, which is the\u00a0thickest layer and contains Langerhans cells and spiny keratinocytes. This is followed by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3547\">stratum granulosum<\/a>, in which keratinocytes are filling with keratin and starting to die. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3548\">stratum lucidum<\/a> is next, but only on the palms and soles. It consists of translucent dead keratinocytes. The outermost layer is the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3549\">stratum corneum<\/a>, which consists of flat, dead, tightly packed keratinocytes that form a tough, waterproof barrier for the rest of the epidermis.<\/li>\n<li>Functions of the epidermis include protecting underlying tissues from physical damage and pathogens. Melanin in the epidermis absorbs and protects underlying tissues from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3537\">UV light<\/a>. The epidermis also prevents loss of water from the body and synthesizes vitamin D.<\/li>\n<li>Melanin is the main pigment that determines the colour of human skin. The pigments carotene and hemoglobin, however, also contribute to skin colour, especially in skin with low levels of melanin.<\/li>\n<li>The surface of healthy skin normally is covered by vast numbers of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2588\">bacteria<\/a> representing about one thousand\u00a0species\u00a0from 19 phyla. Different areas of the body provide diverse habitats for skin microorganisms. Usually, microorganisms on the skin keep each other in check unless their balance is disturbed.<\/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\">10.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the epidermis?<\/li>\n<li>Identify the types of cells in the epidermis.<\/li>\n<li>Describe the layers of the epidermis.<\/li>\n<li>\n<div id=\"h5p-360\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-360\" class=\"h5p-iframe\" data-content-id=\"360\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.3 Label the layers of the Epidermis\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>State one function of each of the four epidermal layers found all over the body.<\/li>\n<li>Explain three ways the epidermis protects the body.<\/li>\n<li>What makes the skin waterproof?<\/li>\n<li>Why is the selective permeability of the epidermis both a benefit and a risk?<\/li>\n<li>How is vitamin D synthesized in the epidermis?<\/li>\n<li>Identify three pigments that impart colour to skin.<\/li>\n<li>Describe bacteria that normally reside on the skin, and explain why they do not usually cause infections.<\/li>\n<li>Explain why the keratinocytes at the surface of the epidermis are dead, while keratinocytes located deeper in the epidermis are still alive.<\/li>\n<li>Which layer of the epidermis contains keratinocytes that have begun to die?<\/li>\n<li>\n<div id=\"h5p-361\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-361\" class=\"h5p-iframe\" data-content-id=\"361\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.3 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain why our skin is not permanently damaged if we rub off some of the surface layer by using a rough washcloth.<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\" style=\"text-align: left\"><span style=\"color: #ffffff\">10.3 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=27lMmdmy-b8<\/p>\n<p style=\"text-align: center\">Jonathan Eisen: Meet your microbes, TED,\u00a02015.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=9AcQXnOscQ8<\/p>\n<p style=\"text-align: center\">Why Do We Blush?, SciShow, 2014.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=_r4c2NT4naQ<\/p>\n<p style=\"text-align: center\">The science of skin colour - Angela Koine Flynn, TED-Ed, 2016.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 10.3.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sunburn.jpg\" rel=\"cc:attributionURL\">Sunburn<\/a> by <a class=\"extiw\" title=\"wikipedia:User:QuinnHK\" href=\"https:\/\/en.wikipedia.org\/wiki\/User:QuinnHK\">QuinnHK<\/a>\u00a0at\u00a0<a class=\"extiw\" title=\"wikipedia:\" href=\"https:\/\/en.wikipedia.org\/wiki\/\">English Wikipedia<\/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>Figure 10.3.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0353_Epidermis.png\" rel=\"cc:attributionURL\">Blausen_0353_Epidermis<\/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\/deed.en\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 10.3.3<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/avlxyz\/10975825785\" rel=\"cc:attributionURL\">Isaac's scraped knee close-up<\/a> by <a class=\"owner-name truncate\" title=\"Go to Alpha's photostream\" href=\"https:\/\/www.flickr.com\/photos\/avlxyz\/\" data-track=\"attributionNameClick\">Alpha<\/a> on <a href=\"http:\/\/flickr.com\" rel=\"cc:attributionURL\">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 10.3.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Nicoderm.JPG\" rel=\"cc:attributionURL\">Nicoderm<\/a> by <a title=\"User:RegBarc\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:RegBarc\">RegBarc<\/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> (http:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/) license. (No machine-readable author provided for original.)<\/p>\n<p><strong>Figure 10.3.5<\/strong><\/p>\n<p><a href=\"https:\/\/www.flickr.com\/photos\/microbeworld\/5619255092\">Staphylococcus aureus bacteria, MRSA<\/a> by <a class=\"owner-name truncate\" title=\"Go to Microbe World's photostream\" href=\"https:\/\/www.flickr.com\/photos\/microbeworld\/\" data-track=\"attributionNameClick\">Microbe World<\/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<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\">Jeff Bone 'n' Pookie. (2020, July 19). Bill Nye the science guy explains we have different skin color. Youtube. https:\/\/www.youtube.com\/watch?v=zOkj5jgC4sM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">SciShow. (2014, July 15). Why do we blush? YouTube. https:\/\/www.youtube.com\/watch?v=9AcQXnOscQ8<\/p>\n<p class=\"hanging-indent\">TED. (2015, July 17). Jonathan Eisen: Meet your microbes. YouTube. https:\/\/www.youtube.com\/watch?v=27lMmdmy-b8<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, February 16). The science of skin color - Angela Koine Flynn. YouTube. https:\/\/youtu.be\/_r4c2NT4naQ<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4181\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4181\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_3519\" aria-describedby=\"caption-attachment-3519\" style=\"width: 320px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3519\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Maud_Stevens_Wagner-1.jpeg-1.jpeg\" alt=\"10.2.1\" width=\"320\" height=\"450\"><figcaption id=\"caption-attachment-3519\" class=\"wp-caption-text\"><em>Figure 10.2.1 The body as a canvas.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Art for All Eras<\/h1>\n<\/div>\n<p>Pictured in Figure 10.2.1, is Maud Stevens Wagner, a tattoo artist from 1907. Tattoos are not just a late 20th and early 21st century trend. They have been popular in many eras and cultures. Tattoos literally illustrate the biggest organ of the human body: the skin. The skin is very thin, but it covers a large area \u2014 about 2 m<sup>2<\/sup>\u00a0in adults. The skin is the major organ in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2905\">integumentary system<\/a>.<\/p>\n<div>\n<h1>What Is the Integumentary System?<\/h1>\n<\/div>\n<p>In addition to the skin, the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2905\">integumentary system<\/a><\/strong>\u00a0includes the\u00a0hair\u00a0and\u00a0nails, which are organs that grow out of the skin. Because the organs of the integumentary system are mostly external to the body, you may think of them as little more than accessories, like clothing or jewelry, but they serve vital physiological functions. They provide a protective covering for the body, sense\u00a0the environment, and help the body maintain\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3669\">homeostasis<\/a>.<\/p>\n<div>\n<h1>The Skin<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a><\/strong> is remarkable not only because it is the body\u2019s largest organ: the average square inch of skin has 20 blood vessels, 650 sweat glands, and more than 1,000 nerve endings. Incredibly, it also has 60,000 pigment-producing cells. All of these structures are packed into a stack of cells that is just 2 mm thick. Although the skin is thin, it consists of two distinct layers: the epidermis and dermis, as shown in the diagram (Figure 10.2.2).<\/p>\n<figure id=\"attachment_3522\" aria-describedby=\"caption-attachment-3522\" style=\"width: 587px\" class=\"wp-caption alignnone\"><img class=\"wp-image-3522\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Anatomy_The_Skin_-_NCI_Visuals_Online-1.jpg\" alt=\"Skin Diagram\" width=\"587\" height=\"585\"><figcaption id=\"caption-attachment-3522\" class=\"wp-caption-text\"><em>Figure 10.2.2 The epidermis is the thinner outer layer of skin, and the dermis is the thicker inner layer of skin. The latter contains structures such as blood vessels and sweat glands.<\/em><\/figcaption><\/figure>\n<h2>Outer Layer of Skin<\/h2>\n<p>The outer layer of skin is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3899\">epidermis<\/a><\/strong>. This layer is thinner than the inner layer (the dermis). The epidermis consists mainly of epithelial\u00a0cells, called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a>,<\/strong>\u00a0which produce the tough, fibrous\u00a0protein\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>.<\/strong>\u00a0The innermost\u00a0cells\u00a0of the epidermis are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3163\">stem cells<\/a>\u00a0that divide continuously to form new cells. The newly formed cells move up through the epidermis toward the skin surface, while producing more and more keratin. The cells become filled with keratin and die by the time they reach the surface, where they form a protective, waterproof layer. As the dead cells are shed from the surface of the skin, they are replaced by other cells that move up from below. The epidermis also contains <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3526\"><strong>melanocytes<\/strong><\/a>, the cells that produce the brown pigment melanin, which gives skin most of its colour. Although the epidermis contains some sensory receptor cells \u2014 called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3527\">Merkel cells<\/a> \u2014 it contains no nerves, blood vessels, or other structures.<\/p>\n<h2>Inner Layer of Skin<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3875\">dermis<\/a><\/strong> is the inner, thicker layer of skin. It consists mainly of tough <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2815\">connective tissue<\/a>, and is attached to the epidermis by collagen fibres. The dermis contains many structures (as shown in Figure 10.2.2), including blood vessels, sweat glands, and hair follicles, which are structures where hairs originate. In addition, the dermis contains many sensory receptors, nerves, and oil glands.<\/p>\n<h2>Functions of the Skin<\/h2>\n<p>The skin has multiple roles in the body. Many of these roles are related to\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3669\">homeostasis<\/a>. The skin\u2019s main functions\u00a0are\u00a0preventing\u00a0water\u00a0loss from the body and serving as a barrier to the entry of microorganisms. Another function of the skin is synthesizing vitamin D, which occurs when the skin is exposed to ultraviolet (UV) light. Melanin in the epidermis blocks some of the UV light and protects the dermis from its damaging effects.<\/p>\n<p>Another important function of the skin is helping to regulate body temperature. When the body is too warm, for example, the skin lowers body temperature by producing sweat, which cools the body when it evaporates. The skin also increases the amount of blood flowing near the body surface through vasodilation (widening of blood vessels), bringing heat from the body core to radiate out into the environment. The sweaty hair and flushed skin of the young man pictured in Figure 10.2.3 reflect these skin responses to overheating.<\/p>\n<figure id=\"attachment_3529\" aria-describedby=\"caption-attachment-3529\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-3529\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/shashank-shekhar-Db1J_qp_ctc-unsplash-scaled-2.jpg\" alt=\"Man Sweating\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-3529\" class=\"wp-caption-text\"><em>Figure 10.2.3 Both sweating and flushing of the skin are signs that the skin is working to cool the body.<\/em><\/figcaption><\/figure>\n<div>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Hair<\/span><\/p>\n<\/div>\n<figure id=\"attachment_3532\" aria-describedby=\"caption-attachment-3532\" style=\"width: 200px\" class=\"wp-caption alignright\"><img class=\"wp-image-3532\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Eyelashes-by-aryan-dhiman-93NBu0zG_H4-unsplash-scaled-2.jpg\" alt=\"Eyelashes\" width=\"200\" height=\"267\"><figcaption id=\"caption-attachment-3532\" class=\"wp-caption-text\"><em>Figure 10.2.4 Eyelashes protect the eyes.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">Hair<\/a><\/strong> is a fibre found only in mammals. It consists mainly of keratin-producing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a>. Each hair grows out of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3923\">follicle<\/a> in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3875\">dermis<\/a>. By the time the hair reaches the surface, it consists mainly of dead cells filled with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>. Hair serves several homeostatic functions. Head hair is important in preventing heat loss from the head and protecting its skin from UV radiation. Hairs in the nose trap dust particles and microorganisms in the air, and prevent them from reaching the lungs. Hair all over the body provides sensory input when objects brush against it, or when it sways in moving air. Eyelashes and eyebrows (see Figure 10.2.4) protect the eyes from water, dirt, and other irritants.<\/p>\n<div>\n<h1>Nails<\/h1>\n<\/div>\n<p>Fingernails and toenails consist of dead <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a> filled with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>. The keratin makes them hard but flexible, which is important for the functions they serve. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3403\">Nails<\/a>\u00a0prevent injury by forming protective plates over the ends of the fingers and toes. They also enhance sensation by acting as a counterforce to the sensitive fingertips when objects are handled. In addition, the fingernails can be used as tools.<\/p>\n<div>\n<h1>Interactions with Other Organ Systems<\/h1>\n<\/div>\n<p>The skin and other parts of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2905\">integumentary system<\/a> work with other organ systems to maintain\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3669\">homeostasis<\/a>.<\/p>\n<ul>\n<li>The skin works with the immune system to defend the body from pathogens by serving as a physical barrier to microorganisms.<\/li>\n<li>Vitamin D is needed by the\u00a0digestive system\u00a0to absorb calcium from food. By synthesizing vitamin D, the skin works with the digestive system to ensure that calcium can be absorbed.<\/li>\n<li>To control body\u00a0temperature, the skin works with the\u00a0cardiovascular system\u00a0to either lose body\u00a0heat, or to conserve it through vasodilation or vasoconstriction.<\/li>\n<li>To detect certain sensations from the outside world, the\u00a0nervous system\u00a0depends on nerve receptors in the skin.<\/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\">10.2 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_5023_2905\">integumentary system<\/a> consists of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">hair<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3403\">nails<\/a>. Functions of the integumentary system include providing a protective covering for the body, sensing\u00a0the environment, and helping the body maintain homeostasis.<\/li>\n<li>The skin consists of two distinct layers: a thinner outer layer called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3899\">epidermis<\/a>, and a thicker\u00a0inner layer called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3875\">dermis<\/a>.<\/li>\n<li>The epidermis consists mainly of epithelial cells called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3524\">keratinocytes<\/a>, which produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3525\">keratin<\/a>. New keratinocytes form at the bottom of the epidermis. They become filled with keratin and die as they move upward toward the surface of the skin, where they form a protective, waterproof layer.<\/li>\n<li>The dermis consists mainly of tough <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2815\">connective tissues<\/a>\u00a0and many structures, including blood vessels, sensory receptors, nerves, hair follicles, and oil and sweat glands.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>\u2019s main functions\u00a0are\u00a0preventing\u00a0water\u00a0loss from the body, serving as a barrier to the entry of microorganisms, synthesizing vitamin D, blocking UV light, and helping to regulate body temperature.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">Hair<\/a> consists mainly of dead keratinocytes and grows out of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3923\">follicles<\/a>\u00a0in the dermis. Hair helps prevent heat loss from the head, and protects its skin from UV light. Hair in the nose filters incoming air, and the eyelashes and eyebrows keep harmful substances out of the\u00a0eyes. Hair all over the body provides tactile sensory input.<\/li>\n<li>Like hair, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3403\">nails<\/a>\u00a0also consist mainly of dead keratinocytes. They help protect the ends of the fingers and toes, enhance the sense of touch in the fingertips, and may be used as tools.<\/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\">10.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Name the organs of the integumentary system.<\/li>\n<li>Compare and contrast the epidermis and dermis.<\/li>\n<li>Identify functions of the skin.<\/li>\n<li>\n<div id=\"h5p-358\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-358\" class=\"h5p-iframe\" data-content-id=\"358\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"10.1 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What is the\u00a0composition of hair?<\/li>\n<li>Describe three physiological roles played by hair.<\/li>\n<li>What do nails consist of?<\/li>\n<li>List two functions of nails.<\/li>\n<li>In terms of\u00a0composition, what do the outermost surface of the skin, the nails, and hair have in common?<\/li>\n<li>Identify two types of cells found in the epidermis of the skin. Describe their functions.<\/li>\n<li>Which structure and layer of skin does hair grow out of?<\/li>\n<li>Identify three main functions of the integumentary system. Give an example of each.<\/li>\n<li>What are two ways in which the integumentary system protects the body against UV radiation?<\/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\">10.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=OxPlCkTKhzY<\/p>\n<p style=\"text-align: center\">The science of skin - Emma Bryce, TED-Ed, 2018.<\/p>\n<p>https:\/\/www.youtube.com\/watch?v=ZSJITdsTze0&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Why do we have to wear sunscreen? - Kevin P. Boyd, TED-Ed, 2013.<\/p>\n<p>https:\/\/www.youtube.com\/watch?time_continue=1&amp;v=Lfhot7tQcWs&amp;feature=emb_logo<\/p>\n<p style=\"text-align: center\">Scarification | National Geographic, 2008.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<div id=\"content\" class=\"site-content\">\n<section class=\"standard post-793 chapter type-chapter status-publish hentry focusable\" data-type=\"chapter\">\n<h2>Attributions<\/h2>\n<p><strong>Figure 10.2.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Maud_Stevens_Wagner.jpeg\" rel=\"cc:attributionURL\">Maud_Stevens_Wagner <\/a>-The Plaza Gallery, Los Angeles, 1907\u00a0from the <a href=\"https:\/\/www.loc.gov\/pictures\/item\/2006687059\/\">Library of Congress<\/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 10.2.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Anatomy_The_Skin_-_NCI_Visuals_Online.jpg\" rel=\"cc:attributionURL\">Anatomy_The_Skin_-_NCI_Visuals_Online<\/a> by Don Bliss (artist) from <a class=\"extiw\" title=\"en:National Cancer Institute\" href=\"https:\/\/en.wikipedia.org\/wiki\/National_Cancer_Institute\">National Cancer Institute<\/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 10.2.3<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/Db1J_qp_ctc\" rel=\"cc:attributionURL\">shashank-shekhar-Db1J_qp_ctc<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@5hashank\">Shashank Shekhar<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the \u00a0<a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p><strong>Figure 10.2.4<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/93NBu0zG_H4\" rel=\"cc:attributionURL\">Eyelashes by aryan-dhiman-93NBu0zG_H4<\/a> [photo] by <a href=\"https:\/\/unsplash.com\/@mylifeasaryan_\">Aryan Dhiman<\/a> on <a href=\"http:\/\/unsplash.com\">Unsplash<\/a> is used under the \u00a0<a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 1.424em;font-weight: bold;color: #333333\">Reference<\/span><\/p>\n<\/section>\n<\/div>\n<p class=\"hanging-indent\">National Geographic. (2008). Scarification | National Geographic. YouTube. https:\/\/www.youtube.com\/watch?v=Lfhot7tQcWs&amp;t=1s<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2018, March 12). The science of skin - Emma Bryce. YouTube. https:\/\/www.youtube.com\/watch?v=OxPlCkTKhzY&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, August 6). Why do we have to wear sunscreen? - Kevin P. Boyd. YouTube. https:\/\/www.youtube.com\/watch?v=ZSJITdsTze0&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_5023_4214\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4214\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4610\" aria-describedby=\"caption-attachment-4610\" style=\"width: 333px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4610\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Handstand-by-jasper-garratt-v5gl4leh-Mk-unsplash-scaled-2.jpg\" alt=\"15.4.1 Handstand\" width=\"333\" height=\"500\"><figcaption id=\"caption-attachment-4610\" class=\"wp-caption-text\"><em>Figure 15.4.1 Let's hope gravity doesn't work too hard in this case.<\/em><\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Head Stand<\/span><\/p>\n<p>Did you ever wonder what would happen if you tried to swallow food while standing on your head like this person in Figure 15.4.1? Many people think that food travels down the gullet from the mouth by the force of gravity. If that were the case, then food you swallowed would stay in your throat while you were standing on your head. In reality, your position doesn\u2019t have much to do with your ability to swallow. Food will travel from your mouth to your stomach whether you are standing upright or upside down. That\u2019s because the tube the food travels through \u2014 the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a> \u2014 moves the food along via muscular contractions known as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>. The esophagus is one of several organs that make up the upper gastrointestinal tract.<\/p>\n<div>\n<h1>Organs of the Upper Gastrointestinal Tract<\/h1>\n<\/div>\n<p>Besides the esophagus, organs of the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4574\">upper gastrointestinal (GI) tract<\/a><\/strong>\u00a0include the mouth, pharynx, and stomach. These hollow organs are all connected to form a tube through which food passes during digestion. The only role in digestion played by the pharynx and esophagus is to move food through the GI tract. The mouth and stomach, in contrast, are organs where digestion \u2014 or the breakdown of food \u2014 also occurs. In both of these organs, food is broken into smaller pieces (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">mechanical digestion<\/a>), as well as broken down chemically (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">chemical digestion<\/a>). It should be noted that the first part of the small intestine (duodenum) is considered in some contexts to be part of the upper GI tract, but that practice is not followed here.<\/p>\n<div>\n<h1>Mouth<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a><\/strong>\u00a0is the first organ of the GI tract. Most of the oral cavity is lined with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3538\">mucous membrane<\/a>. This tissue produces mucus, which helps moisten, soften, and lubricate food. Underlying the mucous membrane is a thin layer of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscle<\/a> to which the mucous membrane is only loosely connected. This gives the mucous membrane considerable ability to stretch as you eat food. The roof of the mouth, called the palate, separates the oral cavity from the nasal cavity. The front part is hard, consisting of mucous membrane covering a plate of bone. The back part of the palate is softer and more pliable, consisting of mucous membrane over muscle and connective tissue. The hard surface of the front of the palate allows for pressure needed in chewing and mixing food. The soft, pliable surface of the back of the palate can move to accommodate the passage of food while swallowing. Muscles at either side of the soft palate contract to create the swallowing action.<\/p>\n<p>Several specific structures in the mouth are specialized for digestion. These include salivary glands, tongue, and teeth.<\/p>\n<h2>Salivary Glands<\/h2>\n<figure id=\"attachment_4611\" aria-describedby=\"caption-attachment-4611\" style=\"width: 357px\" class=\"wp-caption alignright\"><img class=\" wp-image-4611\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0780_SalivaryGlands-1.png\" alt=\"15.4.2\" width=\"357\" height=\"357\"><figcaption id=\"caption-attachment-4611\" class=\"wp-caption-text\"><em>Figure 15.4.2 Salivary glands in the mouth include the three major pairs of glands shown here.<\/em><\/figcaption><\/figure>\n<p>The mouth contains three pairs of major\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4577\">salivary glands<\/a><\/strong>, shown in Figure 15.4.2. These three pairs are all <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3909\">exocrine gland<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 secrete <\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4595\">saliva<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0into the mouth through ducts.<\/span><\/p>\n<ol>\n<li>The largest of the three major pairs of salivary glands are the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4612\">parotid glands<\/a><\/strong>, which are located on either side of the mouth in front of the ears.<\/li>\n<li>The next largest pair is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3365\">submandibular glands<\/a><\/strong>, located beneath the lower jaw.<\/li>\n<li>The third pair is the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3435\">sublingual glands<\/a><\/strong>, located underneath the tongue.<\/li>\n<\/ol>\n<p>In addition to these three pairs of major salivary glands, there are also hundreds of minor salivary glands in the oral mucosa lining the mouth and on the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4615\">tongue<\/a>. Along with the major glands, most of the minor glands secrete the digestive enzyme <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4578\">amylase<\/a>, which begins the chemical digestion of starch and glycogen (polysaccharides). However, the minor salivary glands on the tongue secrete the fat-digesting enzyme <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4602\">lipase<\/a>, which in the mouth is called lingual lipase (to distinguish it from pancreatic lipase secreted by the pancreas).<\/p>\n<p>Saliva secreted by the salivary glands mainly helps digestion, but it also plays other roles. It helps maintain dental health by cleaning the teeth, and it contains <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a> that help protect against infection. By keeping the mouth lubricated, saliva also allows the mouth movements needed for speech.<\/p>\n<h2>Tongue<\/h2>\n<p>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4615\">tongue<\/a> is a fleshy, muscular organ that is attached to the floor of the mouth by a band of ligaments that gives it great mobility. This is necessary so the tongue can manipulate food for chewing and swallowing. Movements of the tongue are also necessary for speaking. The upper surface of the tongue is covered with tiny projections called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4616\">papillae<\/a>, which contain taste buds. The latter are collections of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3128\">chemoreceptor<\/a> cells (shown in Figure 15.4.3). These sensory cells sense chemicals in food and send the information to the brain via cranial nerves, thus enabling the sense of taste.<\/p>\n<figure id=\"attachment_4617\" aria-describedby=\"caption-attachment-4617\" style=\"width: 567px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4617\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1402_The_Tongue-1.jpg\" alt=\"15.4.3 Papillae\" width=\"567\" height=\"477\"><figcaption id=\"caption-attachment-4617\" class=\"wp-caption-text\"><em>Figure 15.4.3 There are several types of papillae located in different areas on the tongue.<\/em><\/figcaption><\/figure>\n<p>There are five basic tastes detected by the chemoreceptor cells in taste buds: saltiness, sourness, bitterness, sweetness, and umami (often described as a meaty taste). Contrary to popular belief, taste buds for the five basic tastes are not located on different parts of the tongue. Why does taste matter? The taste of food helps to stimulate the secretion of saliva from the salivary glands. It also helps us to eat foods that are good for us, instead\u00a0of\u00a0rotten or toxic foods. The detection of saltiness, for example, enables the control of salt intake and salt balance in the body. The detection of sourness may help us avoid spoiled foods, which often taste sour due to fermentation by bacteria. The detection of bitterness warns of poisons, because many plants defend themselves with toxins that taste bitter. The detection of sweetness guides us to foods that supply quick energy. The detection of umami may signal protein-rich foods.<\/p>\n<h2>Teeth<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3363\">teeth<\/a><\/strong> are complex structures made of a bone-like material called dentin and covered with enamel, which is the hardest tissue in the body. Adults normally have a total of 32 teeth, with 16 in each jaw. The right and left sides of each jaw are mirror images in terms of the numbers and types of teeth they contain. Teeth have different shapes to suit them for different aspects of mastication (chewing). The different types of teeth are illustrated in Figure 15.4.4.<\/p>\n<figure id=\"attachment_4623\" aria-describedby=\"caption-attachment-4623\" style=\"width: 453px\" class=\"wp-caption alignright\"><img class=\" wp-image-4623\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-3D_Medical_Animation_Still_Showing_Types_of_Teeth-1.jpg\" alt=\"15.4.4 Teeth\" width=\"453\" height=\"255\"><figcaption id=\"caption-attachment-4623\" class=\"wp-caption-text\"><em>Figure 15.4.4 In adults, both sides of each jaw normally have the same numbers of the four types of teeth shown here.<\/em><\/figcaption><\/figure>\n<ul>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4619\">Incisors<\/a><\/strong>\u00a0are the sharp, blade-like teeth at the front of the mouth. They are used for cutting or biting off pieces of food. In adults, there are normally four incisors in each jaw, or eight in total.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4620\">Canines<\/a><\/strong>\u00a0are the pointed teeth on either side of the incisors. They are used for tearing foods that are tough or stringy. Adults normally have two canines in each jaw, or four altogether.<\/li>\n<li><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4621\">Premolars<\/a><\/strong>\u00a0and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4622\">molars<\/a><\/strong>\u00a0are cuboid teeth with cusps and grooves that are located on the sides and toward the back of the jaws. Premolars are closer to the front of the mouth. Molars are larger and have more cusps than premolars, but both are used for crushing and grinding food. Adults normally have two premolars and three molars on each side of each jaw, for a total of eight premolars and twelve molars.<\/li>\n<\/ul>\n<div>\n<h1>Pharynx<\/h1>\n<\/div>\n<p>The tube-like <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4296\">pharynx<\/a> (see Figure 15.4.5 below) plays a dual role as an organ of both respiration and digestion. As part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2912\">respiratory system<\/a>, it conducts air between the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4295\">nasal cavity<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4298\">larynx<\/a>. As part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3877\">digestive system<\/a>, it allows swallowed food to pass from the oral cavity to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a>. Anything swallowed has priority over inhaled air when passing through the pharynx. During swallowing, the backward motion of the tongue causes a flap of elastic cartilage \u2014 called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4302\">epiglottis<\/a> \u2014 to close over the opening to the larynx. This prevents food or drink from entering the larynx.<\/p>\n<figure id=\"attachment_4625\" aria-describedby=\"caption-attachment-4625\" style=\"width: 424px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4625\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Illu01_head_neck-1.jpg\" alt=\"15.4.5\" width=\"424\" height=\"430\"><figcaption id=\"caption-attachment-4625\" class=\"wp-caption-text\"><em>Figure 15.4.5 The tongue moves backward during swallowing to cause the epiglottis to cover the opening to the larynx. As a result, food passes from the pharynx to the esophagus \u2014 and not into the larynx.<\/em><\/figcaption><\/figure>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Esophagus<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a><\/strong> (shown in Figure 15.4.6) is a muscular tube through which food is pushed from the pharynx to the stomach. The esophagus passes through an opening in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4292\">diaphragm<\/a> (the large breathing muscle that separates the abdomen from the thorax) before reaching the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a>. In adults, the esophagus averages about 25 cm (about 9.8 inches) in length, depending on a person\u2019s height. The inner lining of the esophagus consists of mucous membrane, which provides a smooth, slippery surface for the passage of food. The cells of this membrane are constantly being replaced as they are worn away from the frequent passage of food over them.<\/p>\n<figure id=\"attachment_4626\" aria-describedby=\"caption-attachment-4626\" style=\"width: 234px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4626\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/ZenkerSchraeg-1.gif\" alt=\"15.4.6 Esophagus\" width=\"234\" height=\"600\"><figcaption id=\"caption-attachment-4626\" class=\"wp-caption-text\"><em>Figure 15.4.6 The esophagus moves food by peristalsis from the pharynx to the stomach. Note, this x-ray of a swallow shows a fraction of the ingested liquid being trapped in an atypical diverticulum of the esophagus.<\/em><\/figcaption><\/figure>\n<p>When food is not being swallowed, the esophagus is closed at both ends by upper and lower esophageal sphincters.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4627\">Sphincters<\/a><\/strong>\u00a0are rings of muscle that can contract to close off openings between structures. The upper esophageal sphincter is triggered to relax and open by the act of swallowing, allowing a bolus of food to enter the esophagus from the pharynx. Then, the esophageal sphincter closes again to prevent food from moving back into the pharynx from the esophagus.<\/p>\n<p>Once in the esophagus, the food <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4579\">bolus<\/a> travels down to the stomach, pushed along by the rhythmic contraction and relaxation of muscles (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>). The lower esophageal sphincter is located at the junction between the esophagus and the stomach. This sphincter opens when the bolus reaches it, allowing the food to enter the stomach. The sphincter normally remains closed at other times to prevent the contents of the stomach from entering the esophagus. Failure of this sphincter to remain completely closed can lead to heartburn. If it happens chronically, it can lead to <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/gerd\/symptoms-causes\/syc-20361940\">gastroesophageal reflux disease<\/a> (GERD), in which the mucous membrane of the esophagus may become damaged by the highly acidic contents of the stomach.<\/p>\n<p>See the video below to see how the parts of the upper GI tract work together to carry out swallowing:<\/p>\n<p>https:\/\/youtu.be\/pNcV6yAfq-g<\/p>\n<p style=\"text-align: center\">Swallowing, uploaded by Alejandra Cork, 2012.<\/p>\n<p><span style=\"font-size: 1.602em;font-weight: bold\">Stomach<\/span><\/p>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4558\">stomach<\/a><\/strong> is a J-shaped organ (shown in Figure 15.4.7) that is joined to the esophagus at its upper end, and to the first part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a> (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4576\">duodenum<\/a>) at its lower end. When the stomach is empty of food, it normally has a volume of about 75 millilitres, but it can expand to hold up to about a litre of food. Waves of muscle contractions (peristalsis) passing through the muscular walls of the stomach cause the food inside to be mixed and churned. The wall of the stomach has an extra layer of muscle tissue not found in other organs of the GI tract that helps it squeeze and mix the food. These movements of the stomach wall contribute greatly to mechanical digestion by breaking the food into much smaller pieces. The churning also helps mix the food with stomach secretions that aid in its chemical digestion.<\/p>\n<div>\n<figure id=\"attachment_4628\" aria-describedby=\"caption-attachment-4628\" style=\"width: 412px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4628\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/stomach-layers-white-cc_20190410_1053046020-1.jpg\" alt=\"15.4.7\" width=\"412\" height=\"293\"><figcaption id=\"caption-attachment-4628\" class=\"wp-caption-text\"><em>Figure 15.4.7 The stomach is connected at the top to the esophagus and at the bottom to the duodenum of the small intestine. The pylorus, or pyloric sphincter, controls emptying of the stomach into the small intestine. The outer surface of the stomach is covered with fibrous connective tissue. There are three layers of muscle in the stomach wall. Each layer runs in a different direction: circular, longitudinal and oblique.<\/em><\/figcaption><\/figure>\n<\/div>\n<p>Secretions of the stomach include gastric acid, which consists mainly of hydrochloric acid (HCl). This makes the stomach contents highly acidic, which is necessary so that the enzyme <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4581\">pepsin<\/a> \u2014 also secreted by the stomach \u2014 can begin the digestion of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3721\">protein<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4571\">Mucus<\/a> is secreted by the lining of stomach to provide a slimy protective coating against the otherwise damaging effects of gastric acid. The fat-digesting enzyme <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4602\">lipase<\/a> is secreted in small amounts in the stomach, but very little fat digestion occurs there.<\/p>\n<p>By the time food has been in the stomach for about an hour, it has become the thick, semi-liquid <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4582\">chyme<\/a>. When the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a> is ready to receive chyme, a sphincter between the stomach and duodenum \u2014 called the pyloric sphincter \u2014 opens to allow the chyme to enter the small intestine for further digestion and absorption.<\/p>\n<div>\n<h1>Feature: Reliable Sources<\/h1>\n<\/div>\n<p>The ongoing epidemic of obesity in the wealthier nations of the world, including Canada, has led to the development of several different bariatric surgeries that modify the stomach to help obese patients reduce their food intake and lose weight. Go online to learn more about bariatric surgery. Find sources you judge to be reliable that answer the following questions:<\/p>\n<ol>\n<li>Who qualifies for bariatric surgery?<\/li>\n<li>Describe the bariatric surgeries commonly called stomach stapling, lap band, and gastric sleeve. How does each type of surgery modify the stomach? In terms of weight loss, how effective is each type?<\/li>\n<li>What are the major potential risks of bariatric surgery?<\/li>\n<li>Besides weight loss, what other benefits have been shown to result from bariatric surgery?<\/li>\n<\/ol>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Organs of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4574\">upper gastrointestinal (GI) tract<\/a> include the mouth, pharynx, esophagus, and stomach.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4297\">mouth<\/a> is the first organ of the GI tract. It has several structures that are specialized for digestion, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4577\">salivary glands<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4615\">tongue<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3363\">teeth<\/a>. Both <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4550\">mechanical digestion<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4551\">chemical digestion<\/a> of carbohydrates and fats begin in the mouth.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4296\">pharynx<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4557\">esophagus<\/a> move food from the mouth to the stomach, but are not involved in the process of digestion or absorption. Food moves through the esophagus by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a>.<\/li>\n<li>Mechanical and chemical digestion continue in the stomach. Acid and digestive enzymes secreted by the stomach start the chemical digestion of proteins. The stomach turns masticated food into a semi-fluid mixture called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4582\">chyme<\/a>.<\/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\">15.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-405\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-405\" class=\"h5p-iframe\" data-content-id=\"405\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"15.4 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Identify structures in the mouth that are specialized for digestion.<\/li>\n<li>Describe digestion in the mouth.<\/li>\n<li>What general role do the pharynx and esophagus play in the digestion of food?<\/li>\n<li>How does food travel through the esophagus?<\/li>\n<li>Describe digestion in the stomach.<\/li>\n<li>Describe the differences between how air and food normally move past the pharynx.<\/li>\n<li>Name two structures in the mouth that contribute to mechanical digestion.<\/li>\n<li>What structure normally keeps stomach contents from backing up into the esophagus?<\/li>\n<li>Thirty minutes after you eat a meal, where is most of your food located? Explain your answer.<\/li>\n<li>What are two roles of mucus in the upper GI tract?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">15.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/zGoBFU1q4g0<\/p>\n<p style=\"text-align: center\">What causes cavities? - Mel Rosenberg, TED-Ed, 2016.<\/p>\n<p>https:\/\/youtu.be\/gCrmFbgT37I<\/p>\n<p style=\"text-align: center\">How does alcohol make you drunk? - Judy Grisel, TED-Ed, 2020.<\/p>\n<p>https:\/\/youtu.be\/twJBEypJDfU<\/p>\n<p style=\"text-align: center\">Gastric Bypass Surgery: One Patient\u2019s Journey - Mayo Clinic, 2014.<\/p>\n<p>https:\/\/youtu.be\/u_1sVri3b2w<\/p>\n<p style=\"text-align: center\">Here's What Happens In Your Body When You Swallow Gum | The Human Body, Tech Insider, 2018.<\/p>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 15.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/v5gl4leh-Mk\" rel=\"cc:attributionURL\">Handstand, Pender Island, B.C.<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@jaspergarrattphotography\">Jasper Garratt<\/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 15.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0780_SalivaryGlands.png\" rel=\"cc:attributionURL\">Blausen_0780_SalivaryGlands<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/p>\n<p><strong>Figure 15.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:1402_The_Tongue.jpg\" rel=\"cc:attributionURL\">1402_The_Tongue<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-1-sensory-perception\">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 15.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:3D_Medical_Animation_Still_Showing_Types_of_Teeth.jpg\" rel=\"cc:attributionURL\">1024px-3D_Medical_Animation_Still_Showing_Types_of_Teeth<\/a>\u00a0by <a href=\"http:\/\/www.scientificanimations.com\/\">http:\/\/www.scientificanimations.com<\/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<p><strong>Figure 15.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Illu01_head_neck.jpg\" rel=\"cc:attributionURL\">Illu01_head_neck<\/a> by <a title=\"User:Arcadian\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Arcadian\">Arcadian<\/a> from <a href=\"https:\/\/training.seer.cancer.gov\/head-neck\/anatomy\/overview.html\">NCI\/ SEER Training Modules<\/a> on Wikimedia Common 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 15.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:ZenkerSchraeg.gif\" rel=\"cc:attributionURL\">ZenkerSchraeg<\/a> by <a class=\"external text\" href=\"http:\/\/www.braegelmann.de\/bernd\" rel=\"nofollow\">Bernd Br\u00e4gelmann<\/a>\u00a0<a title=\"User:Braegel\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Braegel\">Braegel<\/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>\u00a0 (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0 (Courtesy of Dr. Martin Steinhoff. It is not known whether there is a possibly necessary approval from the patient.)<\/p>\n<p><strong>Figure 15.4.7<\/strong><\/p>\n<p><a href=\"http:\/\/www.medicalgraphics.de\/en\/free-pictures\/free-pictures\/miscellaneous\/stomach-layers-white-cc-472.html\" rel=\"cc:attributionURL\">Anatomy stomach \u2013 white<\/a> by www.medicalgraphics.de from <a href=\"http:\/\/www.medicalgraphics.de\/en\/free-pictures\/free-pictures\/miscellaneous\/stomach-layers-white-cc-472.html\">MedicalGraphics<\/a> is used under a\u00a0 <a href=\"https:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/\">CC BY-ND 4.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/) license.<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Alejandra Cork. (2012). Swallowing. YouTube. https:\/\/www.youtube.com\/watch?v=pNcV6yAfq-g&amp;t=4s<\/p>\n<p class=\"hanging-indent\"><span class=\"os-title-label\"><span class=\"search-highlight text\" data-timestamp=\"1597545683623\" data-highlight-id=\"5d333280-1dcc-4af7-a378-e35ebd44bb2d\" data-highlighted=\"true\">Betts, J. G., Young, K.A., Wise, J.A., Johnson, E., Poe, B., Kruse, D.H., Korol, O., Johnson, J.E., Womble, M., DeSaix, P. (2016, May 27). Figure\u00a0<\/span><\/span><span class=\"os-number\"><span class=\"search-highlight text\" data-timestamp=\"1597545683623\" data-highlight-id=\"5d333280-1dcc-4af7-a378-e35ebd44bb2d\" data-highlighted=\"true\">14.3<\/span><\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"20203\" class=\"os-title\" data-type=\"title\"><span class=\"search-highlight text\" data-timestamp=\"1597545683623\" data-highlight-id=\"5d333280-1dcc-4af7-a378-e35ebd44bb2d\" data-highlighted=\"true\">The tongue [digital image]. In <em>Anatomy and Physiology<\/em> (Section 14.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/14-1-sensory-perception<\/span><\/span><\/p>\n<p class=\"hanging-indent\">Blausen.com Staff. (2014). Medical gallery of Blausen Medical 2014. <em>WikiJournal of Medicine 1<\/em> (2). DOI:10.15347\/wjm\/2014.010. ISSN 2002-4436.<\/p>\n<p class=\"hanging-indent\">Mayo Clinic. (2014, August 26). Gastric bypass surgery: One patient\u2019s journey - Mayo Clinic. https:\/\/www.youtube.com\/watch?v=twJBEypJDfU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Gastroesophageal reflux disease (GERD) [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/gerd\/symptoms-causes\/syc-20361940<\/p>\n<p class=\"hanging-indent\">Tech Insider. (2018, March 20). Here's what happens in your body when you swallow gum | The human body. YouTube. https:\/\/www.youtube.com\/watch?v=u_1sVri3b2w&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2020, April 9). How does alcohol make you drunk? - Judy Grisel. YouTube. https:\/\/www.youtube.com\/watch?v=gCrmFbgT37I&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2016, October 17). What causes cavities? - Mel Rosenberg. YouTube. https:\/\/www.youtube.com\/watch?v=zGoBFU1q4g0&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_5023_4217\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4217\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4667\" aria-describedby=\"caption-attachment-4667\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4667\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/BADAS_Crohn-1.jpg\" alt=\"15.7.1 Crohn's Rash\" width=\"400\" height=\"263\"><figcaption id=\"caption-attachment-4667\" 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_5023_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_5023_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_5023_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_3513\">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_5023_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_5023_4671\">diarrhea<\/a>.\u00a0Weight\u00a0loss, fever, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3449\">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_5023_3513\">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_5023_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_5023_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_4674\" aria-describedby=\"caption-attachment-4674\" style=\"width: 512px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4674\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/512px-Ds00070_an01934_im00887_divert_s_gif.webp_-1.png\" alt=\"15.7.2\" width=\"512\" height=\"370\"><figcaption id=\"caption-attachment-4674\" 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_4675\" aria-describedby=\"caption-attachment-4675\" style=\"width: 579px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4675\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Colon_diverticulum-1.jpg\" alt=\"15.7.3 Diverticula\" width=\"579\" height=\"428\"><figcaption id=\"caption-attachment-4675\" 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_5023_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_4677\" aria-describedby=\"caption-attachment-4677\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-4677\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/H_pylori_ulcer_diagram-1.png\" alt=\"15.7.4 H.Pylori and Peptic Ulcer\" width=\"1024\" height=\"768\"><figcaption id=\"caption-attachment-4677\" 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_4678\" aria-describedby=\"caption-attachment-4678\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4678\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Endoscopy_training-1.jpg\" alt=\"15.7.5 Endoscopy\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-4678\" 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_5023_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_5023_3707\">pathogens<\/a>. Symptoms typically include some combination of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4671\">diarrhea<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_4683\" aria-describedby=\"caption-attachment-4683\" style=\"width: 419px\" class=\"wp-caption alignleft\"><img class=\"size-full wp-image-4683\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Gastroenteritis_viruses-1.jpg\" alt=\"15.7.6 Gastroenteritis causing Viruses\" width=\"419\" height=\"328\"><figcaption id=\"caption-attachment-4683\" 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_5023_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_5023_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_5023_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_4685\" aria-describedby=\"caption-attachment-4685\" style=\"width: 351px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4685 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Giardia_lamblia_SEM_8698_lores-e1592589161905-1.jpg\" alt=\"15.7.7 Giardia lamblia\" width=\"351\" height=\"388\"><figcaption id=\"caption-attachment-4685\" 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_5023_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_5023_4668\">Crohn\u2019s disease<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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-408\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-408\" class=\"h5p-iframe\" data-content-id=\"408\" 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-409\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-409\" class=\"h5p-iframe\" data-content-id=\"409\" 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_5023_5451\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_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_5023_327\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_327\"><div tabindex=\"-1\"><p>Created by:\u00a0CK-12\/Adapted by Christine Miller<\/p>\n<div>\n<h1>Case Study: Cancer in the Family<\/h1>\n<\/div>\n<figure id=\"attachment_325\" aria-describedby=\"caption-attachment-325\" style=\"width: 430px\" class=\"wp-caption alignleft\"><img class=\"wp-image-325\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Family-Tree.png\" alt=\"Image shows a family tree with three generations. The tree shows cartoon faces for each person on the tree, not names. The images show a variety of diverse faces.\" width=\"430\" height=\"396\"><figcaption id=\"caption-attachment-325\" class=\"wp-caption-text\"><em>Figure 5.1.1 Family tree - three generations.<\/em><\/figcaption><\/figure>\n<p>People tend to carry similar traits to their biological parents, as illustrated by the family tree. Beyond just appearance, you can also inherit traits from your parents that you <em>can\u2019t<\/em>\u00a0see.<\/p>\n<p>Rebecca becomes very aware of this fact when she visits her new doctor for a physical exam. Her doctor asks several questions about her family medical history, including whether Rebecca has or had relatives with cancer. Rebecca tells her that her grandmother, aunt, and uncle \u2014 who have all passed away \u2014 had cancer. They all had breast cancer, including her uncle, and her aunt\u00a0also\u00a0had ovarian cancer. Her doctor asks how old they were when they were diagnosed with cancer. Rebecca is not sure exactly, but she knows that her grandmother was fairly young at the time, probably in her forties.<\/p>\n<p>Rebecca\u2019s doctor explains that while the vast majority of cancers are not due to inherited factors, a cluster of cancers within a family may indicate that there are mutations in certain genes that increase the risk of getting certain types of cancer, particularly breast and ovarian cancer. Some signs that cancers may be due to these genetic factors are present in Rebecca\u2019s family, such as cancer with an early age of onset (e.g., breast cancer before age 50), breast cancer in men, and breast cancer and ovarian cancer within the same person or family.<\/p>\n<p>Based on her family medical history, Rebecca\u2019s doctor recommends that she see a genetic counselor, because these professionals can help determine whether the high incidence of cancers in her family could be due to inherited mutations in their genes. If so, they can test Rebecca to find out whether she has the particular variations of these genes that would increase her risk of getting cancer.<\/p>\n<p>When Rebecca sees the genetic counselor, he asks how her grandmother, aunt, and uncle with cancer are related to her. She says that these relatives are all on her mother\u2019s side \u2014 they are her mother\u2019s mother and siblings. The genetic counselor records this information in the form of a specific type of family tree, called a pedigree, indicating which relatives had which type of cancer, and how they are related to each other and to Rebecca.<\/p>\n<p>He also asks her ethnicity. Rebecca says that her family on both sides are Ashkenazi Jews (Jews whose ancestors came from central and eastern Europe). \u201cBut what does that have to do with anything?\u201d she asks. The counselor tells Rebecca that mutations in two tumor-suppressor genes called <a href=\"https:\/\/en.wikipedia.org\/wiki\/BRCA1\">BRCA1<\/a> and <a href=\"https:\/\/en.wikipedia.org\/wiki\/BRCA2\">BRCA2<\/a>, located on chromosome 17 and 13, respectively, are particularly prevalent in people of <a href=\"https:\/\/en.wikipedia.org\/wiki\/Ashkenazi_Jews\">Ashkenazi<\/a> Jewish descent and greatly increase the risk of getting cancer. About one in 40 Ashkenazi Jewish people have one of these mutations, compared to about one in 800 in the general population. Her ethnicity, along with the types of cancer, age of onset, and the specific relationships between her family members who had cancer, indicate to the counselor that she is a good candidate for genetic testing for the presence of these mutations.<\/p>\n<figure id=\"attachment_325\" aria-describedby=\"caption-attachment-325\" style=\"width: 429px\" class=\"wp-caption alignright\"><img class=\" wp-image-2096\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Rebecca-scaled-1.jpg\" alt=\"In this image, a woman looks thoughtfully out at the countryside.\" width=\"429\" height=\"286\"><figcaption id=\"caption-attachment-325\" class=\"wp-caption-text\"><em>Figure 5.1.2 Rebecca is not sure if she wants to know if she is at an increased risk of breast and ovarian cancer.<\/em><\/figcaption><\/figure>\n<p>Rebecca says that her 72-year-old mother never had cancer, nor had many other relatives on that side of the family. How could the cancers be genetic? The genetic counselor explains that the mutations in the BRCA1 and BRCA2 genes, while dominant, are not inherited by <em>everyone<\/em> in a family. Also, even people with mutations in these genes do not necessarily get cancer \u2014 the mutations simply increase their risk of getting cancer. For instance, 55 to 65 per cent of women with a harmful mutation in the BRCA1 gene will get breast cancer before age 70, compared to 12 per cent of women in the general population who will get breast cancer sometime over the course of their lives.<\/p>\n<p>Rebecca is not sure she wants to know whether she has a higher risk of cancer. The genetic counselor understands her apprehension, but explains that if she knows that she has harmful mutations in either of these genes, her doctor will screen her for cancer more often and at earlier ages. Therefore, any cancers she may develop are likely to be caught earlier when they are often much more treatable. Rebecca decides to go through with the testing, which involves taking a blood sample, and nervously waits for her results.<\/p>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\">Chapter Overview: Genetics<\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>At the end of this chapter, you will find out Rebecca\u2019s test results. By then, you will have learned how traits are inherited from parents to offspring through genes, and how mutations in genes such as BRCA1 and BRCA2 can be passed down and cause disease. Specifically, you will learn about:<\/p>\n<ul>\n<li>The structure of DNA.<\/li>\n<li>How DNA replication occurs.<\/li>\n<li>How DNA was found to be the inherited genetic material.<\/li>\n<li>How genes and their different alleles are located on chromosomes.<\/li>\n<li>The 23 pairs of human chromosomes, which include autosomal and sex chromosomes.<\/li>\n<li>How genes code for proteins using codons made of the sequence of nitrogen bases within RNA and DNA.<\/li>\n<li>The central dogma of molecular biology, which describes how DNA is transcribed into RNA, and then translated into proteins.<\/li>\n<li>The structure, functions, and possible evolutionary history of RNA.<\/li>\n<li>How proteins are synthesized through the transcription of RNA from DNA and the translation of protein from RNA, including how RNA and proteins can be modified, and the roles of the different types of RNA.<\/li>\n<li>What mutations are, what causes them, different specific types of mutations, and the importance of mutations in evolution and to human health.<\/li>\n<li>How the expression of genes into proteins is regulated and why problems in this process can cause diseases, such as cancer.<\/li>\n<li>How Gregor Mendel discovered the laws of inheritance for certain types of traits.<\/li>\n<li>The science of heredity, known as genetics, and the relationship between genes and traits.<\/li>\n<li>How gametes, such as eggs and sperm, are produced through meiosis.<\/li>\n<li>How sexual reproduction works on the cellular level and how it increases genetic variation.<\/li>\n<li>Simple Mendelian and more complex non-Mendelian inheritance of some human traits.<\/li>\n<li>Human genetic disorders, such as Down syndrome, hemophilia A, and disorders involving sex chromosomes.<\/li>\n<li>How biotechnology \u2014 which is the use of technology to alter the genetic makeup of organisms \u2014 is used in medicine and agriculture, how it works, and some of the ethical issues it may raise.<\/li>\n<li>The human genome, how it was sequenced, and how it is contributing to discoveries in science and medicine.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<p>As you read this chapter, keep Rebecca\u2019s situation in mind and think about the following questions:<\/p>\n<ol>\n<li>BCRA1 and BCRA2 are also called Breast cancer type 1 and 2 susceptibility proteins.\u00a0 What do the BRCA1 and BRCA2 genes normally do? How can they cause cancer?<\/li>\n<li>Are BRCA1 and BRCA2 linked genes? Are they on autosomal or sex chromosomes?<\/li>\n<li>After learning more about pedigrees, draw the pedigree for cancer in Rebecca\u2019s family. Use the pedigree to help you think about why it is possible that her mother does not have one of the BRCA gene mutations, even if her grandmother, aunt, and uncle did have it.<\/li>\n<li>Why do you think certain gene mutations are prevalent in certain ethnic groups?<\/li>\n<\/ol>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 5.1.1<\/strong><\/p>\n<p><a href=\"http:\/\/www.clker.com\/search\/face\/12\" rel=\"cc:attributionURL\">Family Tree<\/a> [all individual face images] from <a href=\"http:\/\/www.clker.com\/\">Clker.com<\/a> used and adapted by Christine Miller under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/\">CC0 1.0<\/a> public domain dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/).<\/p>\n<p><strong>Figure 5.1.2<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/P9rQn2qcEV0\" rel=\"cc:attributionURL\">Rebecca<\/a> by <a href=\"https:\/\/unsplash.com\/@kylebroad\">Kyle Broad<\/a> on <a href=\"https:\/\/unsplash.com\/\">Unsplash<\/a> is used under the <a class=\"ICezk _2GAZm _2WvKc\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a> (https:\/\/unsplash.com\/license).<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 27). Ashkenazi Jews. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=Ashkenazi_Jews&amp;oldid=964691647<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, June 22). BRCA1. In <em>Wikipedia<\/em>. https:\/\/en.wikipedia.org\/w\/index.php?title=BRCA1&amp;oldid=963868423<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, May 25). BRCA2. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=BRCA2&amp;oldid=958722957<\/p>\n<p class=\"hanging-indent\">\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_5877\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5877\"><div tabindex=\"-1\"><p>The process of producing cellular energy involving oxygen. Cells break down food in the mitochondria in a long, multi-step process that produces roughly 36 ATP. The first step in is glycolysis, the second is the Krebs cycle and the third is the electron transport 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_5023_5617\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_5617\"><div tabindex=\"-1\"><p>Respiration using electron acceptors other than molecular oxygen. Although oxygen is not the final electron acceptor, the process still uses a respiratory electron transport chain.<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4225\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4225\"><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_5023_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_5023_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_5023_2989\">liver<\/a> damage, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4782\">kidney failure<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4813\">infertility<\/a>, or bladder <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_3707\">pathogen<\/a>.<\/strong>\u00a0Most pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_2588\">bacteria<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_3835\">cardiovascular system<\/a> and plays a major role in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4552\">Lymph<\/a><\/strong>\u00a0is essentially blood plasma that has leaked from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3831\">capillaries<\/a> into tissue spaces. It includes many leukocytes, especially <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4829\">thymus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4497\">spleen<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4830\">tonsils<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_3823\">brain<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_3707\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3683\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_4226\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4226\"><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_5023_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_5023_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_5023_3743\">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_5023_3835\">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_5023_3831\">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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_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_5023_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_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_5023_4552\">lymph<\/a>, the spleen also filters <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_3531\">leukocytes<\/a>\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_3835\">cardiovascular system<\/a>. Lymph is similar in composition to blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_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_5023_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_5023_4829\">thymus<\/a>. Both the bone marrow and thymus are considered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4845\">primary lymphatic organs<\/a>.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4847\">Secondary lymphatic organs<\/a>\u00a0include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4830\">tonsils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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-420\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-420\" class=\"h5p-iframe\" data-content-id=\"420\" 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_5023_4228\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4228\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_4890\" aria-describedby=\"caption-attachment-4890\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4890\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Killer_T_cells_surround_a_cancer_cell-1.png\" alt=\"Figure 17.5.1 Killer T Cells\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-4890\" class=\"wp-caption-text\"><em>Figure 17.5.1 Kill the cancer.<\/em><\/figcaption><\/figure>\n<div>\n<h1>The Kiss of Death<\/h1>\n<\/div>\n<p>The photomicrograph in Figure 17.5.1 shows a group of killer T cells (green and red) surrounding a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancer<\/a> cell (blue, centre). When a killer T cell makes contact with the cancer cell, it attaches to and spreads over the dangerous target. The killer T cell then uses special chemicals stored in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3733\">vesicle<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\">\u00a0(red) to deliver the killing blow. This event has thus been nicknamed \u201cthe kiss of death.\u201d After the target cell is killed, the killer T cells move on to find the next victim. Killer T cells like these are important players in the adaptive immune system.<\/span><\/p>\n<div>\n<h1>What Is the Adaptive Immune System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4822\">adaptive immune system<\/a><\/strong>\u00a0is a subsystem of the overall immune system. It is composed of highly specialized cells and processes that eliminate specific <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">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\">\u00a0and tumor cells. An adaptive immune response is set in motion by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">antigen<\/span><span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a>\u00a0that the immune system recognizes as foreign. Unlike an innate immune response, an adaptive immune response is highly specific to a particular pathogen (or its antigen). An important function of the adaptive immune system that is\u00a0<\/span><em style=\"text-align: initial;font-size: 1em\">not<\/em><span style=\"text-align: initial;font-size: 1em\">\u00a0shared by the innate immune system is the creation of immunological memory \u2014 or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a> \u2014 which occurs after the initial response to a specific pathogen. It allows for a faster, stronger response on subsequent encounters with the same pathogen, usually before the pathogen can even cause symptoms of illness.<\/span><\/p>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">\u00a0are the main cells of the adaptive immune system. They are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3531\">leukocyte<\/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\">\u00a0that arise and mature in organs of the lymphatic system, including the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4021\">bone marrow<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4829\">thymus<\/a>. The human body normally has about 2 trillion lymphocytes, which constitute about 1\/3 of all leukocytes. Most of the lymphocytes are normally sequestered within tissue fluid or organs of the lymphatic system, including the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4830\">tonsil<\/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\">, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4497\">spleen<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">. Only about 2% of the lymphocytes are normally circulating in the blood. There are two main types of lymphocytes involved in adaptive immune responses, called T cells and B cells. T cells destroy infected cells or release chemicals that regulate immune responses. B cells secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a> that bind with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">antigen<\/span><span style=\"font-size: 1em\">s<\/span><span style=\"text-align: initial;font-size: 1em\">[<\/span><span style=\"text-align: initial;font-size: 1em\">\/pb_glossary]<\/span><span style=\"text-align: initial;font-size: 1em\">\u00a0of [pb_glossary id=\"271\"]pathogen<\/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\">\u00a0so they can be removed by other immune cells or processes.<\/span><\/p>\n<div>\n<h1>Pathways of the Adaptive Immune Response<\/h1>\n<p>There are some general similarities in the way in which the separate adaptive immune responses occur in T cell and B cell responses.\u00a0 In both pathways, a foreign antigen is recognized by the B or T cell.\u00a0 From there, cytokines produced by helper T-cells promote clonal expansion of lymphocytes.\u00a0 From this clonal expansion, two types of B or T cells are produced- cells that directly fight the pathogen invasion and cells that remain behind to provide long-term <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a>.\u00a0 Finally, once the pathogen invasion has been eradicated, the plasma cells and killer T cells go through apoptosis (programmed cell death).<\/p>\n<h1>T Cells<\/h1>\n<\/div>\n<p>There are multiple types of\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4892\">T cells<\/a>,<\/strong>\u00a0or T lymphocytes. Major types are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4893\">killer (or cytotoxic) T cells<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3445\">helper T cells<\/a>. Both types develop from immature T cells that become activated by exposure to an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">antigen<\/a>.<\/p>\n<h2>T Cell Activation (or Cell-Mediated Immunity)<\/h2>\n<p>T cells must be activated to become either killer T cells or helper T cells. This requires presentation of a foreign antigen by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4895\">antigen-presenting cells<\/a>, as shown in Figure 17.5.2. Antigen-presenting cells may be <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4875\">dendritic 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\">, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4340\">macrophage<\/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\">, or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cell<\/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\">. Activation occurs when T cells are presented with a foreign antigen coupled with an MHC self antigen. Helper T cells are more easily activated than killer T cells. Activation of killer T cells is strongly regulated and may require additional stimulation from helper T cells.<\/span><\/p>\n<figure id=\"attachment_4898\" aria-describedby=\"caption-attachment-4898\" style=\"width: 580px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4898\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-T_cell_activation.svg_-1.png\" alt=\"17.5.2 T-Cell Activation\" width=\"580\" height=\"877\"><figcaption id=\"caption-attachment-4898\" class=\"wp-caption-text\"><em>Figure 17.5.2 Exposure to a foreign antigen on an antigen-presenting cell is necessary to activate T cells to become killer T cells or helper T cells.<\/em><\/figcaption><\/figure>\n<h2>Killer T Cells<\/h2>\n<p>Activated killer T cells induce the death of cells that bear a specific <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3371\">non-self<\/a> antigen because they are infected with pathogens or are cancerous. The antigen targets the cell for destruction by killer T cells, which travel through the bloodstream searching for target cells to kill. Killer T cells may use various mechanisms to kill target cells. One way is by releasing toxins in granules that enter and kill infected or cancerous cells (see Figure 17.5.3).<\/p>\n<figure id=\"attachment_4900\" aria-describedby=\"caption-attachment-4900\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4900 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Cytotoxic-T-Cell-function-e1592851629363-1.png\" alt=\"17.5.3 Killer T Cell Function\" width=\"1024\" height=\"419\"><figcaption id=\"caption-attachment-4900\" class=\"wp-caption-text\"><em>Figure 17.5.3 A killer T cell releases toxins that destroy an infected body cell and the viruses it contains.<\/em><\/figcaption><\/figure>\n<h2>Helper T Cells<\/h2>\n<p>Activated <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3445\">helper T 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\">\u00a0do not kill infected or cancerous cells. Instead, their role is to \u201cmanage\u201d both <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4820\">innate<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4822\">adaptive immune<\/a> responses by directing other cells to perform these tasks. They control other cells by releasing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">, which are proteins that can influence the activity of many cell types, including <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4893\">killer T cell<\/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\">, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cells<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4340\">macrophages<\/a>.\u00a0Some cytokines released by helper T cells assist with the activation of killer T cells.<\/span><\/p>\n<div>\n<h1>B Cells<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cell<\/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\">, or B lymphocytes, are the major cells involved in the creation of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a> that circulate in blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4395\">plasma<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4552\">lymph<\/a>. Antibodies are large, Y-shaped proteins used by the immune system to identify and neutralize foreign invaders. Besides producing antibodies, B cells may also function as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4895\">antigen-presenting cell<\/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\">, or secrete cytokines that help control other immune cells and responses.<\/span><\/p>\n<h2>B Cell Activation (or Antibody-Mediated Immunity)<\/h2>\n<p>Before B cells can actively function to defend the host, they must be activated. As shown in Figure 17.5.4, B cell activation begins when a B cell engulfs and digests an antigen. The antigen may be either free floating in the lymph, or it may be presented by an antigen-presenting cell, such as a dendritic cell or macrophage. In either case, the B cell then displays antigen fragments bound to its own MHC antigens. The MHC-antigen complex on the B cell attracts helper T cells. The helper T cells, in turn, secrete cytokines that help the B cell to multiply, and the daughter cells to mature into plasma cells.<\/p>\n<figure id=\"attachment_4901\" aria-describedby=\"caption-attachment-4901\" style=\"width: 583px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-4901\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/B_cell_activation.svg_-1.png\" alt=\"17.5.4 B Cell Activation\" width=\"583\" height=\"896\"><figcaption id=\"caption-attachment-4901\" class=\"wp-caption-text\"><em>Figure 17.5.4 B cells are activated and become antibody-producing plasma cells with the help of helper T cells.<\/em><\/figcaption><\/figure>\n<h2>Plasma Cells<\/h2>\n<figure id=\"attachment_4903\" aria-describedby=\"caption-attachment-4903\" style=\"width: 325px\" class=\"wp-caption alignright\"><img class=\" wp-image-4903\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Antibody.svg_-1-2.png\" alt=\"17.5.5 Antibodies match the shape of the antigen\" width=\"325\" height=\"459\"><figcaption id=\"caption-attachment-4903\" class=\"wp-caption-text\"><em>Figure 17.5.5 Each antibody fits its antigen like a lock fits a key.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4902\">Plasma cell<\/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 antibody-secreting cells that form from activated B cells. Each plasma cell is like a tiny antibody factory. It may secrete millions of copies of an antibody, each of which can bind to the specific antigen that activated the original B cell. The specificity of an antibody to a specific antigen is illustrated in Figure 17.5.5. When antibodies bind with antigens, it makes the cells bearing them easier targets for phagocytes to find and destroy. Antibody-antigen complexes may also trigger the complement system of the innate immune system, which destroys the cells in a cascade of protein enzymes. In addition, the complexes are likely to clump together (agglutinate). If this occurs, they are filtered out of the blood in the spleen or liver.<\/span><\/p>\n<div>\n<h1>Immunity<\/h1>\n<\/div>\n<p>Once a pathogen has been cleared from the body, most activated T cells and B cells die within a few days.\u00a0A\u00a0few of the cells, however, survive and remain in the body as memory T cells or memory B cells. These <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4904\"><strong>memory cell<\/strong>s<\/a> are ready to activate an immediate response if they are exposed to the same antigen again in the future. This is the basis of\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a>.<\/strong><\/p>\n<p>The earliest known reference to the concept of immunity relates to the bubonic plaque (see Figure 17.5.6). In 430 B.C., a Greek historian and general named Thucydides noted that people who had recovered from a previous bout of the plague could nurse people who were sick with the plague without contracting the illness a second time. We now know that this is true of many diseases, and that it occurs because of active immunity.<\/p>\n<figure id=\"attachment_4905\" aria-describedby=\"caption-attachment-4905\" style=\"width: 332px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-4905\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Acral_gangrene_due_to_plague-e1592852768241-1.jpg\" alt=\"17.5.6 Bubonic Plague\" width=\"332\" height=\"500\"><figcaption id=\"caption-attachment-4905\" class=\"wp-caption-text\"><em>Figure 17.5.6 Dead, blackened tissues at the finger tips and other extremities are a sign of the bubonic plague, giving rise to its other name, the black death.<\/em><\/figcaption><\/figure>\n<h2>Active Immunity<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4906\">Active immunity<\/a><\/strong>\u00a0is the ability of the adaptive immune system to resist a specific pathogen because it has formed an immunological memory of the pathogen. Active immunity is adaptive, because it occurs during the lifetime of an individual as an adaptation to infection with a specific pathogen, and prepares the immune system for future challenges from that pathogen. Active immunity can come about naturally or artificially.<\/p>\n<h3>Naturally Acquired Active Immunity<\/h3>\n<p>Active immunity is acquired naturally when a pathogen invades the body and activates the adaptive immune system. When the initial infection is over, memory B cells and memory T cells remain, providing immunological memory of the pathogen. As long as the memory cells are alive, the immune system is ready to mount an immediate response if the same pathogen tries to infect the body again.<\/p>\n<h3>Artificially Acquired Active Immunity<\/h3>\n<p>Active immunity can also be acquired artificially through immunization.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4908\">Immunization<\/a><\/strong> is the deliberate exposure of a person to a pathogen in order to provoke an adaptive immune response and the formation of memory cells specific to that pathogen. The pathogen is introduced in a vaccine \u2014 usually by injection, sometimes by nose or mouth (see Figure 17.5.7) \u2014 so immunization is also called vaccination.<\/p>\n<figure id=\"attachment_4909\" aria-describedby=\"caption-attachment-4909\" style=\"width: 511px\" class=\"wp-caption alignleft\"><img class=\" wp-image-4909\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/immunizations-1.jpg\" alt=\"17.5.7 Immunizations\" width=\"511\" height=\"289\"><figcaption id=\"caption-attachment-4909\" class=\"wp-caption-text\"><em>Figure 17.5.7 This young child is receiving a vaccine. Vaccines are a safe way to create immunity against life-threatening diseases.<\/em><\/figcaption><\/figure>\n<p>Typically, only part of a pathogen, a weakened form of the pathogen, or a dead pathogen is used in a vaccine, which causes an adaptive immune response without making the immunized person sick. This is how you most likely became immune to diseases such as <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/measles\/symptoms-causes\/syc-20374857\">measles<\/a>, <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/mumps\/symptoms-causes\/syc-20375361\">mumps<\/a>, and chicken pox. Immunizations may last for a lifetime, or they may require periodic booster shots to maintain immunity. While immunization generally has long-lasting effects, it usually takes several weeks to develop full immunity.<\/p>\n<p>Immunization is the most effective method ever discovered of preventing infectious diseases. As many as 3 million deaths are prevented each year because of vaccinations. Widespread immunity from vaccinations is largely responsible for the worldwide eradication of <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/smallpox\/symptoms-causes\/syc-20353027\">smallpox<\/a>, and the near elimination of several other infectious diseases from many populations, including <a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/polio\/symptoms-causes\/syc-20376512\">polio<\/a> and measles. Immunization is so successful because it exploits the natural specificity and inducibility of the adaptive immune system.<\/p>\n<h2>Passive Immunity<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4910\">Passive immunity<\/a><\/strong>\u00a0results when pathogen-specific antibodies or activated T cells are transferred to a person who has never been exposed to the pathogen. Passive immunity provides immediate protection from a pathogen, but the adaptive immune system does not develop immunological memory to protect the host from the same pathogen in the future. Unlike active immunity, passive immunity lasts only as long as the transferred antibodies or T cells survive in the blood \u2014 usually between a few days and a few months. However, like active immunity, passive immunity can be acquired both naturally and artificially.<\/p>\n<h3>Naturally Acquired Passive Immunity<\/h3>\n<p>Passive immunity is acquired naturally by a fetus through its mother\u2019s blood. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">Antibodies<\/a> are transported from mother to fetus across the placenta, so babies have high levels of antibodies at birth. Their antibodies have the same range of antigen specificities as their mother\u2019s. Passive immunity may also be acquired by an infant through the mother\u2019s breast milk. This gives young infants protection from common pathogens in their environment while their own immune system matures.<\/p>\n<h3>Artificially Acquired Passive Immunity<\/h3>\n<p>Older children and adults can acquire passive immunity artificially through the injection of antibodies or activated T cells, which may be done when there is a high risk of infection and insufficient time for the body to develop active immunity through vaccination. It may also be done to reduce symptoms of ongoing disease, or to compensate for immunodeficiency diseases.<\/p>\n<div>\n<h1>Adaptive Immune Evasion<\/h1>\n<\/div>\n<p>Many pathogens have been around for a long time, living with human populations for generations. To persist, some have evolved mechanisms to evade the adaptive immune system of human hosts. One way they have done this is by rapidly changing their non-essential antigens. This is called antigenic variation. An example of a pathogen that takes this approach is human immunodeficiency virus (HIV). It mutates rapidly so the proteins on its viral envelope are constantly changing. By the time the adaptive immune system responds, the virus\u2019s antigens have changed. Antigenic variation is the main reason that efforts to develop a vaccine against HIV have not yet been successful.<\/p>\n<p>Another evasion approach that some pathogens may take is to mask pathogen antigens with host molecules so the host\u2019s immune system cannot detect the antigens. HIV takes this approach, as well. The envelope that covers the virus is formed from the outermost membrane of the host cell.<\/p>\n<div>\n<h1>Feature: My Human Body<\/h1>\n<\/div>\n<p>If you think that immunizations are just for kids, think again. There are several vaccines recommended by <a href=\"https:\/\/www.healthlinkbc.ca\/tools-videos\/bc-immunization-schedules\">HealthLinkBC<\/a> for people over the age of 18. The tables below from HealthLinkBC show the vaccine schedules recommended for infants and children, school-aged children, and adults and senior. Additional vaccines may be recommended for certain adults based on specific travel plans, medical conditions or other indications. Are you up to date with your vaccines? You can check with your doctor to be sure.<\/p>\n<div>\n<p><img class=\"aligncenter wp-image-4913\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/BC-Immunization-2020-Schedule-Infants-and-Children-1.png\" alt=\"17.5 British Columbia Immunization Schedule - Infants and Children\" width=\"763\" height=\"741\"><\/p>\n<\/div>\n<p><img class=\"wp-image-4917 aligncenter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/BC-Immunization-2020-Schedule-School-Aged-Children-1.png\" alt=\"17.5 BC Immunization 2020 Schedule School-Aged Children\" width=\"694\" height=\"329\"><\/p>\n<p>&nbsp;<\/p>\n<p><img class=\"wp-image-4921 aligncenter\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/BC-Immunization-2020-Schedule-Adults-Seniors-Individuals-at-High-Risk-1.png\" alt=\"17.5 BC Immunization 2020 Schedule Adults, Seniors, Individuals at High Risk\" width=\"715\" height=\"463\"><\/p>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">17.5 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4822\">adaptive immune system<\/a> is a subsystem of the overall immune system that recognizes and makes a tailored attack against specific <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3707\">pathogens<\/a>\u00a0or tumor cells. It is a slower, but more effective response than the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4820\">innate immune response<\/a>, and also leads to immunity to particular pathogens.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4832\">Lymphocytes<\/a>\u00a0produced by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2911\">lymphatic system<\/a> are the main cells of the adaptive immune system. There are two major types of lymphocytes: <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4892\">T cells<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cells<\/a>. Both types must be activated by foreign <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">antigens<\/a>\u00a0to become functioning immune cells.<\/li>\n<li>Most activated T cells become either <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4893\">killer T cells<\/a>\u00a0or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3445\">helper T cells<\/a>. Killer T cells destroy cells that are infected with pathogens or are cancerous. Helper T cells manage immune responses by releasing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4865\">cytokines<\/a>\u00a0that control other types of leukocytes.<\/li>\n<li>Activated B cells form <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4902\">plasma cells<\/a>\u00a0that secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a>, which bind to specific antigens on pathogens or infected cells. The antibody-antigen complexes generally lead to the destruction of the cells, for example, by attracting phagocytes or triggering the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4868\">complement system<\/a>.<\/li>\n<li>After an adaptive immune response occurs, long-lasting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4904\">memory B cells and memory T cells<\/a> may remain to confer immunity to the specific pathogen that caused the adaptive immune response. These memory cells are ready to activate an immediate response if they are exposed to the same antigen again in the future.<\/li>\n<li>Immunity may be active or passive. Active immunity occurs when the immune system has been presented with antigens that elicit an adaptive immune response. This may occur naturally as the result of an infection, or artificially as the result of immunization. Active immunity may last for years or even for life.<\/li>\n<li>Passive immunity occurs without an adaptive immune response by the transfer of antibodies or activated T cells. This may occur naturally between a mother and her fetus or her nursing infant, or it may occur artificially by injection. Passive immunity lasts only as long as the antibodies or activated T cells remain alive in the body, generally just weeks or months.<\/li>\n<li>Many pathogens have evolved mechanisms to evade the adaptive immune system. For example, human immunodeficiency virus (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4501\">HIV<\/a>) evades the adaptive immune system by frequently changing its antigens and by forming its outer envelope from the host\u2019s cell membrane.<\/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\">17.5 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the adaptive immune system?<\/li>\n<li>Define immunity.<\/li>\n<li>\n<div id=\"h5p-422\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-422\" class=\"h5p-iframe\" data-content-id=\"422\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"17.5 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>How are lymphocytes activated?<\/li>\n<li>Identify two common types of T cells and their functions.<\/li>\n<li>How do activated B cells help defend against pathogens?<\/li>\n<li>How does passive immunity differ from active immunity?\u00a0How may passive immunity occur?<\/li>\n<li>What are two ways that active immunity may come about?<\/li>\n<li>What ways of evading the human adaptive immune system evolved in human immunodeficiency virus (HIV)?<\/li>\n<li>Why do vaccinations expose\u00a0a person to a version of a pathogen?<\/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\">17.5 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/rb7TVW77ZCs<\/p>\n<p style=\"text-align: center\">How do vaccines work? - Kelwalin Dhanasarnsombut, TED-Ed, 2015.<\/p>\n<p>https:\/\/youtu.be\/yqUFy-t4MlQ<\/p>\n<p style=\"text-align: center\">How we conquered the deadly smallpox virus - Simona Zompi, TED-Ed, 2013.<\/p>\n<p>https:\/\/youtu.be\/5THf6gTNqO8<\/p>\n<p style=\"text-align: center\">Why Do We Need A New Flu Shot Every Year? Seeker, 2015.<\/p>\n<p>https:\/\/youtu.be\/X-rC78MKZvw<\/p>\n<p style=\"text-align: center\">An HIV Vaccine: Mapping Uncharted Territory, NIAID, 2016.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.5.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Killer_T_cells_surround_a_cancer_cell.png\" rel=\"cc:attributionURL\">Killer_T_cells_surround_a_cancer_cell<\/a> by Alex Ritter, Jennifer Lippincott Schwartz and Gillian Griffiths at the <a href=\"https:\/\/visualsonline.cancer.gov\/details.cfm?imageid=11852\">National Institutes of Health\/ Visuals Online<\/a> 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\/Public_domain).<\/p>\n<p><strong>Figure 17.5.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:T_cell_activation.svg\" rel=\"cc:attributionURL\">T_cell_activation.svg<\/a> by <a title=\"User:Rehua\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Rehua\">Rehua<\/a> (derivative work) 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\/Public_domain).\u00a0(Original image: <a title=\"File:T cell activation.png\" href=\"https:\/\/commons.wikimedia.org\/wiki\/File:T_cell_activation.png\">T_cell_activation.png<\/a>:\u00a0 from <a class=\"external text\" href=\"http:\/\/www.niaid.nih.gov\/publications\/immune\/the_immune_system.pdf\" rel=\"nofollow\">The Immune System - NIH Publication No. 03\u20135423<\/a>)<\/p>\n<p><strong style=\"text-align: initial;font-size: 1em\">Figure 17.5.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_42_02_04.png\" rel=\"cc:attributionURL\">Cytotoxic T Cell function<\/a>\u00a0by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53: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 17.5.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:B_cell_activation.svg\" rel=\"cc:attributionURL\">B_cell_activation.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 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). (Original from <a class=\"external text\" href=\"http:\/\/www.niaid.nih.gov\/publications\/immune\/the_immune_system.pdf\" rel=\"nofollow\">The Immune System - NIH Publication No. 03\u20135423<\/a>)<\/p>\n<p><strong>Figure 17.5.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Antibody.svg\" rel=\"cc:attributionURL\">Antibody.svg<\/a> by <a title=\"User:Fvasconcellos\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Fvasconcellos\">Fvasconcellos<\/a>\u00a0 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\/Public_domain). (Original black and white image from the National Human Genome Research Institute's <a href=\"https:\/\/www.genome.gov\/genetics-glossary\">Talking Genetics Glossary<\/a>)<\/p>\n<p><strong>Figure 17.5.7<\/strong><\/p>\n<p><a href=\"https:\/\/www.health.mil\/News\/Articles\/2020\/05\/01\/CDC-maintains-childhood-immunization-guidelines-during-COVID-19\" rel=\"cc:attributionURL\">immunizations<\/a> by U.S. Air Force photo by Airman 1st Class Destinee Dougherty from Military Health System website, Health.mil, 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>&nbsp;<\/p>\n<h2>References<\/h2>\n<p class=\"hanging-indent\">HealthLinkBC. (2018). B.C. immunization schedules. \u00a0Gov.BC.CA. \u00a0https:\/\/www.healthlinkbc.ca\/tools-videos\/bc-immunization-schedules<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Measles [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/measles\/symptoms-causes\/syc-20374857<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Mumps [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/mumps\/symptoms-causes\/syc-20375361<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Polio [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/polio\/symptoms-causes\/syc-20376512<\/p>\n<p class=\"hanging-indent\">Mayo Clinic Staff. (n.d.). Smallpox [online article]. MayoClinic.org. https:\/\/www.mayoclinic.org\/diseases-conditions\/smallpox\/symptoms-causes\/syc-20353027<\/p>\n<p class=\"hanging-indent\">NIAID. (2016, August 11). An HIV vaccine: Mapping uncharted territory. YouTube. https:\/\/www.youtube.com\/watch?v=X-rC78MKZvw&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">OpenStax. (2016, March 23). Figure 4 Na\u00efve\u00a0<mtext class=\"q-match\">CD4<\/mtext><sup>+<\/sup>\u00a0T cells engage MHC II molecules on antigen-presenting cells (APCs) and become activated. Clones of the activated helper T cell, in turn, activate B cells and CD8<sup>+<\/sup> T cells, which become cytotoxic T cells. Cytotoxic T cells kill infected cells [digital image].\u00a0In <em>OpenStax, Biology<\/em> (Section 42.2). OpenStax CNX. https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:etZobsU-@6\/Adaptive-Immune-Response<\/p>\n<p class=\"hanging-indent\">Seeker. (2015, September 2). Why do we need a new flu shot every year? YouTube. https:\/\/www.youtube.com\/watch?v=5THf6gTNqO8<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, January 12). How do vaccines work? - Kelwalin Dhanasarnsombut. YouTube. https:\/\/www.youtube.com\/watch?v=rb7TVW77ZCs&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2013, October 28). How we conquered the deadly smallpox virus - Simona Zompi. YouTube. https:\/\/www.youtube.com\/watch?v=yqUFy-t4MlQ&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_5023_4230\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4230\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_5024\" aria-describedby=\"caption-attachment-5024\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5024\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Cycling-to-Beat-Blood-Cancer-1.jpg\" alt=\"17.7.1 Cycling to Beat Blood Cancer\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-5024\" class=\"wp-caption-text\"><em>Figure 17.7.1 Be Unstoppable for Leukemia and Lymphoma Research.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Case Study Conclusion: Defending Your Defenses<\/h1>\n<\/div>\n<p>These people are participating in a bike ride to raise funds for leukemia and lymphoma research (Figure 17.7.1). Leukemia and lymphoma are blood cancers. In 2020,\u00a0 approximately 6,900 Canadians will be diagnosed with leukemia and 3,000 will die from this cancer. Lymphoma is the most common type of blood cancer. As a lymphoma patient, Hakeem, who you learned about in the beginning of this chapter, may eventually benefit from research funded by a bike ride like this one.<\/p>\n<p>What type of blood cell is affected in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5026\">lymphoma<\/a>? As the name implies, lymphoma is a cancer that affects lymphocytes, which are a type of leukocyte. As you have learned in this chapter, there are different types of lymphocytes, including the B and T cells of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4822\">adaptive immune system<\/a>. Different types of lymphoma affect different types of lymphocytes in different ways. It is important to correctly identify the type of lymphoma, so that patients can be treated appropriately.<\/p>\n<p>You may recall that one of Hakeem\u2019s symptoms was a swollen <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4831\">lymph node<\/a>, and he was diagnosed with lymphoma after a biopsy of that lymph node. Swollen lymph nodes are a common symptom of lymphoma. As you have learned, lymph nodes are distributed throughout the body along lymphatic vessels, as part of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2911\">lymphatic system<\/a>. The lymph nodes filter <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4552\">lymph<\/a> and store lymphocytes. Therefore, they play an important role in fighting infections. Because of this, they will often swell in response to an infection. In Hakeem\u2019s case, the swelling and other symptoms did not improve after several weeks and a course of antibiotics, which caused Dr. Hayes to suspect lymphoma instead. The biopsy showed that Hakeem did indeed have cancerous lymphocytes in his lymph nodes.<\/p>\n<p>But which type of lymphocytes were affected? Lymphoma most commonly affects B or T lymphocytes. The two major types of lymphoma are called Hodgkin (HL) or non-Hodgkin lymphoma (NHL). NHL is more common than HL. In 2020, the Canadian Cancer Society estimates 10,400 Canadians will be diagnosed with non-Hodgkin lymphoma, whereas 1,000 will be diagnosed with Hodgkin lymphoma. While HL is one distinct type of lymphoma, NHL has about 60 different subtypes, depending on which specific cells are affected and how.<\/p>\n<p>Hakeem was diagnosed with a type of NHL called diffuse large B-cell lymphoma (DLBCL) \u2014 the most common type of NHL. This type of lymphoma affects <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B 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\"> and causes them to appear large under the microscope. In addition to Hakeem\u2019s symptoms of fatigue, swollen lymph nodes, loss of appetite, and weight loss, common symptoms of this type of lymphoma include fever and night sweats. It is an aggressive and fast-growing type of lymphoma that is fatal if not treated. The good news is that with early detection and proper treatment, about 70% of patients with DLBCL can be cured.<\/span><\/p>\n<figure id=\"attachment_5028\" aria-describedby=\"caption-attachment-5028\" style=\"width: 299px\" class=\"wp-caption alignright\"><img class=\" wp-image-5028\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/antigen-stain-1.jpg\" alt=\"17.7.2 Antigen stain\" width=\"299\" height=\"267\"><figcaption id=\"caption-attachment-5028\" class=\"wp-caption-text\">Figure 17.7.2 A lab technician can apply stains that target specific antigens to help identify which type of lymphoma is present.<\/figcaption><\/figure>\n<p>How do physicians determine the specific type of lymphoma? Tissue obtained from a biopsy can be examined under a microscope to observe physical changes (such as abnormal cell size or shape) that are characteristic of a particular subtype of lymphoma. Additionally, tests can be performed on the tissue to determine which cell-surface antigens are present. Recall that antigens are molecules that bind to specific antibodies. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">Antibodies<\/a> can be produced in the laboratory and labeled with compounds that can be identified by their colour under a microscope. When these antibodies are applied to a tissue sample, this colour will appear wherever the antigen is present, because it binds to the antibody. This technique was used in the photomicrograph in Figure 17.7.2 to identify the presence of a cell-surface antigen (shown as reddish-brown) in a sample of skin cells. This technique, called immunohistochemistry, is also commonly used to identify antigens in tissue samples from lymphoma patients.<\/p>\n<p>Why would identifying cell-surface antigens be important in diagnosing and treating lymphoma? As you have learned, the immune system uses antigens present on the surface of cells or pathogens to distinguish between self and non-self, and to launch adaptive immune responses. Cells that become cancerous often change their cell-surface antigens. This is one way that the immune system can identify and destroy them. Also, different cell types in the body can sometimes be identified by the presence of specific cell-surface antigens. Knowing the types of cell-surface antigens present in a tissue sample can help physicians identify which cells are cancerous, and possibly the specific subtype of cancer. Knowing this information can be helpful in choosing more tailored and effective treatments.<\/p>\n<p>One treatment for NHL is, in fact, the use of medications made from antibodies that bind to cell-surface antigens present on cells affected by the specific subtype of NHL. This is called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5004\">immunotherapy<\/a>. These drugs can directly bind to and kill the cancerous cells. For patients with DLBCL like Hakeem, immunotherapy is often used in conjunction with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5029\">chemotherapy<\/a> and radiation as a course of treatment. Although Hakeem has a difficult road ahead, he and his medical team are optimistic that \u2014 given the high success rate when DLBCL is caught and treated early \u2014 he may be cured. More research into how the immune system functions may lead to even better treatments for lymphoma \u2014 and other types of cancers \u2014 in the future.<\/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 17 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>In this chapter, you learned about the immune system. Specifically, you learned that:<\/p>\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_5023_3707\">pathogen<\/a>. Most human pathogens are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3683\">microorganisms<\/a>, such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2588\">bacteria<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4283\">viruses<\/a>. The immune system is the\u00a0body\u00a0system that defends the human host from pathogens and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3513\">cancerous<\/a>\u00a0cells.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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 phagocytize pathogens, and several other general responses.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a> to the pathogens.<\/li>\n<li>Both innate and adaptive immune responses depend on the ability of the immune system to distinguish between self and non-self molecules. Most body cells have <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4825\">major histocompatibility complex (MHC)<\/a> proteins that identify them as self. Pathogens, infected cells, and tumor cells have non-self proteins called antigens that the immune system recognizes as foreign.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2704\">Antigens<\/a>\u00a0are proteins that bind to specific receptors on immune system cells and elicit an adaptive immune response. Some immune cells (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cells<\/a>) respond to foreign antigens by producing antibodies that bind with antigens and target pathogens for destruction.<\/li>\n<li>An important role of the immune system is tumor surveillance. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4893\">Killer T cells<\/a>\u00a0of the adaptive immune system find and destroy tumor cells, which they can identify from their abnormal antigens.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4833\">neuroimmune system<\/a> that protects the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3841\">central nervous system<\/a> is thought to be distinct from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4834\">peripheral immune system<\/a> that protects the rest of the human body. The blood-brain and blood-spinal cord barriers are one type of protection of the neuroimmune system. Neuroglia also play a role in this system, for example, by carrying out <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1680\">phagocytosis<\/a>.<\/li>\n<li>The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2911\">lymphatic system<\/a> is a human organ system that is a vital part of the adaptive immune system. It consists of several organs and a system of vessels that transport or filter the fluid called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4552\">lymph<\/a>. The main immune function of the lymphatic system is to produce, mature, harbor, and circulate white blood cells called lymphocytes, which are the main cells in the adaptive immune system, and are circulated in lymph.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The return of lymph to the bloodstream is one of the functions of the lymphatic system. Lymph flows from tissue spaces, where it leaks out of blood vessels, to major veins in the upper chest. It is then returned to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3835\">cardiovascular system<\/a>. Lymph is similar in composition to blood <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4607\">lacteals<\/a>\u00a0are found in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4543\">villi<\/a> that line the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4559\">small intestine<\/a>. Lacteals absorb fatty acids from the digestion of lipids in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3877\">digestive system<\/a>. The fatty acids are then transported through the network of lymphatic vessels to the bloodstream.<\/li>\n<li>Lymphocytes, which include <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3447\">B cells<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4892\">T cells<\/a>, are the subset of leukocytes involved in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4822\">adaptive immune responses<\/a>. They may create a lasting memory of and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a> to specific pathogens.<\/li>\n<li>All lymphocytes are produced in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4829\">thymus<\/a>. Both the bone marrow and thymus are considered <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4845\">primary lymphatic organs<\/a>.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4847\">Secondary lymphatic organs<\/a> include the tonsils, spleen, and lymph nodes. There are four pairs of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4830\">tonsils<\/a>\u00a0that encircle the throat. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4497\">spleen<\/a> filters blood, as well as lymph. There are hundreds of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4831\">lymph nodes<\/a>\u00a0located 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<\/li>\n<li>Unlike the adaptive immune system, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4820\">innate immune system<\/a> does not confer immunity. The innate immune system includes surface barriers, inflammation, the complement system, and a variety of cellular responses.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The body\u2019s first line of defense consists of three different types of barriers that keep most pathogens out of body tissues. The types of barriers are mechanical, chemical, and biological barriers.<\/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><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4857\">Mechanical barriers<\/a>\u00a0\u2014\u00a0which include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3521\">skin<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3538\">mucous membranes<\/a>, and fluids (such as tears and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4717\">urine<\/a>) \u2014 physically block pathogens from entering the body.<\/li>\n<li>Chemical barriers\u00a0\u2014\u00a0such as enzymes in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4711\">sweat<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4595\">saliva<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4885\">semen<\/a>\u00a0\u2014\u00a0kill pathogens on body surfaces.<\/li>\n<li>Biological barriers are harmless bacteria that use up food and space so pathogenic bacteria cannot colonize the body.<\/li>\n<\/ul>\n<\/li>\n<li>If pathogens breach the protective barriers, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4865\">cytokines<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_4868\">complement system<\/a> is a complex biochemical mechanism that helps <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3567\">antibodies<\/a> kill pathogens. Once activated, the complement system consists of more than two dozen proteins that lead to disruption of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3529\">cell membrane<\/a> of pathogens and bursting of the cells.<\/li>\n<li>Cellular responses of the innate immune system involve various types of leukocytes (white blood cells). For example, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3453\">neutrophils<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4340\">macrophages<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4875\">dendritic cells<\/a>\u00a0phagocytize pathogens. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3481\">Basophils<\/a>\u00a0and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4881\">mast cells<\/a>\u00a0release chemicals that trigger inflammation. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3423\">Natural killer cells<\/a>\u00a0destroy cancerous or virus-infected cells, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3437\">eosinophils<\/a>\u00a0kill 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<\/li>\n<li>The main cells of the adaptive immune system are <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4832\">lymphocytes<\/a>. There are two major types of lymphocytes: T cells and B cells. Both types must be activated by foreign antigens to become functioning immune cells.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Most activated T cells become either <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4893\">killer T cells<\/a>\u00a0or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3445\">helper T cells<\/a>. Killer T cells destroy cells that are infected with pathogens or are cancerous. Helper T cells manage immune responses by releasing cytokines that control other types of leukocytes.<\/li>\n<li>Activated B cells form <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4902\">plasma cell<\/a>s that secrete antibodies, which bind to specific antigens on pathogens or infected cells. The antibody-antigen complexes generally lead to the destruction of the cells, for example, by attracting phagocytes or triggering the complement system.<\/li>\n<\/ul>\n<\/li>\n<li>After an adaptive immune response occurs, long-lasting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4904\">memory B cells and memory T cells<\/a> may remain to confer <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4884\">immunity<\/a> to the specific pathogen that caused the adaptive immune response. These memory cells are ready to activate an immediate response if they are exposed to the same antigen again in the future.<\/li>\n<li>Immunity may be active or passive.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4906\">Active immunity<\/a> occurs when the immune system has been presented with antigens that elicit an adaptive immune response. This may occur naturally as the result of an infection, or artificially as the result of immunization. Active immunity may last for years or even for life.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4910\">Passive immunity<\/a> occurs without an adaptive immune response by the transfer of antibodies or activated T cells. This may occur naturally between a mother and her fetus or her nursing infant, or it may occur artificially by injection. Passive immunity lasts only as long as the antibodies or activated T cells remain alive in the body, generally just weeks or months.<\/li>\n<\/ul>\n<\/li>\n<li>Many pathogens have evolved mechanisms to evade the adaptive immune system. For example, human immunodeficiency virus (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4501\">HIV<\/a>) evades the adaptive immune system by frequently changing its antigens and by forming its outer envelope from the host\u2019s cell membrane.<\/li>\n<li>An <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4877\">allergy<\/a> is a disorder in which the immune system makes an inflammatory response to a harmless antigen. Any antigen that causes allergies is called an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4999\">allergen<\/a>. Common allergens include pollen, dust mites, mold, specific foods (such as peanuts), insect stings, and certain medications (such as aspirin).<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The prevalence of allergies has been increasing for decades, especially in developed countries, where they are much more common than in developing countries. The hygiene hypothesis posits that this has occurred because humans evolved to cope with more pathogens than we now typically face in our relatively sterile environments in developed countries. As a result, the immune system \u201ckeeps busy\u201d by attacking harmless antigens.<\/li>\n<li>Allergies occur when B cells are first activated to produce large amounts of antibodies to an otherwise harmless allergen, and the antibodies attach to mast cells. On subsequent exposures to the allergen, the mast cells immediately release cytokines and histamines that cause inflammation.<\/li>\n<li>Mild allergy symptoms are frequently treated with antihistamines that counter histamines and reduce allergy symptoms. A severe systemic allergic reaction, called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5002\">anaphylaxis<\/a>, is a medical emergency that is usually treated with injections of epinephrine. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5004\">Immunotherapy<\/a> for allergies involves injecting increasing amounts of allergens to desensitize the immune system to them.<\/li>\n<\/ul>\n<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5006\">Autoimmune diseases<\/a>\u00a0occur when the immune system fails to recognize the body\u2019s own molecules as self and attacks them, causing damage to tissues and organs. A family history of autoimmunity and female gender are risk factors for autoimmune diseases.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>In some autoimmune diseases, such as type I diabetes, the immune system attacks and damages specific body cells. In other autoimmune diseases, such as systemic lupus erythematosus, many different tissues and organs may be attacked and injured. Autoimmune diseases generally cannot be cured, but their symptoms can often be managed with drugs or other treatments.<\/li>\n<\/ul>\n<\/li>\n<li>Immunodeficiency occurs when the immune system is not working properly, generally because one or more of its components are inactive. As a result, the immune system is unable to fight off pathogens or cancers that a normal immune system would be able to resist.<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5012\">Primary immunodeficiency<\/a> is present at birth and caused by rare genetic diseases. An example is severe combined immunodeficiency. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5013\">Secondary immunodeficiency<\/a> occurs because of some event or exposure experienced after birth. Possible causes include substance abuse, obesity, and malnutrition, among others.<\/li>\n<li>The most common cause of immunodeficiency in the world today is human immunodeficiency virus (HIV), which infects and destroys helper T cells. HIV is transmitted through mucous membranes or body fluids. The virus may eventually lead to such low levels of helper T cells that opportunistic infections occur. When this happens, the patient is diagnosed with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5016\">acquired immunodeficiency syndrome<\/a> (AIDS). Medications can control the multiplication of HIV in the human body, but\u00a0it can't\u00a0eliminate the virus completely.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Up to this point, this book has covered body systems that carry out processes within individuals, such as the digestive, muscular, and immune systems. Read the next chapter to learn about the body system that allows humans to produce new individuals \u2014 the reproductive system.<\/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 17 Review<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-425\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-425\" class=\"h5p-iframe\" data-content-id=\"425\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Chapter 17 Review\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Compare and contrast a pathogen and an allergen.<\/li>\n<li>Describe three ways in which pathogens can enter the body.<\/li>\n<li>The complement system involves the activation of several proteins to kill pathogens. Why do you think this is considered part of the innate immune system, instead of the adaptive immune system?<\/li>\n<li>Why are innate immune responses generally faster than adaptive immune responses?<\/li>\n<li>Explain how an autoimmune disease could be triggered by a pathogen.<\/li>\n<li>What is an opportunistic infection?\u00a0Name two diseases or conditions that could result in opportunistic infections. Explain your answer.<\/li>\n<li>Which cell type in the immune system can be considered an \u201cantibody factory?\"<\/li>\n<li>Besides foreign pathogens, what is one thing that the immune system protects the body against?<\/li>\n<li>What cell type in the immune system is infected and killed by HIV?<\/li>\n<li>Name two types of cells that produce cytokines in the immune system.\u00a0What are two functions of cytokines in the immune system?<\/li>\n<li>Many pathogens evade the immune system by altering their outer surface in some way. Based on what you know about the functioning of the immune system, why is this often a successful approach?<\/li>\n<li>What is \u201cmissing self?\" How does this condition arise?<\/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\">17.7 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/Z3B-AaqjyjE<\/p>\n<p style=\"text-align: center\">What is leukemia? - Danilo Allegra and Dania Puggioni, TED-Ed, 2015.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 17.7.1<\/strong><\/p>\n<p><a href=\"https:\/\/flic.kr\/p\/eQCQyD\" rel=\"cc:attributionURL\">Cycling to Beat Blood Cancer<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/leukaemia_research\/\">Blood Cancer UK<\/a> (Formerly Bloodwise) on <a href=\"http:\/\/flickr.com\">Flickr<\/a> is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/\">CC BY-NC-ND 2.0<\/a> (https:\/\/creativecommons.org\/licenses\/by-nc-nd\/2.0\/) license.<\/p>\n<p><strong>Figure 17.7.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Langerhans_Cells_in_Normal_Epidermis,_CD1a_Immunostain_(4435883030).jpg\" rel=\"cc:attributionURL\">antigen stain<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/78147607@N00\" rel=\"nofollow\">Ed Uthman<\/a> from Houston, TX, 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<h2>References<\/h2>\n<p class=\"hanging-indent\">Hodgkin lymphoma statistics [online article]. (2020). Canadian Cancer Society. https:\/\/www.cancer.ca:443\/en\/cancer-information\/cancer-type\/hodgkin-lymphoma\/statistics\/?region=on<\/p>\n<p class=\"hanging-indent\">Non-Hodgkin lymphoma statistics [online article]. (2020). Canadian Cancer Society. https:\/\/www.cancer.ca:443\/en\/cancer-information\/cancer-type\/non-hodgkin-lymphoma\/statistics\/?region=on<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, April 30). What is leukemia? - Danilo Allegra and Dania Puggioni. YouTube. https:\/\/www.youtube.com\/watch?v=Z3B-AaqjyjE&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_5023_4231\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4231\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_5036\" aria-describedby=\"caption-attachment-5036\" style=\"width: 391px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-5036\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Sperm-egg-1.jpg\" alt=\"17.2.1 Sperm and Egg\" width=\"391\" height=\"265\"><figcaption id=\"caption-attachment-5036\" class=\"wp-caption-text\">Figure 17.2.1 Love at first sight!<\/figcaption><\/figure>\n<div>\n<h1>It\u2019s All about Sex<\/h1>\n<\/div>\n<p>A tiny <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> from dad breaks through the surface of a huge egg from mom. Voil\u00e0! In\u00a0nine\u00a0months, a new son or daughter will be born. Like most other multicellular organisms, human beings reproduce sexually. In human sexual reproduction, males produce sperm and females produce eggs, and a new offspring forms when a sperm unites with an egg. How do sperm and eggs form? And how do they arrive together at the right place and time so they can unite to form a new offspring? These are functions of the reproductive system.<\/p>\n<div>\n<h1>What Is the Reproductive System?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2916\">reproductive system<\/a><\/strong>\u00a0is the human organ system responsible for the production and fertilization of gametes (sperm or eggs) and, in females, the carrying of a fetus. Both male and female reproductive systems have organs called\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3408\">gonad<\/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\">\u00a0that produce gametes. A\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3931\">gamete<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">\u00a0is a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2484\">haploid<\/a> cell that combines with another haploid gamete during <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">fertilization<\/a>, forming a single diploid cell called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2471\">zygote<\/a>. Besides producing gametes, the gonads also produce sex hormones.\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5037\">Sex hormones<\/a><\/strong><span style=\"text-align: initial;font-size: 1em\"> are endocrine hormones that control the development of sex organs before birth, sexual maturation at puberty, and reproduction once sexual maturation has occurred. Other reproductive system organs have various functions, such as maturing gametes, delivering gametes to the site of fertilization, and providing an environment for the development and growth of an offspring.<\/span><\/p>\n<div>\n<h1>Sex Differences in the Reproductive System<\/h1>\n<\/div>\n<p>The reproductive system is the only human organ system that is significantly different between males and females. Embryonic structures that will develop into the reproductive system start out the same in males and females, but by birth, the reproductive systems have differentiated. How does this happen?<\/p>\n<h2>Sex Differentiation<\/h2>\n<p>Starting around the seventh week after conception in genetically male (XY) embryos, a gene called SRY on the Y chromosome (shown in Figure 18.2.2) initiates the production of multiple proteins. These proteins cause undifferentiated gonadal tissue to develop into male gonads (testes). The male gonads then secrete hormones \u2014 including the male sex hormone testosterone \u2014 that trigger other changes in the developing offspring (now called a fetus), causing it to develop a complete male reproductive system. Without a Y chromosome, an embryo will develop female gonads (ovaries) that will produce the female sex hormone estrogen. Estrogen, in turn, will lead to the formation of the other organs of a normal female reproductive system.<\/p>\n<figure id=\"attachment_5060\" aria-describedby=\"caption-attachment-5060\" style=\"width: 580px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-5060\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Y-Chromosome-1.png\" alt=\"18.2.2 Y Chromosome SRY gene\" width=\"580\" height=\"420\"><figcaption id=\"caption-attachment-5060\" class=\"wp-caption-text\"><em>Figure 18.2.2 The SRY gene on the short arm of the Y chromosome causes the undifferentiated gonads of an embryo to develop into testes. Otherwise, the gonads develop into ovaries.<\/em><\/figcaption><\/figure>\n<h2>Homologous Structures<\/h2>\n<p>Undifferentiated embryonic tissues develop into different structures in male and female <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5086\">fetus<span style=\"font-size: 1em\">es<\/span><span style=\"text-align: initial;font-size: 1em\"><\/a><\/span><span style=\"text-align: initial;font-size: 1em\">. Structures that arise from the same tissues in males and females are called\u00a0<\/span><strong style=\"text-align: initial;font-size: 1em\"><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5087\">homologous structure<\/strong><strong style=\"font-size: 1em;text-align: initial\">s<\/strong><strong style=\"text-align: initial;font-size: 1em\"><\/a><\/strong><span style=\"text-align: initial;font-size: 1em\">.\u00a0The male testes and female ovaries, for example, are homologous structures that develop from the undifferentiated gonads of the embryo. Likewise, the male penis and female clitoris are homologous structures that develop from the same embryonic tissues.<\/span><\/p>\n<h2>Sex Hormones and Maturation<\/h2>\n<p>Male and female reproductive systems are different at birth, but they are immature and incapable of producing gametes or sex hormones. Maturation of the reproductive system occurs during puberty, when hormones from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2937\">hypothalamus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a> stimulate the testes or ovaries to start producing sex hormones again. The main sex hormones are\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a><\/strong>\u00a0in males and\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a><\/strong>\u00a0in females. Sex hormones, in turn, lead to the growth and maturation of the reproductive organs, rapid body growth, and the development of secondary sex characteristics.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5088\">Secondary sex characteristic<\/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 traits that are different in mature males and females, but are not directly involved in reproduction. They include facial hair in males and breasts in females.<\/span><\/p>\n<div>\n<h1>Male Reproductive System<\/h1>\n<\/div>\n<p>The main structures of the male reproductive system are external to the body and illustrated in Figure 18.2.3. The two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a> (singular, testis) hang between the thighs in a sac of skin called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5089\">scrotum<\/a>. The testes produce both <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a>. Resting atop each testis is a coiled structure called the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a> (plural, epididymes). The function of the epididymes is to mature and store sperm. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5091\">penis<\/a> is a tubular organ that contains the urethra and has the ability to stiffen during sexual arousal. Sperm passes out of the body through the urethra during a sexual climax (orgasm). This release of sperm is called ejaculation.<\/p>\n<p>In addition to these organs, the male reproductive system consists of several ducts and glands that are internal to the body. The ducts, which include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5095\"><em>vas deferens<\/em><\/a> (also called the ductus deferens), transport sperm from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a> to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4732\">urethra<\/a>. The glands, which include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5096\">prostate gland<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5097\">seminal vesicles<\/a>, produce fluids that become part of semen. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4885\">Semen<\/a> is the fluid that carries sperm through the urethra and out of the body. It contains substances that control pH and provide sperm with nutrients for energy.<\/p>\n<figure id=\"attachment_5166\" aria-describedby=\"caption-attachment-5166\" style=\"width: 743px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-5166\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/3D_Medical_Animation_Vas_Deferens-2.jpg\" alt=\"18.2.3 Male Reproductive System\" width=\"743\" height=\"418\"><figcaption id=\"caption-attachment-5166\" class=\"wp-caption-text\">Figure 18.2.3 Most of the major male reproductive organs are located outside of the body.<\/figcaption><\/figure>\n<div>\n<h1>Female Reproductive System<\/h1>\n<\/div>\n<p>The main structures of the female reproductive system are internal to the body and shown in the following figure. They include the paired <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, which are small, ovoid structures that produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5099\">ova<\/a> and secrete <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a>. The two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5101\">oviducts<\/a> (sometimes called Fallopian tubes or uterine tubes) start near the ovaries and end at the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>. Their function is to transport ova from the ovaries to the uterus. If an egg is fertilized, it usually occurs while it is traveling through an oviduct. The uterus is a pear-shaped muscular organ that functions to carry a fetus until birth. It can expand greatly to accommodate a growing fetus, and its muscular walls can contract forcefully during labour to push the baby out of the uterus and into the vagina. The <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5143\">vagina<\/a> is a tubular tract connecting the uterus to the outside of the body. The vagina is where sperm are usually deposited during <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5149\">sexual intercourse<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5150\">ejaculation<\/a>. The vagina is also called the birth canal because a baby travels through the vagina to leave the body during birth.<\/p>\n<figure id=\"attachment_5151\" aria-describedby=\"caption-attachment-5151\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5151\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Blausen_0399_FemaleReproSystem_01-1.png\" alt=\"18.2.4 Female Reproductive System\" width=\"500\" height=\"500\"><figcaption id=\"caption-attachment-5151\" class=\"wp-caption-text\">Figure 18.2.4 The main organs of the female reproductive system lie within the abdominal cavity.<\/figcaption><\/figure>\n<p>The external structures of the female reproductive system\u00a0are referred to collectively as the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5152\">vulva<\/a>. They include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5153\">clitoris<\/a>, which is homologous to the male penis. They also include two pairs of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5154\">labia<\/a> (singular, labium), which surround and protect the openings of the urethra and vagina.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.2 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_5023_2916\">reproductive system<\/a> is the human organ system responsible for the production and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">fertilization<\/a> of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3931\">gametes<\/a>\u00a0and, in females, the carrying of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_3408\">gonads<\/a>\u00a0(<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a> in males, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a> in females) that produce gametes (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> or ova) and sex hormones (such as <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a> in males and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a> in females). Sex <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3569\">hormones<\/a> are endocrine hormones that control the prenatal development of reproductive organs, sexual maturation at puberty, and reproduction after <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5155\">puberty<\/a>.<\/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>Structures such as testes and ovaries that arise from the same undifferentiated embryonic tissues in males and females are called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5087\">homologous structures<\/a>.<\/li>\n<li>Male and female reproductive systems are different at birth, but at that point, they are 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_5023_2937\">hypothalamus<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a> stimulate the gonads to\u00a0produce\u00a0sex hormones again. The sex hormones, in turn, cause the changes of puberty.<\/li>\n<li>Male reproductive system organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5091\">penis<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5095\"><em>vas deferens<\/em><\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5096\">prostate gland<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5097\">seminal vesicles<\/a>.<\/li>\n<li>Female reproductive system organs include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5101\">oviducts<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5143\">vagina<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5153\">clitoris<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5154\">labia<\/a>.<\/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\">18.2 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is the reproductive system?<\/li>\n<li>\n<div id=\"h5p-426\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-426\" class=\"h5p-iframe\" data-content-id=\"426\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.2 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Explain the difference between the vulva and the vagina.<\/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\">18.2 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/kMWxuF9YW38<\/p>\n<p style=\"text-align: center\">Sex Determination: More Complicated Than You Thought, TED-Ed, 2012.<\/p>\n<p>https:\/\/youtu.be\/vcPJkz-D5II<\/p>\n<p style=\"text-align: center\">The evolution of animal genitalia - Menno Schilthuizen, TED-Ed, 2017.<\/p>\n<p>https:\/\/youtu.be\/l5knvmy1Z3s<\/p>\n<p style=\"text-align: center\">Hormones and Gender Transition, Reactions, 2015.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.2.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sperm-egg.jpg\" rel=\"cc:attributionURL\">Sperm-egg<\/a> by Unknown author 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>\u00a0<\/i><\/p>\n<p><strong>Figure 18.2.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Y_Chromosome.png\" rel=\"cc:attributionURL\">Y Chromosome<\/a> by <a title=\"User:Christinelmiller\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Christinelmiller\">Christinelmiller<\/a> <span style=\"text-align: initial;font-size: 1em\">on Wikimedia Commons is used under a <a style=\"text-align: initial;font-size: 1em\" 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.\u00a0<\/span><\/p>\n<p><strong>Figure 18.2.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:3D_Medical_Animation_Vas_Deferens.jpg\" rel=\"cc:attributionURL\">3D_Medical_Animation_Vas_Deferens<\/a> by https:\/\/www.scientificanimations.com 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 18.2.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0399_FemaleReproSystem_01.png\" rel=\"cc:attributionURL\">Blausen_0399_FemaleReproSystem_01<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a> <span style=\"text-align: initial;font-size: 1em\">on Wikimedia Commons is used under a <\/span><a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a><span style=\"text-align: initial;font-size: 1em\"> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.<\/span><\/p>\n<p><span style=\"text-align: initial;font-size: 1em\"><span style=\"font-size: 1.424em;font-weight: bold\"><br \/>\nReferences<\/span><\/span><span style=\"text-align: initial;font-size: 1em\">\u00a0<\/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\">Reactions. (2015, June 8). Hormones and gender transition. YouTube. https:\/\/www.youtube.com\/watch?v=l5knvmy1Z3s&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2012, April 23). Sex determination: More complicated than you thought. YouTube. https:\/\/www.youtube.com\/watch?v=kMWxuF9YW38&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2017, April 24). The evolution of animal genitalia - Menno Schilthuizen. YouTube. https:\/\/www.youtube.com\/watch?v=vcPJkz-D5II&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_5023_4243\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4243\"><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_5023_4233\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4233\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_5194\" aria-describedby=\"caption-attachment-5194\" style=\"width: 334px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-5194\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Sperm-20051108-1.jpg\" alt=\"18.4.1 Sperm\" width=\"334\" height=\"330\"><figcaption id=\"caption-attachment-5194\" class=\"wp-caption-text\"><em>Figure 18.4.1 Sperm-ho!<\/em><\/figcaption><\/figure>\n<div>\n<h1>Colourful Sperm<\/h1>\n<\/div>\n<p>This false-colour image (Figure 18.4.1) shows real human sperm. The tiny gametes are obviously greatly magnified in the picture, because they are actually the smallest of all human cells. In fact, human sperm cells are small, even when compared with sperm cells of other animals. Mice sperm are about <em>twice<\/em> the length of human sperm! Human\u00a0sperm may be small in size, but in a normal, healthy man, huge numbers of them are usually released during each ejaculation. There may be hundreds of millions of sperm cells in a single teaspoon of semen. Producing sperm is one of the major\u00a0functions of the male reproductive system.<\/p>\n<div>\n<figure id=\"attachment_5195\" aria-describedby=\"caption-attachment-5195\" style=\"width: 356px\" class=\"wp-caption alignright\"><img class=\" wp-image-5195\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Sperm-Anatomy-1.png\" alt=\"18.4.2 Sperm Anatomy\" width=\"356\" height=\"516\"><figcaption id=\"caption-attachment-5195\" class=\"wp-caption-text\"><em>Figure 18.4.2 Each normal mature sperm cell has the structures labeled in this image.<\/em><\/figcaption><\/figure>\n<h1>Sperm Anatomy<\/h1>\n<\/div>\n<p>A mature sperm cell has several structures that help it reach and penetrate an egg. These are labeled in the drawing of a sperm shown in Figure 18.4.2.<\/p>\n<ul>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5196\">head<\/a><\/strong>\u00a0is the part of the sperm that contains the\u00a0nucleus\u00a0\u2014 and not much else. The nucleus, in turn, contains tightly coiled\u00a0DNA\u00a0that is the male parent\u2019s contribution to the genetic makeup of a zygote (if one forms). Each sperm is a haploid cell, containing half the chromosomal complement of a normal, diploid body cell.<\/li>\n<li>The front of the head is an area called the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5197\">acrosome<\/a><\/strong>. The acrosome contains enzymes that help the sperm penetrate an ovum (if it reaches one).<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5198\">midpiece<\/a><\/strong>\u00a0is the part of the sperm between the head and the flagellum. The midpiece is packed with\u00a0mitochondria\u00a0that produce the\u00a0energy\u00a0needed to move the flagellum.<\/li>\n<li>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3515\">flagellum<\/a><\/strong> (also called the tail) can rotate like a propeller, allowing the sperm to \u201cswim\u201d through the female reproductive tract to reach an ovum if one is present.<\/li>\n<\/ul>\n<div>\n<h1>Spermatogenesis<\/h1>\n<\/div>\n<p>The process of producing sperm is known as\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">spermatogenesis<\/a>. <\/strong>Spermatogenesis normally starts when a male reaches <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5155\">puberty<\/a>, and it usually continues uninterrupted until death, although a decrease in sperm production generally occurs at older ages. A young, healthy male may produce hundreds of millions of sperm a day! Only about half of these, however, are likely to become viable, mature sperm.<\/p>\n<h2>Where Sperm Are Produced<\/h2>\n<p>Spermatogenesis occurs in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5160\">seminiferous tubules<\/a> in the testes. Spermatogenesis requires high concentrations of testosterone. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">Testosterone<\/a> is secreted by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5171\">Leydig\u00a0cells<\/a>, which are adjacent to the seminiferous tubules in the testes.<\/p>\n<p>Sperm production in the seminiferous tubules is very sensitive to temperature. This may be the most important reason the testes are located outside the body in the scrotum. The temperature inside the scrotum is generally about 2 degrees Celsius cooler than core body temperature. This lower temperature is optimal for spermatogenesis. The scrotum regulates its internal temperature as needed by contractions of the smooth muscles lining the scrotum. When the temperature inside the scrotum becomes too low, the scrotal muscles contract. The contraction of the muscles pulls the scrotum higher against the body, where the temperature is warmer. The opposite occurs when the temperature inside the scrotum becomes too high.<\/p>\n<h2>Events of Spermatogenesis<\/h2>\n<figure id=\"attachment_5200\" aria-describedby=\"caption-attachment-5200\" style=\"width: 256px\" class=\"wp-caption alignright\"><img class=\"size-full wp-image-5200\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Spermatogenesis-1.jpg\" alt=\"18.4.3 Spermatogenesis\" width=\"256\" height=\"594\"><figcaption id=\"caption-attachment-5200\" class=\"wp-caption-text\"><em>Figure 18.4.3 Spermatogenesis includes one mitotic division and two meiotic divisions.<\/em><\/figcaption><\/figure>\n<p>Figure 18.4.3 summarizes the main cellular events that occur in the process of spermatogenesis. The process begins with a diploid stem cell called a <strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5199\">spermatogonium<\/a><\/strong>\u00a0(plural, spermatogonia), and involves several cell divisions. The entire process takes at least ten weeks to complete, including maturation in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a>.<\/p>\n<ol>\n<li>A spermatogonium undergoes\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1987\">mitosis<\/a>\u00a0to produce two <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2103\">diploid<\/a> cells called primary spermatocytes. One of the primary spermatocytes goes on to produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a>. The other replenishes the reserve of spermatogonia.<\/li>\n<li>The primary spermatocyte undergoes\u00a0meiosis\u00a0I to produce two haploid daughter cells called secondary spermatocytes.<\/li>\n<li>The secondary spermatocytes rapidly undergo\u00a0meiosis\u00a0II to produce a total of four <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2484\">haploid<\/a> daughter cells called spermatids.<\/li>\n<li>The spermatids begin to form a tail, and their\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_277\">DNA<\/a>\u00a0becomes highly condensed. Unnecessary cytoplasm and\u00a0organelles\u00a0are removed from the cells, and they form a head, midpiece, and flagellum. The resulting cells are sperm (spermatozoa).<\/li>\n<\/ol>\n<div><\/div>\n<p>As shown in Figure 18.4.4, the events of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">spermatogenesis<\/a> begin near the wall of the seminiferous tubule \u2014 where spermatogonia are located \u2014 and continue inward toward the lumen of the tubule. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">\u00a0extend from the wall of the seminiferous tubule inward toward the lumen, so they are in contact with developing sperm at all stages of spermatogenesis. Sertoli cells play several roles in spermatogenesis:<\/span><\/p>\n<ul>\n<li>They secrete\u00a0endocrine <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3569\">hormones<\/a>\u00a0that help regulate spermatogenesis.<\/li>\n<li>They secrete substances that initiate\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2486\">meiosis<\/a>.<\/li>\n<li>They concentrate testosterone (from <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5171\">Leydig cells<\/a>), which is needed at high levels to maintain spermatogenesis.<\/li>\n<li>They <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_1680\">phagocytize<\/a> the extra cytoplasm that is shed from developing sperm cells.<\/li>\n<li>They secrete testicular fluid that helps carry sperm into the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a>.<\/li>\n<li>They maintain a blood-testis barrier, so immune system cells cannot reach and attack the sperm.<\/li>\n<\/ul>\n<figure id=\"attachment_5201\" aria-describedby=\"caption-attachment-5201\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-5201\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Testis-cross-section-2-1.jpg\" alt=\"18.4.4 Testis Structure\" width=\"900\" height=\"511\"><figcaption id=\"caption-attachment-5201\" class=\"wp-caption-text\"><em>Figure 18.4.4 Cross-section of a testis and seminiferous tubules.<\/em><\/figcaption><\/figure>\n<h2>Maturation in the Epididymis<\/h2>\n<p>Although the sperm produced in the testes have tails, they are not yet motile (able to \u201cswim\u201d). The non-motile sperm are transported to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a> in testicular fluid that is secreted by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">\u00a0with the help of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristaltic contractions<\/a>. In the epididymis, the sperm gain motility, so they are capable of swimming up the female genital tract and reaching an ovum. The mature sperm are stored in the epididymis until ejaculation occurs.<\/span><\/p>\n<div>\n<h1>Ejaculation<\/h1>\n<\/div>\n<p>Sperm are released from the body during\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5150\">ejaculation<\/a>,<\/strong>\u00a0which typically occurs during orgasm. Hundreds of millions of mature sperm \u2014 contained within a small amount of thick, whitish fluid called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4885\">semen<\/a>\u00a0\u2014\u00a0are propelled from the penis during a normal ejaculation.<\/p>\n<h2>How Ejaculation Occurs<\/h2>\n<p>Ejaculation occurs when <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a> of the muscle layers of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5095\"><em>vas deferens<\/em><\/a> and other accessory structures propel sperm from the epididymes, where mature sperm are stored. The muscle contractions force the sperm through the <em>vas deferens<\/em> and the ejaculatory ducts, and then out of the penis through the urethra. Due to the peristaltic action of the\u00a0muscles, the ejaculation occurs in a series of spurts.<\/p>\n<h2>The Role of Semen<\/h2>\n<p>As sperm travel through the ejaculatory ducts during ejaculation, they mix with secretions from the seminal vesicles, prostate gland, and bulbourethral glands to form semen (see Figure 18.4.5 ). The average amount of semen per ejaculate is about 3.7 mL, which is a little less than a teaspoonful. Most of this volume of semen consists of glandular secretions, with the hundreds of millions of sperm cells actually contributing relatively little to the total volume.<\/p>\n<figure id=\"attachment_5202\" aria-describedby=\"caption-attachment-5202\" style=\"width: 389px\" class=\"wp-caption alignleft\"><img class=\" wp-image-5202\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Human_semen_in_a_petri_dish-1.jpg\" alt=\"18.4.5\" width=\"389\" height=\"292\"><figcaption id=\"caption-attachment-5202\" class=\"wp-caption-text\"><em>Figure 18.4.5 This petri dish shows normal human semen in a typical ejaculate.<\/em><\/figcaption><\/figure>\n<p>The secretions in semen are important for the survival and motility of sperm. They provide a medium through which sperm can swim. They also include sperm-sustaining substances, such as high concentrations of the sugar fructose, which is the main source of\u00a0energy\u00a0for sperm. In addition, semen contains many alkaline substances that help neutralize the acidic environment in the female vagina. This protects the\u00a0DNA\u00a0in sperm from being denatured by\u00a0acid, and prolongs the life of sperm in the female reproductive tract.<\/p>\n<div>\n<h1>Erection<\/h1>\n<\/div>\n<p>Besides providing a way for sperm to leave the body, the main role of the penis in\u00a0reproduction\u00a0is\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5203\">intromission<\/a>,<\/strong>\u00a0or depositing sperm in the vagina of the female reproductive tract. Intromission depends on the ability of the penis to become stiff and erect, a state referred to as an\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5204\">erection<\/a>.<\/strong>\u00a0The human penis, unlike that of most other mammals, contains no erectile bone. Instead, in order to reach its erect state, it relies entirely on engorgement with\u00a0blood\u00a0of its columns of spongy tissue. During sexual arousal, the arteries that supply blood to the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5091\">penis<\/a> dilate, allowing more blood to fill the spongy tissue. The now-engorged spongy tissue presses against and constricts the veins that carry blood away from the penis. As a result, more blood enters than leaves the penis, until a constant erectile size is achieved.<\/p>\n<p>In addition to sperm, the penis also transports urine out of the body. These two functions cannot occur simultaneously. During an erection, the sphincters that prevent urine from leaving the bladder are controlled by centres in the brain so they cannot relax and allow urine to enter the urethra.<\/p>\n<div>\n<h1>Testosterone Production<\/h1>\n<\/div>\n<p>The final major function of the male reproductive system is the production of the male sex\u00a0hormone\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a>. In mature males, this occurs mainly in the testes. Testosterone production is under the control of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5205\">luteinizing hormone<\/a> (LH) from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a>. LH stimulates <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5171\">Leydig 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\">\u00a0in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a> to secrete testosterone.<\/span><\/p>\n<p>Testosterone is important for male sexual\u00a0development\u00a0at\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5155\">puberty<\/a>. It stimulates maturation of the\u00a0male reproductive organs, as well as the development of secondary male sex characteristics (such as facial hair). Testosterone is also needed in mature males for normal <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">spermatogenesis<\/a> to be maintained in the testes. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">Follicle stimulating\u00a0hormone<\/a>\u00a0(FSH) from the\u00a0pituitary gland\u00a0is also needed for spermatogenesis to occur, in part because it helps <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">\u00a0in the testes concentrate testosterone to high enough levels to maintain sperm production. Testosterone is also needed for proper functioning of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5096\">prostate gland<\/a>. In addition, testosterone plays a role in <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5204\">erection<\/a>, allowing sperm\u00a0to\u00a0be deposited within the female reproductive tract.<\/span><\/p>\n<div>\n<h1>Feature: My\u00a0Human Body<\/h1>\n<\/div>\n<figure id=\"attachment_5207\" aria-describedby=\"caption-attachment-5207\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5207\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Laptop-by-logan-weaver-b76PEyeIptQ-unsplash-scaled-2.jpg\" alt=\"18.4.6 Laptop and Sperm Production\" width=\"400\" height=\"267\"><figcaption id=\"caption-attachment-5207\" class=\"wp-caption-text\"><em>Figure 18.4.6 The heat emitted by a laptop could decrease sperm production.<\/em><\/figcaption><\/figure>\n<p>If you\u2019re a man and you use a laptop computer on your lap for long periods of time, you may be decreasing your fertility. The reason? A laptop computer generates considerable\u00a0heat, and its proximity to the scrotum during typical use results in a significant rise in\u00a0temperature\u00a0inside the scrotum. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">Spermatogenesis<\/a> is very sensitive to high temperatures, so it may be adversely affected by laptop computer use. If you want to avoid the potentially fertility-depressing effect of laptop computer use, you might want to consider using your laptop computer on a table or other surface rather than on your lap \u2014 at least when you log on for long computer sessions. Other activities that raise scrotal temperature and have the potential to reduce spermatogenesis including soaking in hot tubs, wearing tight clothing, and biking. Although the effects of short-term scrotal heating on fertility seem to be temporary, years of such heat exposure may cause irreversible effects on sperm production.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Parts of a mature sperm include the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5196\">head<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5197\">acrosome<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5198\">midpiece<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3515\">flagellum<\/a>. The process of producing sperm is called spermatogenesis. This normally starts during\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5155\">puberty<\/a>, and continues uninterrupted until death.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">Spermatogenesis<\/a> occurs in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5160\">seminiferous tubules<\/a> in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a>, and requires high concentrations of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3409\">testosterone<\/a>. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5169\">Sertoli cells<\/a>\u00a0in the testes play many roles in spermatogenesis, including concentrating testosterone under the influence of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">follicle stimulating\u00a0hormone<\/a>\u00a0from the\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a>.<\/li>\n<li>Spermatogenesis begins with a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2103\">diploid<\/a> stem cell called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5199\">spermatogonium<\/a>, which undergoes\u00a0mitosis\u00a0to produce a primary spermatocyte. The primary spermatocyte undergoes meiosis I to produce <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2484\">haploid<\/a> 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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a>.<\/li>\n<li>Before sperm are able to \u201cswim,\u201d they must mature in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5090\">epididymis<\/a>. The mature sperm are then stored in the epididymis until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5150\">ejaculation<\/a> occurs.<\/li>\n<li>Ejaculation is the process in which <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4885\">semen<\/a> is propelled by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2890\">peristalsis<\/a> in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5095\"><em>vas deferens<\/em><\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5174\">ejaculatory ducts<\/a>\u00a0from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4732\">urethra<\/a> in the penis. Semen is a whitish fluid that contains sperm and secretions from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5097\">seminal vesicles<\/a>, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5096\">prostate gland<\/a>, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5183\">bulbourethral glands<\/a>. These alkaline secretions are important for sperm survival and motility.<\/li>\n<li>Besides ejaculating sperm, another reproductive role of the penis is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5203\">intromission<\/a>, which is depositing sperm in the female <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5143\">vagina<\/a>. This requires the penis to become stiff and erect, a state referred to as an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5204\">erection<\/a>. Erection usually occurs with sexual arousal as the columns of spongy tissue inside the penis become engorged with\u00a0blood.<\/li>\n<li><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5171\">Leydig cells<\/a>\u00a0in the testes secrete testosterone under the control of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5205\">luteinizing hormone<\/a> (LH) from the pituitary gland. Testosterone is needed for male sexual\u00a0development\u00a0at puberty, and to maintain normal spermatogenesis after puberty. It also plays a role in prostate function and\u00a0penis's ability\u00a0to become erect.<\/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\">18.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>&nbsp;<\/p>\n<ol>\n<li>\n<div id=\"h5p-429\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-429\" class=\"h5p-iframe\" data-content-id=\"429\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.4 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Compare and contrast the terms: erection, ejaculation, and intromission.<\/li>\n<li>Describe semen and its components.<\/li>\n<li>Explain how erection occurs.<\/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\">18.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/gNHSTa0Yct4<\/p>\n<p style=\"text-align: center\">How You're Destroying Your Sperm! Seeker, 2014.<\/p>\n<p>https:\/\/youtu.be\/krSMZDsjLuU<\/p>\n<p style=\"text-align: center\">Human Physiology - Reproduction: Spermatogenesis, Janux, 2015.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.4.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sperm-20051108.jpg\" rel=\"cc:attributionURL\">Sperm-20051108<\/a> by <a class=\"external text\" href=\"https:\/\/www.flickr.com\/people\/93087247@N00\" rel=\"nofollow\">Gilberto Santa Rosa<\/a>\u00a0from\u00a0<a class=\"extiw\" title=\"w:Rio de Janeiro\" href=\"https:\/\/en.wikipedia.org\/wiki\/Rio_de_Janeiro\">Rio de Janeiro<\/a>,\u00a0<a class=\"extiw\" title=\"w:Brazil\" href=\"https:\/\/en.wikipedia.org\/wiki\/Brazil\">Brazil<\/a> on Wikimedia Commons is used under a <a href=\"https:\/\/creativecommons.org\/licenses\/by\/2.0\" rel=\"license\">CC BY 2.0<\/a>\u00a0(https:\/\/creativecommons.org\/licenses\/by\/2.0) license.<\/p>\n<p><strong>Figure 18.4.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Sperm_Anatomy.png\" rel=\"cc:attributionURL\">Sperm Anatomy<\/a> by <a title=\"User:Christinelmiller\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Christinelmiller\">Christinelmiller<\/a> on Wikimedia Commons is used under a \u00a0<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 18.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_28_01_04.jpg\" rel=\"cc:attributionURL\">Spermatogenesis<\/a>\u00a0by <a href=\"https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-1-anatomy-and-physiology-of-the-male-reproductive-system\">OpenStax College<\/a> is used and adapted by Christine Miller 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 18.4.4<\/strong><\/p>\n<p><a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.4\/\" rel=\"cc:attributionURL\">Testis-cross-section<\/a>\u00a0by <a href=\"https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.4\/\">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=2.264717007.1988667202.1598996862-1392032960.1592870652\">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<p><strong>Figure 18.4.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Human_semen_in_a_petri_dish.jpg\" rel=\"cc:attributionURL\">Human_semen_in_a_petri_dish<\/a> by <a title=\"User:Digitalkil\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Digitalkil\">Digitalkil<\/a> 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><strong>Figure 18.4.6<\/strong><\/p>\n<p><a href=\"https:\/\/unsplash.com\/photos\/b76PEyeIptQ\" rel=\"cc:attributionURL\">Laptop by logan-weaver-b76PEyeIptQ-unsplash<\/a> [photo] by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@lgnwvr\">LOGAN WEAVER<\/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<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\u00a0<\/span><span class=\"os-number\">27.5<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"81306\" class=\"os-title\" data-type=\"title\">Spermatogenesis [digital image].\u00a0 In <em>Anatomy and Physiology<\/em> (Section 27.1). OpenStax. https:\/\/openstax.org\/books\/anatomy-and-physiology\/pages\/27-1-anatomy-and-physiology-of-the-male-reproductive-system<\/span><\/p>\n<p class=\"hanging-indent\">Brainard, J\/ CK-12 Foundation. (2016). <span id=\"81306\" class=\"os-title\" data-type=\"title\">F<\/span>igure 4 Cross-section of a testis and seminiferous tubules [digital image]. In <em>CK-12 College Human Biology<\/em> (Section 20.4) [online Flexbook]. CK12.org. https:\/\/www.ck12.org\/book\/ck-12-college-human-biology\/section\/20.4\/<\/p>\n<p class=\"hanging-indent\">Janux. (2015, January 10). Human physiology - Reproduction: spermatogenesis. YouTube. https:\/\/www.youtube.com\/watch?v=krSMZDsjLuU&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">Seeker. (2014, June 16). How you're destroying your sperm! YouTube. https:\/\/www.youtube.com\/watch?v=gNHSTa0Yct4&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_5023_4237\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4237\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<figure id=\"attachment_5295\" aria-describedby=\"caption-attachment-5295\" style=\"width: 400px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5295\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/WaterforPeople_Uganda-1.jpg\" alt=\"18.8.1 Menstruation Awareness\" width=\"400\" height=\"300\"><figcaption id=\"caption-attachment-5295\" class=\"wp-caption-text\"><em>Figure 18.8.1 It's healthy to talk about menstruation.<\/em><\/figcaption><\/figure>\n<div>\n<h1>Taboo Topic<\/h1>\n<\/div>\n<p>The banner in Figure 18.8.1 was carried in a 2014 march in Uganda as part of the celebration of Menstrual Hygiene Day. Menstrual Hygiene Day is an awareness day on May 28 of each year that aims to raise awareness worldwide about menstruation and menstrual hygiene. Maintaining good menstrual hygiene is difficult in developing countries like Uganda because of taboos on discussing menstruation and lack of availability of menstrual hygiene products. Poor menstrual hygiene, in turn, can lead to embarrassment, degradation, and reproductive health problems in females. May 28 was chosen as Menstrual Hygiene Day because of its symbolism. May is the fifth month of the year, and most women average five days of menstrual bleeding each month. The 28th day was chosen because the menstrual cycle averages about 28 days.<\/p>\n<div>\n<h1>What Is the Menstrual Cycle?<\/h1>\n<\/div>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5293\">menstrual cycle<\/a><\/strong> refers to natural changes that occur in the female reproductive system each month during the reproductive years. The cycle is necessary for the production of ova and the preparation of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a> for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5280\">pregnancy<\/a>. It involves changes in both the ovaries and the uterus, and is controlled by pituitary and ovarian hormones. Day 1 of the cycle is the first day of the menstrual period,\u00a0when bleeding from the uterus begins as the built-up <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5241\">endometrium<\/a> lining the uterus is shed. The endometrium builds up again during the remainder of the cycle, only to be shed again during the beginning of the next cycle if\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5280\">pregnancy<\/a>\u00a0does not occur. In the ovaries, the menstrual cycle includes the\u00a0development\u00a0of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">follicle<\/a>, ovulation of a secondary oocyte, and then degeneration of the follicle if pregnancy does not occur. Both uterine and ovarian changes during the menstrual cycle are generally divided into three phases, although the phases are not the same in the two organs.<\/p>\n<h2>Menarche and Menopause<\/h2>\n<p>The female reproductive years are delineated by the start and stop of the menstrual cycle. The first menstrual period usually occurs around 12 or 13 years of age, an event that is known as\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5300\">menarche<\/a>.<\/strong>\u00a0There is considerable variation among individuals in the age at menarche. It may occasionally occur as early as eight years of age or as late as 16 years of age and still be considered normal. The average age is generally later in the developing world, and earlier in the developed world. This variation is thought to be largely attributable to nutritional differences.<\/p>\n<p>The cessation of menstrual cycles at the end of a woman\u2019s reproductive years is termed\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5255\">menopause<\/a>.<\/strong>\u00a0The average age of menopause is 52 years, but it may occur normally at any age between about 45 and 55 years of age. The age of menopause varies due to a variety of biological and environmental factors.\u00a0It\u00a0may occur earlier as a result of certain illnesses or medical treatments.<\/p>\n<h2>Variation in the Menstrual Cycle<\/h2>\n<p>The length of the menstrual cycle \u2014 as well as its phases \u2014 may vary considerably, not only among different women, but also from month to month for a given woman. The average length of time between the first day of one menstrual period and the first day of the next menstrual period is 28 days, but it may range from 21 days to 45 days. Cycles are considered regular when a woman\u2019s longest and shortest cycles differ by less than eight days. The menstrual period itself is usually about five days long, but it may vary in length from about two days to seven days.<\/p>\n<div>\n<h1>Ovarian Cycle<\/h1>\n<\/div>\n<p>The events of the menstrual cycle that take place in the ovaries make up the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5301\">ovarian cycle<\/a>.<\/strong> It consists of changes that occur in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">follicles<\/a> of one of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>. The ovarian cycle is divided into the following three phases: follicular phase, ovulation, and luteal phase. These phases are illustrated in Figure 18.8.2.<\/p>\n<figure id=\"attachment_5302\" aria-describedby=\"caption-attachment-5302\" style=\"width: 919px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5302 \" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Ovarian-Cycle-e1593185427416-1.png\" alt=\"18.8.2 Ovarian Cycle\" width=\"919\" height=\"473\"><figcaption id=\"caption-attachment-5302\" class=\"wp-caption-text\"><em>Figure 18.8.2 The phases and days of the ovarian cycle are shown in this diagram. The ovarian cycle depicted in the diagram represents a cycle in which fertilization does not occur so the corpus luteum degenerates during the luteal phase.<\/em><\/figcaption><\/figure>\n<h2>Follicular Phase<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5303\">follicular phase<\/a><\/strong>\u00a0is the first phase of the ovarian cycle. It generally lasts about 12 to 14 days for a 28-day menstrual cycle. During this phase, several <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">ovarian follicle<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 stimulated to begin maturing, but usually only one \u2014 called the Graafian follicle \u2014 matures completely so it is ready to release an egg. The other maturing follicles stop growing and disintegrate. Follicular development occurs because of a rise in the blood level of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">follicle stimulating hormone<\/a> (FSH), which is secreted by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a>. The maturing follicle releases <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a>, the level of which rises throughout the follicular phase. You can see these and other changes in hormone levels that occur during the menstrual cycle in the following chart.<\/span><\/p>\n<figure id=\"attachment_5304\" aria-describedby=\"caption-attachment-5304\" style=\"width: 724px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5304 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Figure_43_04_04-e1593185848433-1.png\" alt=\"18.8.3 Pituitary and Ovarian Hormones\" width=\"724\" height=\"457\"><figcaption id=\"caption-attachment-5304\" class=\"wp-caption-text\"><em>Figure 18.8.3 FSH and estrogen increase during the first half of the menstrual cycle. LH surges shortly before ovulation occurs due to the rise in estrogen.<\/em><\/figcaption><\/figure>\n<h2>Ovulation<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5239\">Ovulation<\/a><\/strong>\u00a0is the second phase of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5301\">ovarian cycle<\/a>. It usually occurs around day 14 of a 28-day menstrual cycle. During this phase, the Graafian follicle ruptures and releases its ovum. Ovulation is stimulated by a sudden rise in the blood level of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5205\">luteinizing hormone<\/a> (LH) from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a>. This is called the LH surge. You can see the LH surge in the top hormone graph in Figure 18.8.3. The LH surge generally starts around day 12 of the cycle and lasts for a day or two. The surge in LH is triggered by a continued rise in estrogen from the maturing follicle in the ovary. During the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5303\">follicular phase<\/a>, the rising estrogen level actually suppresses LH secretion by the pituitary gland. However, by the time the follicular phase is nearing its end, the level of estrogen reaches a threshold level above which this effect is reversed, and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a> stimulates the release of a large amount of LH. The surge in LH matures the ovum and weakens the wall of the follicle, causing the fully developed follicle to release its secondary <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5274\">oocyte<\/a>.<\/p>\n<h2>Luteal Phase<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5305\">luteal phase<\/a><\/strong>\u00a0is the third and final phase of the ovarian cycle. It typically lasts about 14 days in a 28-day menstrual cycle. At the beginning of the luteal phase, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">FSH<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5306\">LH<\/a> cause the Graafian follicle that ovulated the egg to transform into a structure called a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5277\">corpus luteum<\/a>. The corpus luteum secretes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3411\">progesterone<\/a>, which in turn suppresses FSH and LH production by the pituitary gland and stimulates the continued buildup of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5241\">endometrium<\/a> in the uterus. How this phase ends depends on whether or not the ovum has been fertilized.<\/p>\n<ul>\n<li>If\u00a0fertilization\u00a0has not occurred, the falling levels of FSH and LH during the luteal phase cause the corpus luteum to atrophy, so its production of progesterone declines. Without a high level of progesterone to maintain it, the endometrium starts to break down. By the end of the luteal phase, the endometrium can no longer be maintained, and the next menstrual cycle begins with the shedding of the endometrium (menses).<\/li>\n<li>If\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">fertilization<\/a>\u00a0has occurred so a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2471\">zygote<\/a> forms and then divides to become a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5279\">blastocyst<\/a>, the outer layer of the blastocyst produces a\u00a0hormone\u00a0called <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5307\">human chorionic gonadotropin<\/a> (HCG). This hormone is very similar to LH and preserves the corpus luteum. The corpus luteum can then continue to secrete progesterone to maintain the new pregnancy.<\/li>\n<\/ul>\n<div>\n<h1>Uterine Cycle<\/h1>\n<\/div>\n<p>The events of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5293\">menstrual cycle<\/a> that take place in the uterus make up the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5308\">uterine cycle<\/a><\/strong>. This cycle consists of changes that occur mainly in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5241\">endometrium<\/a>, which is the layer of tissue that lines the uterus. The uterine cycle is divided into the following three phases: menstruation, proliferative phase, and secretory phase. These phases are illustrated in Figure 18.8.4.<\/p>\n<figure id=\"attachment_5309\" aria-describedby=\"caption-attachment-5309\" style=\"width: 488px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5309 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Ovarian-and-menstrual-cycle-e1593188761715-1.jpg\" alt=\"18.8.4 Uterine cycle\" width=\"488\" height=\"206\"><figcaption id=\"caption-attachment-5309\" class=\"wp-caption-text\"><em>Figure 18.8.4 The uterine cycle begins with menstruation, which starts on day 1 of the cycle. The relative thickness of the endometrium in each phase is indicated in pink.<\/em><\/figcaption><\/figure>\n<h2>Menstruation<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5310\">Menstruation<\/a><\/strong> (also called menstrual period or menses) is the first phase of the uterine cycle. It occurs if <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3917\">fertilization<\/a> has not taken place during the preceding menstrual cycle. During menstruation, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5241\">endometrium<\/a> of the uterus, which has built up during the preceding cycle, degenerates and is shed from the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>, flowing through an opening in the cervix, and out through the external opening of the vagina. The average loss of blood during menstruation is about 35 mL (about 1 oz or 2 tablespoons). The flow of blood is often accompanied by uterine cramps, which may be severe in some women.<\/p>\n<h2>Proliferative Phase<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5311\">proliferative phase<\/a><\/strong>\u00a0is the second phase of the uterine cycle. During this phase, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a> secreted by\u00a0cells\u00a0of the maturing <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">ovarian follicle<\/a> causes the lining of the uterus to grow, or proliferate. Estrogen also stimulates the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5235\">cervix<\/a> of the uterus to secrete larger amounts of thinner mucus that can help\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a>\u00a0swim through the cervix and into the uterus, making fertilization more likely.<\/p>\n<h2>Secretory Phase<\/h2>\n<p>The\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5312\">secretory phase<\/a><\/strong>\u00a0is the third and final phase of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5308\">uterine cycle<\/a>. During this phase, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3411\">progesterone<\/a> produced by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5277\">corpus luteum<\/a> in the ovary stimulates further changes in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5241\">endometrium<\/a> so it is more receptive to implantation of a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5279\">blastocyst<\/a>. For example, progesterone increases blood flow to the uterus and promotes uterine secretions. It also decreases the contractility of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2982\">smooth muscle<\/a> tissue in the uterine wall.<\/p>\n<p>&nbsp;<\/p>\n<h1>Bringing it All Together<\/h1>\n<p>It is important to note that the pituitary gland, the ovaries and the uterus are all responsible for parts of the ovarian and uterine cycles.\u00a0 The pituitary hormones, LH and FSH affect the ovarian cycle and its hormones.\u00a0 The ovarian hormones, estrogen and progesterone affect the uterine cycle and also feedback on the pituitary gland.\u00a0 Look at Figure 18.8.5 and look at what is happening on different days of the cycle in each of the sets of hormones, the ovarian cycle and the uterine cycle.<\/p>\n<figure id=\"attachment_5313\" aria-describedby=\"caption-attachment-5313\" style=\"width: 1000px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-5313\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1000px-MenstrualCycle2_en.svg_-1.png\" alt=\"18.8.8 Overview of ovarian and uterine cycle\" width=\"1000\" height=\"977\"><figcaption id=\"caption-attachment-5313\" class=\"wp-caption-text\"><em>Figure 18.8.5 The pituitary gland, ovarian cycle and uterine cycle are all interrelated in their regulation and participation in the monthly reproductive cycles of women.<\/em><\/figcaption><\/figure>\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\">18.8 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_5023_5293\">menstrual cycle<\/a> 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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a> for <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5280\">pregnancy<\/a>. It involves changes in both the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a> and uterus, and is controlled by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a> hormones (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5206\">FSH<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5306\">LH<\/a>) and ovarian hormones (<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3903\">estrogen<\/a> and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3411\">progesterone<\/a>).<\/li>\n<li>The female reproductive period is delineated by <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_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_5023_5301\">ovarian cycle<\/a>. It includes the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5303\">follicular phase<\/a> (when a <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5253\">follicle<\/a> and its ovum mature due to rising levels of FSH), <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5239\">ovulation<\/a> (when the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5099\">ovum<\/a> 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_5023_5305\">luteal phase<\/a> (when the follicle is transformed into a structure called a corpus luteum 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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5293\">menstrual cycle<\/a> that take place in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a> make up the uterine cycle. It includes <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_5311\">proliferative phase<\/a>, during which the endometrium builds up again until <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5239\">ovulation<\/a> occurs; and the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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_5023_5262\">embryo<\/a>.<\/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\">18.8 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>\n<div id=\"h5p-433\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-433\" class=\"h5p-iframe\" data-content-id=\"433\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.8 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>What is the menstrual cycle? Why is the menstrual cycle necessary in order for pregnancy to occur?<\/li>\n<li>What organs are involved in the menstrual cycle?<\/li>\n<li>Identify the two major events that mark the beginning and end of the reproductive period in females. When do these events typically occur?<\/li>\n<li>Discuss the average length of the menstrual cycle and menstruation, as well as variations that are considered normal.<\/li>\n<li>If the LH surge did not occur in a menstrual cycle, what do you think would happen? Explain your answer.<\/li>\n<li>Give one reason why FSH and LH levels drop in the luteal phase of the menstrual cycle.<\/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\">18.8 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/cjbgZwgdY7Q<\/p>\n<p style=\"text-align: center\">Why do women have periods? TED-Ed, 2015.<\/p>\n<p>https:\/\/youtu.be\/5B3Abpv0ysM<\/p>\n<p style=\"text-align: center\">Girl's Rite of Passage | National Geographic, 2007.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.8.1<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:WaterforPeople_Uganda.jpg\" rel=\"cc:attributionURL\">WaterforPeople_Uganda<\/a> by <a href=\"https:\/\/www.flickr.com\/photos\/gtzecosan\/17511016219\/in\/album-72157626959211983\/\">WaterforPeople_Uganda<\/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 18.8.2<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_43_04_04.png%20andhttps:\/\/commons.wikimedia.org\/wiki\/File:MenstrualCycle2_en.svg\" rel=\"cc:attributionURL\">Ovarian Cycle<\/a> by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:Ha3dnFEx@6\/Hormonal-Control-of-Human-Reproduction\">CNX OpenStax<\/a> on Wikimedia Commons is used and adapted 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 18.8.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_43_04_04.png\" rel=\"cc:attributionURL\">Figure_43_04_04<\/a>\u00a0by <a href=\"https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:Ha3dnFEx@6\/Hormonal-Control-of-Human-Reproduction\">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. (Original: modification of work by Mikael H\u00e4ggstr\u00f6m)<\/p>\n<p><strong>Figure 18.8.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Figure_28_02_07.jpg\" rel=\"cc:attributionURL\">Ovarian and menstrual cycle<\/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\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 18.8.5<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:MenstrualCycle2_en.svg\" rel=\"cc:attributionURL\">1000px-MenstrualCycle2_en.svg<\/a> by <a title=\"User:Isometrik\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Isometrik\">Isometrik<\/a> on Wikimedia Common 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<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). <span class=\"os-title-label\">Figure\u00a0<\/span><span class=\"os-number\">27.15<\/span><span class=\"os-divider\">\u00a0<\/span><span id=\"78432\" class=\"os-title\" data-type=\"title\">Hormone levels in ovarian and menstrual cycles<\/span> [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<\/p>\n<p class=\"hanging-indent\">National Geographic. (2007, May 31). Girl's rite of passage | National Geographic. YouTube. https:\/\/www.youtube.com\/watch?v=5B3Abpv0ysM&amp;feature=youtu.be<\/p>\n<p class=\"hanging-indent\">OpenStax. (2016, May 27) Figure 4 Rising and falling hormone levels result in progression of the ovarian and menstrual cycles [digital image]. In <em>Open Stax, Biology<\/em> (Section 43.4). OpenStax CNX. https:\/\/cnx.org\/contents\/GFy_h8cu@10.53:Ha3dnFEx@6\/Hormonal-Control-of-Human-Reproduction<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, October 19). Why do women have periods? YouTube.\u00a0 https:\/\/www.youtube.com\/watch?v=cjbgZwgdY7Q&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_5023_4239\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4239\"><div tabindex=\"-1\"><p>Created by CK-12 Foundation\/Adapted by Christine Miller<\/p>\n<div id=\"h5p-435\">\n<div class=\"h5p-content\" data-content-id=\"435\"><\/div>\n<\/div>\n<p><em>Figure 18.10.1 Families all have something in common.<\/em><\/p>\n<div>\n<h1>Family Portrait<\/h1>\n<\/div>\n<p>What do all these families (Figure 18.10.1) have in common?\u00a0 They were born!\u00a0 Every person on this planet was conceived, carried in utero and then born.\u00a0 While families come in all shapes, sizes and styles, we all came into existence in the same way.\u00a0 Virtually all human societies past and present \u2014 value having children. Indeed, for many people, parenthood is an important life goal. Unfortunately, some people are unable to achieve that goal because of infertility.<\/p>\n<div>\n<h1>What Is Infertility?<\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4813\">Infertility<\/a><\/strong> is the inability of a sexually mature adult to reproduce by natural means. For scientific and medical purposes, infertility is generally defined as the failure to achieve a successful pregnancy after at least one year of regular, unprotected sexual intercourse. Infertility may be primary or secondary. Primary infertility applies to cases in which an individual has never achieved a successful pregnancy. Secondary infertility applies to cases in which an individual has had at least one successful pregnancy, but fails to achieve another after trying for at least a year. Infertility is a common problem. The government of Canada reported that in 2019, 16% of Canadian couples experience infertility, a number which has doubled since the 1980s. If you look around at the couples you know, that means that almost 1 in 6 of them are having issues with fertility.<\/p>\n<div>\n<h1>Causes of Infertility<\/h1>\n<\/div>\n<p><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5280\">Pregnancy<\/a> is the result of a multi-step process. In order for a normal pregnancy to occur, a woman must release an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5099\">ovum<\/a> from one of her <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, the ovum must go through an <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5101\">oviduct<\/a>, a man\u2019s <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a> must fertilize the ovum as it passes through the oviduct, and then the resulting <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2471\">zygote<\/a> must implant in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>. If there is a problem with any of these steps, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4813\">infertility<\/a> can result.<\/p>\n<p>A couple\u2019s infertility may be due to a problem with either the male or the female partner. As shown in the circle graph below (Figure 18.10.2), about 40% of infertility cases are due to female infertility, and about 30% are due to male infertility. The remaining 30% of cases are due to a combination of male and female problems or unknown causes.<\/p>\n<figure id=\"attachment_5342\" aria-describedby=\"caption-attachment-5342\" style=\"width: 900px\" class=\"wp-caption aligncenter\"><img class=\"wp-image-5342 size-full\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Causes-of-infertility-in-Canada-1.png\" alt=\"18.10.2 Causes of Infertility\" width=\"900\" height=\"515\"><figcaption id=\"caption-attachment-5342\" class=\"wp-caption-text\"><em>Figure 18.10.2 This graph shows that infertility affects males as often as females, and that the cause of infertility often is unexplained.<\/em><\/figcaption><\/figure>\n<h2>Causes of Male Infertility<\/h2>\n<p>Male infertility occurs when there are no, or too few, <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a>, or when the sperm are not healthy and motile and cannot travel through the female reproductive tract to fertilize an egg. A common cause of inadequate numbers or motility of sperm is varicocele, which is enlargement of blood vessels in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5089\">scrotum<\/a>. This may raise the temperature of the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3486\">testes<\/a> and adversely affect sperm production. In other cases, there is no problem with the sperm, but there is a blockage in the male reproductive tract that prevents the sperm from being ejaculated.<\/p>\n<p>Factors that increase a man\u2019s risk of infertility include heavy alcohol use, drug abuse, cigarette smoking, exposure to environmental toxins (such as pesticides or lead), certain medications, serious diseases (such as kidney disease), and radiation or chemotherapy for cancer. Another risk factor is advancing age. Male fertility normally peaks in the mid-twenties and gradually declines after about age 40, although it may never actually drop to zero.<\/p>\n<h2>Causes of Female Infertility<\/h2>\n<p>Female infertility generally occurs due to one of two problems: failure to produce viable <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5099\">ova<\/a> by the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3487\">ovaries<\/a>, or structural problems in the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_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\">\u00a0or <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5102\">uterus<\/a>. The most common cause of female infertility is a problem with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5239\">ovulation<\/a>. Without ovulation, there are no ova to be fertilized. Anovulatory cycles (menstrual cycles in which ovulation does not occur) may be associated with no or irregular menstrual periods, but even regular menstrual periods may be anovulatory for a variety of reasons. The most common cause of anovulatory cycles is <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_3485\"><strong>polycystic ovary syndrome (PCOS)<\/strong><\/a>, which causes hormone imbalances that can interfere with normal ovulation. Another relatively common cause of anovulation is primary ovarian insufficiency. In this condition, the ovaries stop working normally and producing viable eggs at a relatively early age, generally before the age of 40.<\/span><\/p>\n<p>Structural problems with the oviducts or uterus are less common causes of female infertility. The oviducts may be blocked as a result of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5333\">endometriosis<\/a>. Another possible cause is pelvic inflammatory disease, which occurs when sexually transmitted infections spread to the oviducts or other female reproductive organs (see Figure 18.10.3). The infection may lead to scarring and blockage of the oviducts. If an ovum is produced and the oviducts are functioning \u2014 and a woman has a condition such as uterine fibroids \u2014 implantation in the uterus may not be possible. Uterine fibroids are non-cancerous clumps of tissue and muscle that form on the walls of the uterus.<\/p>\n<figure id=\"attachment_5344\" aria-describedby=\"caption-attachment-5344\" style=\"width: 1024px\" class=\"wp-caption aligncenter\"><img class=\"size-full wp-image-5344\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0719_PelvicInflammatoryDisease-1.png\" alt=\"18.10.3 Pelvic inflammatory disease\" width=\"1024\" height=\"768\"><figcaption id=\"caption-attachment-5344\" class=\"wp-caption-text\"><em>Figure 18.10.3 An infection of the Fallopian tubes may cause scarring and blockage of the tubes, so sperm cannot reach eggs for fertilization.<\/em><\/figcaption><\/figure>\n<p>Factors that increase a woman\u2019s risk of infertility include tobacco smoking, excessive use of alcohol, stress, poor diet, strenuous athletic training, and being overweight or underweight. Advanced age is even more problematic for females than males. Female fertility normally peaks in the mid-twenties, and continuously declines after age 30 and until menopause around the age of 52, after which the ovary no longer releases eggs. About 1\/3 of couples in which the woman is over age 35 have fertility problems. In older women, more cycles are likely to be anovulatory, and the eggs may not be as healthy.<\/p>\n<h1>Diagnosing Causes of Infertility<\/h1>\n<p>Diagnosing the cause(s) of a couple\u2019s infertility often requires testing both the man and the woman for potential problems. In men, the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_4885\">semen<\/a> is likely to be examined for the number, shape, and motility of sperm. If problems are found with sperm, further studies are likely to be done, such as medical imaging to look for structural problems with the testes or ducts.<\/p>\n<p>In women, the first step is most often determining whether <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5239\">ovulation<\/a> is occurring. This can be done at home by carefully monitoring body temperature (it rises slightly around the time of ovulation) or using a home ovulation test kit, which is available over the counter at most drugstores. Whether or not ovulation is occurring can also be detected with blood tests or ultrasound imaging of the ovaries. If ovulation is occurring normally, then the next step may be an X-ray of the oviducts and uterus to see if there are any blockages or other structural problems. Another approach to examining the female reproductive tract for potential problems is laparoscopy. In this surgical procedure, a tiny camera is inserted into the woman\u2019s abdomen through a small incision. This allows the doctor to directly inspect the reproductive organs.<\/p>\n<div>\n<h1>Treating Infertility<\/h1>\n<\/div>\n<p>Infertility often can be treated successfully. The type of treatment depends on the cause of infertility.<\/p>\n<h2>Treating Male Infertility<\/h2>\n<p>Medical problems that interfere with sperm production may be treated with medications or other interventions that may lead to the resumption of normal sperm production.\u00a0If, for example,\u00a0an infection is interfering with sperm production, then antibiotics that clear up the infection may resolve the problem. If there is a blockage in the male reproductive tract that prevents the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5150\">ejaculation<\/a> of sperm, surgery may be able to remove the blockage. Alternatively, the man\u2019s sperm may be removed from his body and then used for artificial insemination of his partner. In this procedure, the sperm are injected into the woman\u2019s reproductive tract.<\/p>\n<h2>Treating Female Infertility<\/h2>\n<p>In females, it may be possible to correct blocked Fallopian tubes or uterine fibroids with surgery. Ovulation problems, on the other hand, are usually treated with hormones that act either on the <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2938\">pituitary gland<\/a> or on the ovaries. Hormonal treatments that stimulate ovulation often result in more than one egg being ovulated at a time, thus increasing the chances of a woman having twins, triplets, or even higher multiple births. Multiple fetuses are at greater risk of being born too early or having health and developmental problems. The mother is also at greater risk of complications arising during pregnancy. Therefore, the possibility of multiple fetuses should be weighed in making a decision about this type of infertility treatment.<\/p>\n<h2>Assisted Reproductive Technology<\/h2>\n<p>Some cases of infertility are treated with\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5345\">assisted reproductive technology (ART)<\/a><\/strong>. This is a collection of medical procedures in which ova are removed from the woman\u2019s body and sperm are taken from the man\u2019s body to be manipulated in ways that increase the chances of fertilization occurring. The eggs and sperm may be injected into one of the woman\u2019s oviducts for fertilization to take place <em>in vivo<\/em>\u00a0(in the body). More commonly, however, the eggs and sperm are mixed together outside the body so fertilization takes place\u00a0<em>in vitro<\/em> (in a test tube or dish in a lab). The latter approach is illustrated in Figure 18.10.4. With <em>in vitro <\/em>fertilization, the fertilized eggs may be allowed to develop into embryos before being placed in the woman\u2019s uterus.<\/p>\n<figure id=\"attachment_5346\" aria-describedby=\"caption-attachment-5346\" style=\"width: 508px\" class=\"wp-caption aligncenter\"><img class=\" wp-image-5346\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/1024px-Blausen_0060_AssistedReproductiveTechnology-1.png\" alt=\"18.10.4 Assisted Reproductive Technology\" width=\"508\" height=\"381\"><figcaption id=\"caption-attachment-5346\" class=\"wp-caption-text\"><em>Figure 18.10.4 This figure shows one way ART procedures may be used to treat infertility. An egg is removed from the female reproductive tract, injected with sperm from her partner, and allowed to develop into an embryo in the lab. Then, the embryo is placed inside the woman\u2019s uterus for implantation and development during the remainder of gestation.<\/em><\/figcaption><\/figure>\n<p>ART has about a 40% chance of leading to a live birth in women under the age of 35, but only about a 20%t chance of success in women over the age of 35. Some studies have found a higher-than-average risk of birth defects in children produced by ART procedures, but this may be due to the generally higher ages of the parent \u2014 not the technologies used.<\/p>\n<h2>Other Approaches<\/h2>\n<p>Other approaches for certain causes of infertility include the use of a surrogate mother, a gestational carrier, or sperm donation.<\/p>\n<ul>\n<li>A\u00a0<strong>surrogate mother<\/strong>\u00a0is a woman who agrees to become pregnant using the man\u2019s sperm and her own egg. The child, who will be the biological offspring of the surrogate and the male partner, is given up at birth for adoption by the couple. Surrogacy might be selected by women with no eggs or unhealthy eggs.\u00a0A\u00a0woman who carries a mutant gene for a serious genetic disorder might choose this option to ensure that the defective gene is not passed on to the offspring.<\/li>\n<li>A\u00a0<strong>gestational carrier<\/strong>\u00a0is a woman who agrees to receive a transplanted embryo from a couple and carry it to term. The child, who will be the biological offspring of the couple, is given to the parents at birth. A gestational carrier might be used by women who have normal ovulation but no uterus, or who cannot safely carry a fetus to term because of a serious health problem (such as kidney disease or cancer).<\/li>\n<li><strong>Sperm donation<\/strong>\u00a0is the use of sperm from a fertile man (generally through artificial insemination) for cases in which the male partner in a couple is infertile, or in which a woman seeks to become pregnant without a male partner.\u00a0A\u00a0lesbian couple may use donated sperm to enable one of them to become pregnant and have a child.\u00a0Sperm can be obtained from a sperm bank, which buys and stores sperm for artificial insemination, or a male friend or other individual may donate sperm to a specific woman.<\/li>\n<\/ul>\n<div>\n<h1>Social and Ethical Issues Relating to Infertility<\/h1>\n<\/div>\n<p>For people who have a strong desire for children of their own, infertility may lead to deep disappointment and depression. Individuals who are infertile may even feel biologically inadequate. Partners in infertile couples may argue and feel resentment toward each other, and married couples may get divorced because of infertility. Infertility treatments \u2014 especially ART procedures \u2014 are generally time-consuming and expensive. The high cost of the treatments can put them out of financial reach of many couples.<\/p>\n<h2>Ethical Concerns<\/h2>\n<p>Some people question whether the allocation of medical resources to infertility treatments is justified, and whether the resources could be better used in other ways. The status of embryos that are created\u00a0<em>in vitro<\/em>\u00a0and then not used for a pregnancy is another source of debate. Some people oppose their destruction on religious grounds, and couples may sometimes argue about what should be done with their extra embryos. Ethical issues are also raised by procedures that increase the chances of multiple births, because of the medical and developmental risks associated with multiple births.<\/p>\n<h2>Infertility in Developing Countries<\/h2>\n<p>Infertility is an under-appreciated problem in the poorer nations of the world, because of assumptions about overpopulation problems and high birth rates in developing countries. In fact, infertility is at least as great a problem in developing as in developed countries. High rates of health problems and inadequate health care in the poorer nations increase the risk of infertility. At the same time, infertility treatments are usually not available \u2014 or are far too expensive \u2014 for the vast majority of people who may need them. In addition, in many developing countries, the production of children is highly valued. Children may be needed for family income generation and economic security of the elderly. It is not uncommon for infertility to lead to social stigmatization, psychological problems, and abandonment by spouses.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff\">18.10 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_5023_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 <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2506\">sperm<\/a>. This may be caused by problems with <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_2507\">spermatogenesis<\/a>, 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 (PCOS) is the most common cause of failure to produce viable ova. <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5333\">Endometriosis<\/a> 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<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_5023_5345\">assisted reproductive technology (ART)<\/a>. This is a collection of medical procedures in which ova 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<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>but not used for pregnancy. Infertility is an under-appreciated problem in developing countries, where birth rates are high and children have high economic \u2014 as well as social \u2014 value. In these countries, poor health care is likely to lead to more problems with infertility and fewer options for treatment.<\/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\">18.10 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>What is infertility? How is infertility defined scientifically and medically?<\/li>\n<li>What percentage of infertility in couples is due to male infertility? What percentage is due to female infertility?<\/li>\n<li>Identify causes of and risk factors for male infertility.<\/li>\n<li>Identify causes of and risk factors for female infertility.<\/li>\n<li>How are causes of infertility in couples diagnosed?<\/li>\n<li>How is infertility treated?<\/li>\n<li>Discuss some of the social and ethical issues associated with infertility or its treatment.<\/li>\n<li>Why is infertility an under-appreciated problem in developing countries?<\/li>\n<li>Describe two similarities between causes of male and female infertility.<\/li>\n<li>Explain the difference between males and females in terms of how age affects fertility.<\/li>\n<li>\n<div id=\"h5p-436\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-436\" class=\"h5p-iframe\" data-content-id=\"436\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"18.10 Quiz\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Do you think that taking medication to stimulate ovulation is likely to improve fertility in cases where infertility is due to endometriosis? 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\">18.10 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/P27waC05Hdk<\/p>\n<p>How <em>in vitro<\/em> fertilization (IVF) works - Nassim Assefi and Brian A. Levine, TED-Ed, 2015<\/p>\n<p>https:\/\/youtu.be\/6BBmMtVfZ4Y<\/p>\n<p style=\"text-align: center\">A journey through infertility -- over terror's edge | Camille Preston | TEDxBeaconStreet, TEDx Talks, 2014.<\/p>\n<p>https:\/\/youtu.be\/iqA8uAjvEdM<\/p>\n<p style=\"text-align: center\">Smoking Marijuana May Lower Sperm Count by 33%, David Pakman Show, 2015.<\/p>\n<p>https:\/\/youtu.be\/V6-v4eF9dyA<\/p>\n<p style=\"text-align: center\">ivf embryo developing over 5 days by fertility Dr Raewyn Teirney, Fertility Specialist Sydney, 2014.<\/p>\n<p>https:\/\/youtu.be\/4Khn_z9FPmU<\/p>\n<p style=\"text-align: center\">Homosexuality: It's about survival - not sex | James O'Keefe | TEDxTallaght, 2016.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<h2>Attributions<\/h2>\n<p><strong>Figure 18.10.1<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/www.flickr.com\/photos\/bobjagendorf\/9177582651\">Gay Pride Parade NYC 2013 - Happy Family<\/a> by <a class=\"owner-name truncate\" title=\"Go to Bob Jagendorf's photostream\" href=\"https:\/\/www.flickr.com\/photos\/bobjagendorf\/\" data-track=\"attributionNameClick\">Bob Jagendorf<\/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.<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/kf3dLxBql6U\">#beaches #summer #family #blue #water<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@theuntangled_\">Jove Duero<\/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).<\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/MOqAfi6GvVU\">Photograph of five men near outdoor<\/a> by <a href=\"https:\/\/unsplash.com\/@dollargill\">Dollar Gill<\/a> on <a style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/\">Unsplash<\/a><span style=\"font-size: 1em\"> is used under the <\/span><a class=\"ICezk _2GAZm _2WvKc\" style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a><span style=\"font-size: 1em\"> (https:\/\/unsplash.com\/license).\u00a0<\/span><\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/JYJxLjvIGWY\">Fam\u00edlia<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@laerciocavalcanti\">Laercio Cavalcanti<\/a> on <a style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/\">Unsplash<\/a><span style=\"font-size: 1em\"> is used under the <\/span><a class=\"ICezk _2GAZm _2WvKc\" style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a><span style=\"font-size: 1em\"> (https:\/\/unsplash.com\/license).\u00a0<\/span><\/li>\n<li><a href=\"https:\/\/unsplash.com\/photos\/GmDVGjqeVEk\">Happiness \ud83d\ude42<\/a> by <a class=\"_3XzpS _1ByhS _4kjHg _1O9Y0 _3l__V _1CBrG xLon9\" href=\"https:\/\/unsplash.com\/@suicide_chewbacca\">Ashwini Chaudhary<\/a> on <a style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/\">Unsplash<\/a><span style=\"font-size: 1em\"> is used under the <\/span><a class=\"ICezk _2GAZm _2WvKc\" style=\"font-size: 1em\" href=\"https:\/\/unsplash.com\/license\">Unsplash License<\/a><span style=\"font-size: 1em\"> (https:\/\/unsplash.com\/license).\u00a0<\/span><\/li>\n<\/ul>\n<p><strong>Figure 18.10.2<\/strong><\/p>\n<p>Causes of infertility in Canada by Christine Miller is in the <a href=\"https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/\" rel=\"license\">Public Domain<\/a> (https:\/\/creativecommons.org\/publicdomain\/mark\/1.0\/).<\/p>\n<p><strong>Figure 18.10.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0719_PelvicInflammatoryDisease.png\" rel=\"cc:attributionURL\">1024px-Blausen_0719_PelvicInflammatoryDisease<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a><span style=\"text-align: initial;font-size: 1em\"> on Wikimedia Commons is used under a <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/p>\n<p><strong>Figure 18.10.4<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Blausen_0060_AssistedReproductiveTechnology.png\" rel=\"cc:attributionURL\">1024px-Blausen_0060_AssistedReproductiveTechnology<\/a> by <a title=\"User:BruceBlaus\" href=\"https:\/\/commons.wikimedia.org\/wiki\/User:BruceBlaus\">BruceBlaus<\/a><span style=\"text-align: initial;font-size: 1em\"> on Wikimedia Commons is used under a <a style=\"text-align: initial;font-size: 1em\" href=\"https:\/\/creativecommons.org\/licenses\/by\/3.0\" rel=\"license\">CC BY 3.0<\/a> (https:\/\/creativecommons.org\/licenses\/by\/3.0) license.\u00a0<\/span><\/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\">David Pakman Show. (2015, September 1). Smoking marijuana may lower sperm count by 33%. YouTube. https:\/\/www.youtube.com\/watch?v=iqA8uAjvEdM<\/p>\n<p class=\"hanging-indent\">Fertility Specialist Sydney. (2014, April 11). ivf embryo developing over 5 days by fertility Dr Raewyn Teirney. YouTube. https:\/\/www.youtube.com\/watch?v=V6-v4eF9dyA&amp;t=5s<\/p>\n<p class=\"hanging-indent\">Public Health Agency of Canada. (2019, May 28). Fertility. Government of Canada. https:\/\/www.canada.ca\/en\/public-health\/services\/fertility\/fertility.html<\/p>\n<p class=\"hanging-indent\">TED-Ed. (2015, May 7). How <em>in vitro<\/em> fertilization (IVF) works - Nassim Assefi and Brian A. Levine.\u00a0 YouTube. https:\/\/www.youtube.com\/watch?v=P27waC05Hdk&amp;t=4s<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2014, June 26). A journey through infertility -- over terror's edge | Camille Preston | TEDxBeaconStreet. YouTube. https:\/\/www.youtube.com\/watch?v=6BBmMtVfZ4Y&amp;t=2s<\/p>\n<p class=\"hanging-indent\">TEDx Talks. (2016, November 15). Homosexuality: It's about survival - not sex | James O'Keefe | TEDxTallaght. YouTube. https:\/\/www.youtube.com\/watch?v=4Khn_z9FPmU&amp;t=1s<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_5023_4253\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4253\"><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_5023_4255\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4255\"><div tabindex=\"-1\"><div>\n<p>&nbsp;<\/p>\n<p><img class=\"wp-image-41 aligncenter\" title=\"CC0 1.0 Universal (CC0 1.0) from openclipart.org\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/Question-Guy-3.png\" alt=\"Clip art of a person thinking with a thought bubble filled with question marks.\" width=\"166\" height=\"184\" \/><\/p>\n<h1 style=\"margin-top: 2.14286em; margin-bottom: 1.42857em; line-height: 1.28571em;\"><span style=\"text-align: initial; font-size: 1em;\"><span style=\"font-size: 22.784px;\">Defining Science<\/span><\/span><\/h1>\n<\/div>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5809\">Science<\/a><\/strong>\u00a0is a distinctive way of gaining knowledge about the natural world that starts with a question and then tries to answer the question\u00a0using\u00a0evidence and logic.\u00a0It\u00a0is an exciting exploration of all the whys and hows that any curious person might\u00a0ask\u00a0about the world. You can be part of that exploration! Besides your curiosity, all you need is a basic understanding of how scientists think and how <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5809\">science<\/a> is done. In this concept, you'll learn how to think like a scientist.<\/p>\n<h2><span style=\"font-size: 1em; font-weight: bold;\">Thinking Like a Scientist<\/span><\/h2>\n<p>Thinking like a scientist rests on certain underlying assumptions. Scientists assume that:<\/p>\n<p>&nbsp;<\/p>\n<div><img class=\"aligncenter wp-image-1856\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Thinking-like-a-scientist-2.png\" alt=\"\" width=\"300\" height=\"300\" \/><\/div>\n<h2>Nature Is\u00a0Understandable<\/h2>\n<p>Scientists think of nature as a single system controlled by natural laws. By discovering natural laws, scientists strive to increase their understanding of the natural world. Laws of nature are expressed as scientific laws. A\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5653\">scientific law<\/a><\/strong>\u00a0is a statement that describes what always happens under certain conditions in nature.<\/p>\n<h2>Scientific Ideas Are Open to\u00a0Change<\/h2>\n<p>Science is\u00a0both\u00a0a process\u00a0and\u00a0body of knowledge.\u00a0Scientific knowledge is generated through systematic processes, such as\u00a0<a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5649\"><strong>observation<\/strong><\/a>\u00a0and experimentation.\u00a0Scientists are always testing and revising their ideas, and as new observations are made, existing ideas may be challenged. Ideas may be replaced with new ideas that better fit the facts, but more often, existing ideas are simply revised. Through many new discoveries over time, scientists gradually build an increasingly accurate and detailed understanding of the natural world.<\/p>\n<h2>Scientific Knowledge May Be Long Lasting<\/h2>\n<p>Many scientific ideas have\u00a0stood\u00a0the test of time. About 200 years ago, the scientist <a href=\"https:\/\/en.wikipedia.org\/wiki\/John_Dalton\">John Dalton<\/a> proposed atomic theory \u2014 the theory that all matter is made of tiny particles called atoms. This theory is still valid today. During the two centuries since the theory was first proposed,\u00a0scientists have\u00a0learned a lot more about atoms and the even smaller particles\u00a0that compose them. Nonetheless, the idea that all matter consists of atoms remains valid. There are many other examples of basic\u00a0scientific\u00a0ideas that have been tested repeatedly and proven sound. You will learn about many of them as you study human biology.<\/p>\n<h2>Not All Questions Can be Answered by Science<\/h2>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5809\">Science<\/a><\/strong> rests on evidence and logic, and evidence comes from observations. Therefore, science deals only with things that can be observed. An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5649\">observation<\/a><\/strong>\u00a0is anything that is detected through human\u00a0senses\u00a0or with instruments or\u00a0measuring devices that extend human\u00a0senses. Things that cannot be observed or measured by\u00a0current\u00a0means \u2014 such as supernatural beings or events \u2014 are outside the bounds of science. Consider these two questions about life on Earth:<\/p>\n<ul>\n<li>Did life on Earth evolve over time?<\/li>\n<li>How did life on Earth originate?<\/li>\n<\/ul>\n<p>The first question can be answered by science on the basis of scientific evidence (such as\u00a0fossils\u00a0and logical arguments). The second question could be a matter of belief, but no evidence can be gathered to support or refute it. Therefore, it is outside the realm of science.<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">1.3 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>Science is a distinctive way of gaining knowledge about the natural world that tries to answer questions\u00a0using\u00a0evidence and logic.<\/li>\n<li>Scientists assume that nature can be understood\u00a0through systematic study.<\/li>\n<li>Scientific ideas are open to revision.<\/li>\n<li>Sound scientific ideas withstand the test of time.<\/li>\n<li>Science cannot provide answers to all of our questions.<\/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;\">1.3 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Define science.<\/li>\n<li>What is the general goal of science?<\/li>\n<li>\n<div id=\"h5p-440\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-440\" class=\"h5p-iframe\" data-content-id=\"440\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Nature of Science\"><\/iframe><\/div>\n<\/div>\n<\/li>\n<li>Identify four basic assumptions that scientists make when they study the natural world.<\/li>\n<li>Do observations in science have to be made by the naked eye? Can you think of a way in which scientists might be able to make observations about something they cannot directly see?<\/li>\n<li>If something cannot be observed, can it be tested scientifically? Explain your reasoning.<\/li>\n<li>Scientific knowledge builds upon itself. Give an example of a scientific idea from the reading where the initial idea\u00a0developed further\u00a0as science advanced.<\/li>\n<li>Discuss this statement: \u201cScientific ideas are always changing, so they can't be trusted.\u201d Do you think this is true?<\/li>\n<li>Why do you think that scientific knowledge expands as technology becomes more advanced?<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\">1.3 Explore More<\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/youtu.be\/3nAETHZTObk<\/p>\n<p style=\"text-align: center;\">Nature of Science with the Ameoba Sisters, 2019.<\/p>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<div>\n<h2><strong>References<\/strong><\/h2>\n<p class=\"hanging-indent\">Amoeba Sisters. (2019, Jun 6). Nature of science with Ameoba Sisters. YouTube. https:\/\/www.youtube.com\/watch?v=3nAETHZTObk<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, July 25). John Dalton. In\u00a0<i>Wikipedia. <\/i>\u00a0https:\/\/en.wikipedia.org\/w\/index.php?title=John_Dalton&amp;oldid=969425891<\/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_5023_4257\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4257\"><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_5023_4258\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4258\"><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_5023_4254\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4254\"><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_5023_4260\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4260\"><div tabindex=\"-1\"><div>\n<p>&nbsp;<\/p>\n<h1 style=\"margin-top: 2.14286em; margin-bottom: 1.42857em; line-height: 1.28571em;\">\"Doing\" Science<\/h1>\n<\/div>\n<p>Science is as much about doing\u00a0as\u00a0knowing. Scientists are always trying to learn more and gain a better understanding of the natural world. There are basic methods of gaining knowledge that are common to all of science. At the\u00a0heart\u00a0of science is the scientific investigation. A\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5647\">scientific investigation<\/a><\/strong>\u00a0is a systematic approach to answering questions about the physical and natural world.\u00a0Scientific investigations can be observational\u00a0\u2014\u00a0 for example, observing a cell under a\u00a0microscope\u00a0and recording detailed descriptions. Other scientific investigations\u00a0are\u00a0experimental \u2014 for example, treating a cell with a drug while recording changes in the behavior of the cell.<\/p>\n<p>The flow chart below\u00a0shows the typical steps followed in an experimental\u00a0scientific investigation.\u00a0The series of steps shown in the flow chart is frequently referred to as the\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5645\">scientific method<\/a>.<\/strong>\u00a0Science textbooks often present this simple, linear \"recipe\" for a scientific investigation. This is an oversimplification of how science is actually done, but it\u00a0does highlight the basic plan and purpose of\u00a0an experimental\u00a0scientific investigation: testing ideas with evidence. Each of the steps in the flow chart is discussed in greater detail below.<\/p>\n<figure id=\"attachment_45\" aria-describedby=\"caption-attachment-45\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img class=\"wp-image-45 size-medium\" title=\"By Thebiologyprimer [CC0], from Wikimedia Commons\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2019\/06\/The_Scientific_Method_simple-3.png\" alt=\"Diagram shows the scientific cycle arranged in a circular formation: Observation, questions, hypothesis, experiment, analysis, conclusion and then returning to observation again.\" width=\"300\" height=\"280\" \/><figcaption id=\"caption-attachment-45\" class=\"wp-caption-text\"><em>Figure 1.4.1 The Scientific Method is a never ending cycle.<\/em><\/figcaption><\/figure>\n<p><strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5809\">Science<\/a><\/strong> is actually a complex endeavor that cannot be reduced to a single, linear sequence of steps, like the instructions on a package of cake mix. Real science is nonlinear, iterative (repetitive), creative, unpredictable, and exciting. Scientists often undertake the steps of an investigation in a different sequence, or they repeat the same steps many times as they gain more information and develop new ideas. Scientific investigations often raise new questions as old ones are answered. Successive investigations may address the same questions, but at ever deeper levels. Alternatively, an investigation might lead to an unexpected\u00a0observation that sparks a new question and takes the\u00a0research\u00a0in a completely different direction.<\/p>\n<p>Knowing how scientists \"do\" science can help you in your everyday life, even if you aren't a scientist. Some steps of the scientific process\u00a0\u2014\u00a0such as asking questions and evaluating evidence\u00a0\u2014\u00a0can be applied to answering real-life questions and solving practical problems.<\/p>\n<div>\n<h1>Making Observations<\/h1>\n<\/div>\n<figure id=\"attachment_46\" aria-describedby=\"caption-attachment-46\" style=\"width: 300px\" class=\"wp-caption alignright\"><img class=\"wp-image-46 size-medium\" title=\"Photo by rawpixel on Unsplash\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Xray-2-scaled.jpg\" alt=\"A health professional viewing an xray.\" width=\"300\" height=\"141\" \/><figcaption id=\"caption-attachment-46\" class=\"wp-caption-text\"><em>Figure 1.4.2 Health professionals use many tools in order to make observations.<\/em><\/figcaption><\/figure>\n<p>Testing an idea typically begins with observations. An\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5649\">observation<\/a><\/strong> is anything that is detected through human senses or with instruments or measuring devices that enhance human senses. We usually think of observations as things we see with our eyes, but we can also make observations with our sense of touch, smell, taste, or hearing. In addition, we can extend and improve our own senses with instruments such as thermometers and microscopes. Other instruments can be used to sense things that human senses cannot detect at all, such as ultraviolet light or radio waves.<\/p>\n<figure id=\"attachment_47\" aria-describedby=\"caption-attachment-47\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img class=\"wp-image-47 size-medium\" title=\"Photo by Ministry of Information Photo Division Photographer [Public domain], via Wikimedia Commons\" src=\"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-content\/uploads\/sites\/152\/2023\/10\/Alexander-Flemming-2.jpg\" alt=\"A black and white photo of Alexander Fleming examining bacterial growth on a petri dish.\" width=\"300\" height=\"251\" \/><figcaption id=\"caption-attachment-47\" class=\"wp-caption-text\"><em>Figure 1.4.3 Alexander Fleming examining bacterial growth.<\/em><\/figcaption><\/figure>\n<p>Sometimes, chance observations lead to important scientific discoveries. One such\u00a0observation\u00a0was made by the Scottish biologist<a href=\"https:\/\/en.wikipedia.org\/wiki\/Alexander_Fleming\" target=\"_blank\" rel=\"noopener noreferrer\"> Alexander Fleming<\/a> (pictured\u00a0below) in the 1920s. Fleming's name may sound familiar to you because he is famous for\u00a0a\u00a0major\u00a0discovery. Fleming had been growing a certain type of\u00a0bacteria\u00a0on glass plates in his lab when he noticed that one of the plates\u00a0was\u00a0contaminated with\u00a0mold. On closer examination, Fleming observed that the area around the mold was free of\u00a0bacteria.<\/p>\n<h1>Asking Questions<\/h1>\n<p>Observations often lead to interesting questions. This is especially true if the observer is thinking like a scientist. Having scientific training and knowledge is also useful. Relevant background knowledge and logical thinking help make sense of observations so the observer can form particularly salient questions. Fleming, for example, wondered whether the\u00a0mold\u00a0\u2014\u00a0or some substance it produced\u00a0\u2014\u00a0had killed\u00a0bacteria\u00a0on the plate. Fortunately for us, Fleming didn't just throw out the mold-contaminated plate. Instead, he investigated his question and in so doing, discovered the antibiotic penicillin.<\/p>\n<div>\n<h1>Hypothesis\u00a0Formation<\/h1>\n<\/div>\n<p>Typically, the next step in a scientific investigation is to form a\u00a0hypothesis. A\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5579\">hypothesis<\/a><\/strong>\u00a0is a possible answer to a scientific question. But it isn\u2019t just\u00a0<em>any<\/em>\u00a0answer. A hypothesis must be based on scientific knowledge. In other words, it shouldn't be at odds with what is already known about the natural world. A hypothesis also must be logical, and it is beneficial if the hypothesis is relatively simple. In addition, to be useful in science, a hypothesis must be testable and <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5376\"><strong>falsifiable<\/strong><\/a>. In other words, it must be possible to subject the hypothesis to a test that generates evidence for or against it. It must also be possible to make observations that would disprove the hypothesis if it really is false.<\/p>\n<p>For example,\u00a0Fleming's hypothesis might have been:\u00a0\u201cA particular kind of bacteria growing on a plate will die when exposed to a particular kind of\u00a0mold.\u201d\u00a0The hypothesis is logical and based directly on observations. The hypothesis is also simple,\u00a0involving just one type each of mold and bacteria growing on a plate. In addition, hypotheses are subject to \"if\/then\" conditions.\u00a0Thus, Fleming might have stated, \"If a certain type of mold is introduced to a particular kind of bacteria growing on a plate, then the bacteria will die.\" This makes\u00a0the hypothesis\u00a0easy to test and ensures that it is falsifiable. If the bacteria were to grow in the presence of the mold, it would disprove the hypothesis (assuming the hypothesis is really false).<\/p>\n<div>\n<h1>Hypothesis Testing<\/h1>\n<\/div>\n<p>Hypothesis testing is at the\u00a0heart\u00a0of\u00a0the scientific method. How would Fleming test his hypothesis? He would gather relevant data as evidence.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5581\">Evidence<\/a><\/strong>\u00a0is any type of data that may be used to test a hypothesis.\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5583\">Data<\/a><\/strong>\u00a0(singular, datum)\u00a0are essentially just observations. The observations may be measurements in an\u00a0experiment\u00a0or just something the researcher notices. Testing a hypothesis then involves using the data to answer two basic questions:<\/p>\n<ol>\n<li>If my hypothesis is true, what would I expect to observe?<\/li>\n<li>Does what I actually observe match what I expected to observe?<\/li>\n<\/ol>\n<p>A hypothesis is supported if the actual observations (data) match the expected observations. A hypothesis is refuted if the actual observations differ from the expected observations.<\/p>\n<p>The scientific method is employed by scientists around the world, but it is not always conducted in the order above. Sometimes,\u00a0hypothesis\u00a0are formulated before observations are collected; sometimes observations are made before hypothesis are created. Regardless, it is important that scientists record their procedures carefully, allowing others to reproduce and verify the experimental data and results. After many experiments provide results supporting a hypothesis, the hypothesis becomes a\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5585\">theory<\/a><\/strong>.\u00a0Theories\u00a0remain theories forever, and are constantly being retested with every\u00a0experiment\u00a0and\u00a0observation. Theories can never become fact or\u00a0<strong><a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_5023_5587\">law<\/a><\/strong>.<\/p>\n<p>In science, a law is a mathematical relationship that exists between observations under a given set of conditions. There is a fundamental difference between observations of the physical world and explanations of the nature of the physical world. Hypotheses and\u00a0theories\u00a0are explanations, whereas laws and measurements are observational<\/p>\n<div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">1.4 Summary<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<ul>\n<li>The scientific method consists of making observations, formulating a hypothesis, testing the hypothesis with new observations, making a new hypothesis if the new observations contradict the old hypothesis, or continuing to test the hypothesis if the observations agree.<\/li>\n<li>A hypothesis is a tentative explanation that can be tested by further\u00a0observation.<\/li>\n<li>A theory is a hypothesis that has been supported with repeated testing.<\/li>\n<li>A\u00a0scientific law\u00a0is a statement that summarizes the results of many observations.<\/li>\n<li>Experimental data must be verified by\u00a0reproduction\u00a0from other scientists.<\/li>\n<li>Theories must agree with all observations made on the phenomenon under study.<\/li>\n<li>Theories are continually tested, forever.<\/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;\">1.4 Review Questions<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<div id=\"h5p-441\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-441\" class=\"h5p-iframe\" data-content-id=\"441\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Steps in the Scientific Method - Order the pictures\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div>\u00a0 \u00a0 \u00a0 \u00a0<\/p>\n<div id=\"h5p-442\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-442\" class=\"h5p-iframe\" data-content-id=\"442\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Science Terms Flashcards\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div><\/div>\n<\/div>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h1 class=\"textbox__title\"><span style=\"color: #ffffff;\">1.4 Explore More<\/span><\/h1>\n<\/header>\n<div class=\"textbox__content\">\n<p>https:\/\/www.youtube.com\/watch?v=F8UFGu2M2gM<\/p>\n<p style=\"text-align: center;\">How simple ideas lead to scientific discoveries, TED-Ed,\u00a0 2012.<\/p>\n<\/div>\n<\/div>\n<h2 id=\"x-ck12-YzhkZDM1NjIyZWY2OTkxNDVlODQ3NzVmZGJkNzkyYmY.-wlj\"><strong>Attributions<\/strong><\/h2>\n<p><strong>Figure 1.4.1<\/strong><\/p>\n<p class=\"firstHeading\" lang=\"en\"><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:The_Scientific_Method_(simple).png\">The Scientific Method (simple)<\/a>, by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Thebiologyprimer\">Thebiologyprimer<\/a> on Wikimedia Commons\u00a0is used under a <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\">CC0 1.0<\/a> Universal Public Domain Dedication license (https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en).<\/p>\n<p><strong>Figure 1.4.2<\/strong><\/p>\n<p lang=\"en\"><a href=\"https:\/\/pixabay.com\/photos\/anatomy-bone-bones-check-doctor-3003099\/\">Anatomy Bone Bones Check Doctor Examine Film<\/a>, by <a href=\"https:\/\/pixabay.com\/users\/rawpixel-4283981\/\">rawpixel<\/a> on <a href=\"https:\/\/pixabay.com\/\">Pixabay<\/a>, used under the <a href=\"https:\/\/pixabay.com\/service\/license\/\">Pixabay License<\/a> (https:\/\/pixabay.com\/de\/service\/license\/).<\/p>\n<p><strong>Figure 1.4.3<\/strong><\/p>\n<p><a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Penicillin_Past,_Present_and_Future-_the_Development_and_Production_of_Penicillin,_England,_1944_D17802.jpg\">Penicillin Past, Present and Future- the Development and Production of Penicillin, England, 1944<\/a>, by Ministry of Information Photo Division Photographer. This photograph was scanned and released by the Imperial War Museum on the <a class=\"external text\" href=\"http:\/\/www.iwm.org.uk\/corporate\/privacy-copyright\/licence\" rel=\"nofollow\">IWM Non Commercial Licence.<\/a> It is now in the <a href=\"https:\/\/commons.wikimedia.org\/wiki\/Commons:Licensing#Material_in_the_public_domain\">public domain<\/a> (https:\/\/en.wikipedia.org\/wiki\/Public_domain).<\/p>\n<\/div>\n<h2><strong>References<\/strong><\/h2>\n<p class=\"hanging-indent\">TED-Ed. (2012, Mar 13). How simple ideas lead to scientific discoveries. YouTube. https:\/\/www.youtube.com\/watch?v=F8UFGu2M2gM<\/p>\n<p class=\"hanging-indent\">Wikipedia contributors. (2020, July 7). Alexander Fleming. In\u00a0<i>Wikipedia. <\/i>https:\/\/en.wikipedia.org\/w\/index.php?title=Alexander_Fleming&amp;oldid=966489433<\/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_5023_4262\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4262\"><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_5023_4264\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_5023_4264\"><div tabindex=\"-1\"><\/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":7,"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-5023","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by-nc"],"part":4973,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/5023","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\/5023\/revisions"}],"predecessor-version":[{"id":6473,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/5023\/revisions\/6473"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/parts\/4973"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapters\/5023\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/media?parent=5023"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/pressbooks\/v2\/chapter-type?post=5023"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/contributor?post=5023"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/acchumanbio\/wp-json\/wp\/v2\/license?post=5023"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}